{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T18:05:21Z","timestamp":1791137121810,"version":"4.1.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012352","name":"Universit\u00e0 degli Studi di Milano","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012352","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Mycobacterium avium complex<\/jats:italic>\n                      (MAC) is the major cause of nontuberculous mycobacterial pulmonary disease (NTM-PD) and clofazimine is increasingly used as an adjunctive therapy. We evaluated outcomes and tolerability of clofazimine-containing regimens in MAC-PD across two European centers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective observational study of MAC-PD treated from 2020 to 2024 in Milan (Italy) and Nijmegen (Netherlands). Diagnosis followed ATS\/ERS\/ESCMID\/IDSA and BTS criteria. Clinical, radiological and microbiological data were collected. Outcomes included treatment completion, mortality and adverse drug events (ADEs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 90 cases were included (74% female, median age 68\u00a0years). Disease patterns differed by center, with nodular-bronchiectatic forms prevailing in Milan and fibrocavitary disease in Nijmegen. Clofazimine discontinuation due to ADEs occurred in 14%. Overall, 74% completed therapy and mortality was 8%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clofazimine-containing regimens showed acceptable safety and favorable outcomes in diverse European MAC-PD populations, supporting its role as a valuable adjunct in MAC-PD management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02787-x","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T14:44:24Z","timestamp":1775054664000},"page":"1593-1598","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Treatment outcomes of clofazimine-containing regimens in Mycobacterium avium complex pulmonary disease: a retrospective study from two European reference centers"],"prefix":"10.1007","volume":"54","author":[{"given":"Serena","family":"Piccirillo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccol\u00f2","family":"Riccardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Fumagalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakko","family":"van Ingen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"van Arkel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Ferrarese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Repossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Mantero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Blasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi Ruffo","family":"Codecasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"issue":"1","key":"2787_CR1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00535-2020","volume":"56","author":"CL Daley","year":"2020","unstructured":"Daley CL, Iaccarino JM, Lange C, Cambau E, Wallace RJ Jr, Andrejak C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS\/ERS\/ESCMID\/IDSA clinical practice guideline. Eur Respir J. 2020;56(1):2000535. https:\/\/doi.org\/10.1183\/13993003.00535-2020.","journal-title":"Eur Respir J"},{"issue":"2","key":"2787_CR2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01855-2016","volume":"49","author":"J van Ingen","year":"2017","unstructured":"van Ingen J, Wagner D, Gallagher J, Morimoto K, Lange C, Haworth CS, et al. Poor adherence to diagnosis and treatment guidelines for nontuberculous mycobacterial lung disease in EU and Japan. Eur Respir J. 2017;49(2):1601855. https:\/\/doi.org\/10.1183\/13993003.01855-2016.","journal-title":"Eur Respir J"},{"issue":"6","key":"2787_CR3","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1016\/j.chest.2022.06.017","volume":"162","author":"J van Ingen","year":"2022","unstructured":"van Ingen J, Aliberti S, Andrejak C, Chalmers JD, Codecasa LR, Daley CL, et al. Management of drug toxicity in Mycobacterium avium complex pulmonary disease: an expert panel survey. Chest. 