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Published VersionCC BY-NC-ND V4.0, Open Access
Journal article
Treatment outcomes and safety of clofazimine in nontuberculous mycobacterial pulmonary disease (NTM-PD)
Mycobacteria, Vol.2, pp.1-9
2026
Abstract
Background
Nontuberculous mycobacterial (NTM) infections are difficult to treat and are associated with significant morbidity and mortality. Reported success rates with guideline-based therapy vary depending on NTM species and up to 70% experience treatment related side effects. There is limited data on the safety and efficacy of clofazimine, a commonly used second line drug in the treatment of NTM pulmonary disease (NTM-PD).
Methods
All patients with NTM-PD treated with clofazimine between June 2017 and June 2022 across five major metropolitan hospitals were analysed to determine the success rates of clofazimine containing regimens and associated adverse events, in the treatment of NTM-PD.
Results
A total of 157 patients were included in the analysis. Clofazimine was used as first line therapy in 93 patients (59%), substitution therapy in 29 patients (19%) and as add-on therapy in 35 patients (22%). Of the 147 patients with a treatment outcome recorded, 88 patients (56%) had successful treatment outcomes (61% [65/106] with
Mycobacterium avium
complex; 56% [19/34] of patients with
M. abscessus
infection). Success was more likely when clofazimine was used in a first line treatment regimen (62%) or as a substitute treatment (68%) than as salvage therapy (47%). Adverse events were reported in 50% (79/157) of patients, mostly dermatological (41/157, 26%) and gastrointestinal (36/157, 23%). 21 patients (13%) discontinued clofazimine due to an adverse event.
Conclusion
The inclusion of clofazimine in treatment regimens for NTM-PD resulted in comparable outcomes and a favourable safety profile when compared with other first line therapy.
Details
- Title
- Treatment outcomes and safety of clofazimine in nontuberculous mycobacterial pulmonary disease (NTM-PD)
- Authors
- Shaun J. W. Kang - Greenslopes Private HospitalAdrian Watt - Logan HospitalMalcolm R. Wilson - Greenslopes Private HospitalGeoffrey W. Eather - Greenslopes Private HospitalTimothy Baird - University of the Sunshine CoastIeuan E. S. Evans - Greenslopes Private HospitalAndrew J. Burke - The University of QueenslandRachel M. Thomson (Corresponding Author) - The University of Queensland
- Publication details
- Mycobacteria, Vol.2, pp.1-9
- Publisher
- BioMed Central Ltd.
- Date published
- 2026
- DOI
- 10.1186/s44350-026-00012-1
- ISSN
- 3004-9555
- Copyright note
- This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
- Data Availability
- The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
- Organisation Unit
- School of Science, Technology and Engineering; Centre for Bioinnovation
- Language
- English
- Record Identifier
- 991216244802621
- Output Type
- Journal article
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