This content is for healthcare professionals only.

This activity is funded by an independent medical education grant from Insmed.
This medical education is jointly provided by USF Health and touchIME.

Faculty & Disclosures

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    Faculty & Disclosures
    Prof. Doreen Addrizzo-Harris

    NYU Grossman School of Medicine, New York, NY, USA

    Prof. Doreen Addrizzo-Harris is a professor of medicine at the NYU Grossman School of Medicine in New York. She serves as the associate director for Education and Faculty Affairs, is the director of the NYU Bronchiectasis and NTM Program, and is co-director of the NYU Pulmonary Faculty Practice. read more

    Prof. Addrizzo-Harris has served on the board of the Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD), and served as president from 2006–2007. She has authored 43 peer-reviewed publications and 65 scientific abstracts. She has participated in numerous clinical trials, many as principal investigator. The American College of Chest Physicians (CHEST) have recognized Prof. Addrizzo Harris as a Distinguished CHEST Educator each year since 2017; she received the Distinguished Service Award in 2019, and the 2021 Master Clinician Educator Award. She was also awarded the 2020 first place Program Director of the American Thoracic Society (ATS) Best Practice Program.

    Prof. Doreen Addrizzo-Harris discloses: Grants/research support from AN2 Therapeutics, Boehringer Ingelheim, HillRom and Insmed.
    Dr Ashwin Basavaraj

    NYU Grossman School of Medicine, New York, NY, USA

    Dr Ashwin Basavaraj is an assistant professor of medicine at NYU Grossman School of Medicine and an assistant director of the NYU Bronchiectasis and NTM Program. He is also section chief of Pulmonary, Critical Care and Sleep Medicine at Bellevue Hospital, New York. read more

    Dr Basavaraj is co-director of the NYU annual Bronchiectasis and NTM Symposium, and the patient-focussed Bronchiectasis and NTM Education Hybrid Program. He is involved in several active clinical trials focusing on NTM. Dr Basavaraj continues providing clinical care, seeing pulmonary patients both at NYU Grossman School of Medicine and at the Bellevue Hospital Center.

    Dr Ashwin Basavaraj discloses: Advisory board/panel fees and consultancy fees from HillRom, Insmed, PhysioAssist and Zambon. Grants/research support from Hillrom.
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    Management of patients with NTM-LD: Improving adherence for optimal outcomes

    Faculty Podcast Featured
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    • Downloads including slides are available for this activity in the Toolkit
    Learning Objectives

    After watching this activity, participants should be better able to:

    • Appraise strategies to reduce time to diagnosis for patients with NTM-LD
    • Utilize guideline recommendations when setting individualized treatment goals for patients with NTM-LD
    • Apply strategies to manage adverse events for improved outcomes and adherence in patients with NTM-LD
    Overview

    In this activity, expert pulmonologists respond to questions from the respiratory and infectious diseases community on reducing diagnostic delays for NTM-LD, setting individualized treatment goals and guideline-recommended treatment, and improving outcomes with effective monitoring and management of treatment-emergent side effects.

    This activity is jointly provided by USF Health and touchIME. read more

    Target Audience

    This activity has been designed to meet the educational needs of pulmonologists, radiologists, infectious disease specialists, including specialist infectious disease nurses, and hospital pharmacists involved in the management of patients with NTM-LD.

    Disclosures

    USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

    Faculty

    Prof. Doreen Addrizzo-Harris discloses: Grants/research support from AN2 Therapeutics, Boehringer Ingelheim, HillRom and Insmed.

    Dr Ashwin Basavaraj discloses: Advisory board/panel fees and consultancy fees from HillRom, Insmed, PhysioAssist and Zambon. Grants/research support from Hillrom.

    Content reviewer

    Angela M. Hill, Pharm.D., CRPh has no relevant financial relationships to disclose.

    Touch Medical Director

    Katrina Lester and Sola Neunie have no financial interests/relationships or affiliations in relation to this activity.

    USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

    Requirements for Successful Completion

    In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

    If you have questions regarding credit please contact cpdsupport@usf.edu 

    Accreditations

    Physicians

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

    USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu)

    Advanced Practice Providers

    Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

    The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

    Nurses

    USF Health is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

    A maximum of 0.75 contact hours may be earned by learners who successfully complete this continuing professional development activity. USF Health, the accredited provider, acknowledges touchIME as the joint provider in the planning and execution of this CNE activity.

    This activity is awarded 0.75 ANCC pharmacotherapeutic contact hour.

    Pharmacists

    USF Health is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This knowledge-based program has been approved for 0.75 contact hours (0.75 CEUs).  Universal program number is as follows: 0230-0000-22-041-H01-P.

    Date of original release: 30 November 2022. Date credits expire: 30 November 2024.

    If you have any questions regarding credit please contact cpdsupport@usf.edu

    This activity is CE/CME accredited

    To obtain contact hours from this activity, please complete this post-activity test.

