1450. Trends in hospitalizations and outpatient visits with early or delayed antibiotic treatment initiation in nontuberculous mycobacterial lung disease

Abstract Background The 2020 treatment guidelines for patients diagnosed with nontuberculous mycobacterial lung disease (NTMLD) recommend antibiotic initiation rather than “watchful waiting” most patients. Little is known regarding how delayed (DT) may impact healthcare resource utilization (HRU). goal of this study was to assess HRU early (ET) or DT in NTMLD. Methods We conducted a retrospective observational cohort using MarketScan claims from July 2014 June 2020. Inclusion criteria were: ≥ 2 NTMLD medical (with date first claim as index date); continuous enrollment spanning 12 months pre–index (baseline) 24 post–index date; concomitant antibiotics used NTMLD, ie, drug classes within 28 days each other; and no tuberculosis diagnosis. Mean time (TT) define ET (TT ≤ 3 months) > groups. Trends hospitalizations (any, respiratory-related) any outpatient visits at baseline, year 1 (Y1), (Y2) were described. Results A total 518 included: 395 (76%) 123 (24%) tended be younger male; had higher prevalence emphysema, asthma, bronchiectasis. decrease baseline the proportion hospitalized mean number Y1 Y2 (Figure 1A 1B). an increase Y1, followed by Y2, although remained baseline. Similar trends respiratory-related observed per patient group 1C 1D). emergency room whereas showed little improvement 2A 2B). Figure 1.Proportion (A) hospitalization (C) respiratory disease–related (B) (D) NTMLDFigure 2.(A) Proportion ER Number Conclusion During years after diagnosis, improvements who received ET, Disclosures Kevin L. Winthrop, MD, MPH, AN2: Advisor/Consultant|AN2: Grant/Research Support|Insmed: Advisor/Consultant|Insmed: Support|Paratek: Advisor/Consultant|Paratek: Support|Red Hill Biopharma: Advisor/Consultant|Red Support|Spero Therapeutics: Advisor/Consultant Catherine Waweru, PhD, Insmed Incorporated: Employee|Insmed Stocks/Bonds Mariam Hassan, B. Pharm, Sara Burns, MS, Panalgo: Employee Anjan Chatterjee, Stocks/Bonds.