2022;162(6):1304\u201316. https:\/\/doi.org\/10.1016\/j.chest.2022.06.017.","journal-title":"Chest"},{"issue":"3","key":"2787_CR4","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1055\/s-0038-1666792","volume":"39","author":"SMH Zweijpfenning","year":"2018","unstructured":"Zweijpfenning SMH, van Ingen J, Hoefsloot W. Geographic distribution of nontuberculous mycobacteria isolated from clinical specimens: a systematic review. Semin Respir Crit Care Med. 2018;39(3):336\u201342. https:\/\/doi.org\/10.1055\/s-0038-1666792.","journal-title":"Semin Respir Crit Care Med"},{"key":"2787_CR5","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.638306","volume":"8","author":"MJ Nasiri","year":"2021","unstructured":"Nasiri MJ, Calcagno T, Hosseini SS, Hematian A, Nojookambari NY, Karimi-Yazdi M, et al. Role of clofazimine in treatment of Mycobacterium avium complex. Front Med. 2021;8:638306. https:\/\/doi.org\/10.3389\/fmed.2021.638306.","journal-title":"Front Med"},{"issue":"Suppl 2","key":"2787_CR6","doi-asserted-by":"publisher","first-page":"ii1","DOI":"10.1136\/thoraxjnl-2017-210927","volume":"72","author":"British Thoracic Society","year":"2017","unstructured":"British Thoracic Society. Guidelines for the management of nontuberculous mycobacterial pulmonary disease. Thorax. 2017;72(Suppl 2):ii1\u201364. https:\/\/doi.org\/10.1136\/thoraxjnl-2017-210927.","journal-title":"Thorax"},{"issue":"1","key":"2787_CR7","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-023-02400-4","volume":"23","author":"SC Park","year":"2023","unstructured":"Park SC, Kim SR, Lee J, Lee SH, Oh YH, Jeon K, et al. Global trends and treatment outcomes in Mycobacterium avium complex pulmonary disease: a systematic review. BMC Pulm Med. 2023;23(1):124. https:\/\/doi.org\/10.1186\/s12890-023-02400-4.","journal-title":"BMC Pulm Med"},{"issue":"6","key":"2787_CR8","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1016\/j.chest.2017.01.028","volume":"151","author":"WJ Koh","year":"2017","unstructured":"Koh WJ, Hong GK, Lee JY, Suh GY, Chung MP, Lee SD, et al. Clinical significance of cavitary nodular bronchiectatic Mycobacterium avium complex pulmonary disease. Chest. 2017;151(6):1220\u201330. https:\/\/doi.org\/10.1016\/j.chest.2017.01.028.","journal-title":"Chest"},{"issue":"6","key":"2787_CR9","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01380-2017","volume":"50","author":"MR Loebinger","year":"2017","unstructured":"Loebinger MR, Maglio F, Ormerod LP, Wells AU. Mycobacterium avium complex infection: phenotypes and outcomes. Eur Respir J. 2017;50(6):1701380. https:\/\/doi.org\/10.1183\/13993003.01380-2017.","journal-title":"Eur Respir J"},{"issue":"2","key":"2787_CR10","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02503-2016","volume":"50","author":"WJ Koh","year":"2017","unstructured":"Koh WJ, Moon SM, Kim SY, Lee NJ, Lee SH, Kwon YS, et al. Outcomes of Mycobacterium avium complex lung disease based on clinical phenotype. Eur Respir J. 2017;50(2):1602503. https:\/\/doi.org\/10.1183\/13993003.02503-2016.","journal-title":"Eur Respir J"},{"issue":"5","key":"2787_CR11","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1093\/cid\/ciab433","volume":"73","author":"J Chen","year":"2021","unstructured":"Chen J, Li X, Li Y, Li P, Wang R, Zhao Y, et al. Efficacy and safety of clofazimine-containing regimens in Mycobacterium avium complex pulmonary disease. Clin Infect Dis. 2021;73(5):867\u201375. https:\/\/doi.org\/10.1093\/cid\/ciab433.","journal-title":"Clin Infect Dis"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02787-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-026-02787-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02787-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:39:34Z","timestamp":1782920374000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-026-02787-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["2787"],"URL":"https:\/\/doi.org\/10.1007\/s15010-026-02787-x","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-8949602\/v1","asserted-by":"object"}]},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,1]]},"assertion":[{"value":"23 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the local Ethics Committees of the participating centers in Milan, Italy, and Nijmegen, The Netherlands (approval number: ID5749_SA_06.12.2024_N).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Due to the retrospective nature of the study, the requirement for informed consent was waived by the Ethics Committees.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}