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    Topics covered in this activity

    Bacterial Infections
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    This Activity Is Funded By:

    An independent medical education grant from Insmed.
    This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 30 November 2022. Date credits expire: 30 November 2024.

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    touchIN CONVERSATION
    Management of patients with NTM-LD: Improving adherence for optimal outcomes
    0.75 CE/CME credit
    Question 1/4
    Your 60-year-old male patient fits the radiographic and clinical criteria for a diagnosis of NTM-LD. To confirm a diagnosis, you would like to obtain a sputum sample for laboratory assessment. Unfortunately, he is unable to produce sputum spontaneously. To avoid any diagnostic delays, which of the following actions would you take?

    NTM-LD, nontuberculous mycobacterial lung disease.

    The 2020 ATS/ERS/ESCMID/IDSA clinical practice guidelines recommend that sputum should be induced with hypertonic saline if spontaneous sputum specimens cannot be collected. Bronchoscopy should only be considered in exceptional circumstances and performed only in patients from whom sputum specimens cannot be obtained spontaneously or through induction.

    Abbreviations

    ATS, American Thoracic Society; ERS, European Respiratory Society; ESCMID, European Society of Clinical Microbiology and Infectious Diseases; IDSA, Infectious Disease Society of America.

    Reference

    Daley CL, et al. Eur Respir J. 2020;56:2000535.

    Question 2/4
    Your 70-year-old male patient is being treated for mild-to-moderate nodular-bronchiectatic MAC NTM-LD. He has been taking a three-drug macrolide-based regimen TIW for the last 6 months. Having obtained regular sputum cultures since treatment initiation, his most recent laboratory results show that the cultures remain positive. What do you do next?

    ALIS, amikacin liposome inhalation suspension; MAC, Mycobacterium avium complex; NTM-LD, nontuberculous mycobacterial lung disease; TIW, three times a week.

    The 2020 ATS/ERS/ESCMID/IDSA clinical practice guidelines recommend a three-drug macrolide-based regimen (GBT) for patients with macrolide-susceptible MAC NTM-LD, TIW in patients with nodular-bronchiectatic disease. Patients with severe/advanced disease should consider daily dosing.

    ALIS is the only therapeutic agent approved by the FDA for treatment of refractory MAC NTM-LD, which is recommended as an add-on to the GBT regimen if sputum cultures remain positive after 6 months of GBT alone. Where ALIS is not yet available, guidelines recommend the addition of inhaled parenteral amikacin.

    Abbreviations

    ALIS, amikacin liposome inhalation suspension; ATS, American Thoracic Society; ERS, European Respiratory Society; ESCMID, European Society of Clinical Microbiology and Infectious Diseases; FDA, US Food and Drug Administration; GBT, guideline-based treatment; IDSA, Infectious Disease Society of America; MAC, Mycobacterium avium complex; NTM-LD, nontuberculous mycobacterial lung disease; TIW, three times a week.

    Reference

    Daley CL, et al. Eur Respir J. 2020;56:2000535.

    Question 3/4
    In your patients with cavitary macrolide-susceptible MAC NTM-LD taking a daily, three-drug, macrolide-based regimen and IV amikacin TIW, how would you determine whether the treatment regimen is working?

    IV, intravenous; MAC, Mycobacterium avium complex; NTM-LD, nontuberculous mycobacterial lung disease; TIW, three times a week.

    The 2020 ATS/ERS/ESCMID/IDSA clinical practice guidelines recommend obtaining sputum specimens every 1–2 months to monitor for culture conversion and thereby determine the duration of therapy. The recommendation is to continue treatment for at least 12 months after culture conversion.

    Abbreviations:

    ATS, American Thoracic Society; ERS, European Respiratory Society; ESCMID, European Society of Clinical Microbiology and Infectious Diseases; IDSA, Infectious Disease Society of America.

    Reference

    Daley CL, et al. Eur Respir J. 2020;56:2000535.

    Question 4/4
    How frequently should patients be monitored for side effects of anti-NTM drugs?

    NTM, nontuberculous mycobacteria.

    The 2020 ATS/ERS/ESCMID/IDSA clinical practice guidelines recommend that monitoring for side effects of anti-NTM drugs should be individualized based on age, comorbidities, concurrent drugs, overlapping drug toxicities and resources. The guidelines state that no studies, to date, have identified the optimum frequency or most cost-effective approach to monitoring for drug-related adverse reactions.

    Abbreviations

    ATS, American Thoracic Society; ERS, European Respiratory Society; ESCMID, European Society of Clinical Microbiology and Infectious Diseases; IDSA, Infectious Disease Society of America; NTM, nontuberculous mycobacteria.

    Reference

    Daley CL, et al. Eur Respir J. 2020;56:2000535.

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    This Activity Is Funded By:

    An independent medical education grant from Insmed.
    This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 30 November 2022. Date credits expire: 30 November 2024.

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