Nontuberculous mycobacteria lung disease (NTM-LD) is associated with significant loss of lung function, increased morbidity and mortality and reduced quality of life. Patients with NTM-LD commonly have comorbid conditions that can complicate diagnosis and treatment. Greater awareness and understanding of NTM-LD and a multidisciplinary approach to its management may help improve outcomes for patients.

NTM lung disease is associated with increased morbidity and mortality

Professor James Chalmers

University of Dundee, Dundee, Scotland, UK

Dr Arietta Spinou

King's College London, UK

James Chalmers, Professor and Consultant Respiratory Physician, Dundee, UK and Arietta Spinou, Lecturer in Cardiorespiratory Physiotherapy Practice and Research, London consider the significant burden of NTM lung disease on patients and how the signs and symptoms of NTM often overlap with underlying lung conditions and require a high index of suspicion for NTM.

The impact of undiagnosed or untreated NTM lung disease

Professor James Chalmers

University of Dundee, Dundee, Scotland, UK

Professor Stefano Aliberti

University of Milan, Milan, Italy

James Chalmers, Professor and Consultant Respiratory Physician, Dundee, UK and Stefano Aliberti, Associate Professor in Respiratory Medicine, Milan, Italy, discuss the increasing prevalence, incidence and mortality of NTM lung disease; however NTM continues to be under-diagnosed or misdiagnosed. Improved awareness of NTM will have important implications for patient care.

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NTM lung disease contributes to progressive lung function decline

Professor Stefano Aliberti

University of Milan, Milan, Italy

Dr Arietta Spinou

King's College London, UK

Stefano Aliberti, Associate Professor in Respiratory Medicine, Milan, Italy, and Arietta Spinou, Lecturer in Cardiorespiratory Physiotherapy Practice and Research, London consider how NTM lung disease follows a chronic course that contributes to a progressive decline in lung function. Optimal management of NTM infections requires multidisciplinary team involvement and close collaboration between specialties.

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Beyond pharmaceutical intervention: physiotherapy and lifestyle in NTM lung disease

Professor Stefano Aliberti

University of Milan, Milan, Italy

Dr Arietta Spinou

King's College London, UK

Stefano Aliberti, Associate Professor in Respiratory Medicine, Milan, Italy, and Arietta Spinou, Lecturer in Cardiorespiratory Physiotherapy Practice and Research, London discuss non-pharmaceutical interventions for the management of patients with NTM lung disease and why they should be included in standard clinical care.

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Clinical assessment of patients with NTM and its impact on patient care

The following videos were filmed during the ERS 2018 congress and provide clinical perspectives on the current challenges for diagnosis and treatment of nontuberculous mycobacteria (NTM) infections and how to optimise patient management moving forward.

Stefano Aliberti (University of Milan [UNIMI], Milan, Italy) shares his expert clinical perspectives on the main challenges encountered in NTM) diagnosis, the role of the multidisciplinary team, and identifying patient groups for whom management plans are more challenging to establish.

Claire Andréjak (University Hospital Amiens, Amiens, France) shares her expert clinical perspectives on establishing an effective management plan following NTM diagnosis, the main limitations of current treatment options, and emerging treatment options for patients with NTM infection.

Eva Polverino (Hospital Vall d’Hebron, Barcelona, Spain) shares her expert clinical perspectives on the main factors to consider when NTM is suspected in patients with bronchiectasis, the role of the multidisciplinary team, and current and emerging treatment options for patients with NTM and bronchiectasis.

Jakobus van Ingen (Radboud University Medical Center, Nijmegen, The Netherlands) shares his expert clinical perspectives on the importance of establishing the underlying microbiology in NTM lung disease, which microbiological tools should be used for diagnosis, and how to optimise patient outcomes in patients with NTM lung disease.

James Chalmers (University of Dundee, Dundee, Scotland, UK) shares his expert clinical perspectives on the main factors to consider when NTM is suspected in patients with bronchiectasis, the role of the multidisciplinary team, and current and emerging treatment options for patients with NTM and bronchiectasis.

Tobias Welte (Hannover Medical School, Hannover, Germany) shares his expert clinical perspectives on the unmet needs currently encountered by patients with NTM lung disease, the main limitations for current NTM lung disease therapies and how to establish an effective management plan following a diagnosis of NTM.

Expert Faculty

PROFESSOR JAMES CHALMERS

DR ARIETTA SPINOU

PROFESSOR STEFANO ALIBERTI

PROFESSOR JAMES CHALMERS

James Chalmers is a Professor and Consultant Respiratory Physician at the School of Medicine, University of Dundee. His laboratory focuses on the interaction between neutrophils and bacteria during acute and chronic airway infections.  Professor Chalmers has a particular interest in optimizing antibiotic use by encouraging accurate identification of bacterial infections and understanding of the selective drivers of antimicrobial resistance in chronic airways diseases.

Professor Chalmers has authored over 130 peer-reviewed articles and 30 reviews, and he has a clinical interest in improving diagnosis, treatment and outcomes in chronic lung diseases, including NTM-LD.

Disclosures: James Chalmers has received research grants from GlaxoSmithKline, Boehringer Ingelheim, AstraZeneca, Pfizer, Grifols, Bayer AG, Polyphor and Insmed; and received consultancy, congress travel or speaker fees from GlaxoSmithKline, Bayer Healthcare, Aradigm Corporation, Grifols, Pfizer, Boehringer Ingelheim, Napp and Insmed.

DR ARIETTA SPINOU

Arietta Spinou is a lecturer in cardiorespiratory physiotherapy, with clinical experience from Greece, Finland and the UK.  She has worked as a senior and specialist respiratory physiotherapist in the NHS primary and secondary care.  Dr Spinou’s interests focus on cardiorespiratory physiotherapy in chronic lung conditions, including airway clearance and cough assisted techniques and physiology, pulmonary rehabilitation, and outcome measures.

Disclosures: Arietta Spinou has nothing to disclose in relation to this video interview

PROFESSOR STEFANO ALIBERTI

Stefano Aliberti is a Professor in the Department of Pathophysiology and Transplantation at the University of Milan, Milan, Italy.  Professor Aliberti is the co-chair of the European Bronchiectasis Network (EMBARC), Chair of the Italian Registry of Adult Bronchiectasis (IRIDE) and Chair of the Italian Registry on Non-Tuberculous Mycobacteria (IRENE).  He has been involved in over 300 publications.

Disclosures: Stefano Aliberti has received grants and personal fees from Chiesi, GSK, Insmed, Zambon, Fisher & Paykel and AstraZeneca.

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