Julie V. Philley, MD

Chair of the Department of Medicine
Chief of Pulmonary and Critical Care
UT Health North Campus Tyler
The University of Texas Health Sciences Center
Houston, Texas

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What are the diagnostic challenges associated with MAC lung disease, the latency period between symptom onset and diagnosis, the disease burden as we understand it; and finally, the geographical distribution of this infection in the United States?

Julie Philley, MD

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What are the clinical phenotypes and variable presentations of MAC lung disease that practitioners should be aware of to ensure that patients who have NTM pulmonary disease are diagnosed in timely fashion?

Julie Philley, MD

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With respect to the patient who has bronchiectasis as a risk factor for MAC lung infection, how are these patients evaluated? In particular, what radiographic findings suggest the presence of MAC, and how do you risk stratify these individuals?

Julie Philley, MD

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What novel dosing schedules and combination regimens are being investigated for oral agents commonly deployed and guideline-endorsed to treat MAC lung disease?

Julie Philley, MD

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Given the heterogeneous clinical profiles for NTM pulmonary disease, what radiographic or other criteria determine which patients with culture positivity for MAC lung disease should be treated and which are suitable for “watch, wait, and monitor?”

Julie Philley, MD

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Which subgroup of patients with MAC lung disease, based on radiographic findings and symptoms, are likely to manifest clinical improvement with oral antimicrobial therapy? What role do underlying co-morbid condition play in predicting response?

Julie Philley, MD

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How frequently should microbiological sampling-whether by sputum or bronchoscopy—be performed in patients with MAC culture positivity who are being treated with antimicrobial therapy?

Julie Philley, MD

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What are the triggers and/or ATS/IDSA guidelines that would prompt you use amikacin for MAC lung disease, in either an IV or liposome aerosol suspension formulation? What is the role, based on the CONVERT trial, for the inhalation suspension?

Julie Philley, MD

$Once the decision is made to deploy amikacin in a patient with refractory MAC lung disease, what do we know about the problematic/toxicity/adherence and side effect pitfalls of IV amikacin, based on results of the CONVERT trial?$ Video

Once the decision is made to deploy amikacin in a patient with refractory MAC lung disease, what do we know about the problematic/toxicity/adherence and side effect pitfalls of IV amikacin, based on results of the CONVERT trial?

Julie Philley, MD

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How have the results of the CONVERT trial and other studies, and the mechanistic/penetration features of this formulation, influenced your decision-making as it regards selecting an amikacin-based formulation for treating MAC lung disease?

Julie Philley, MD

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When should the clinician suspect antimicrobial resistance in the setting of MAC lung disease? How is this confirmed?

Julie Philley, MD

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Are there any postulated strategies for preventing NTM pulmonary disease?

Julie Philley, MD

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What is your approach to MAC lung disease patients who fail to microbially convert despite intensive oral anti-infective therapy?

Julie Philley, MD

$Based on the current IDSA/ATS guidelines and recent trials, including CONVERT, what do you see as the most important advances in our understanding of NTM pulmonary disease, in particular, with respect to refractory MAC lung disease?$ Video

Based on the current IDSA/ATS guidelines and recent trials, including CONVERT, what do you see as the most important advances in our understanding of NTM pulmonary disease, in particular, with respect to refractory MAC lung disease?

Julie Philley, MD