Virant-Young Deborah, Thomas Justin, Woiderski Sarah, Powers Michelle, Carlier Joseph, McCarty James, Kupchick Tyler, Larder Anthony
J Am Osteopath Assoc. 2015 Sep;115(9):546-55. doi: 10.7556/jaoa.2015.112.
Therapy for cystic fibrosis (CF) has progressed during the past several decades. Much of this progress is because of advances in genetic testing to precisely identify the underlying cause of CF transmembrane regulator (CFTR) dysfunction. However, with more than 1900 mutations that can produce a faulty CFTR, the management of CF can remain a challenge. Several innovative drugs recently approved by the Food and Drug Administration, termed genetic modulators, target the underlying disease by modulating the CFTR defect. This review provides physicians with an established simple classification scheme to guide their use of these drugs. The treatment challenge of 1900 CFTR mutations has been simplified into 6 physiologic classes, each paired with an available therapy to offer patients the most functional improvement. Drug therapy monitoring, adverse effects, and indications for discontinuation must also be considered.
在过去几十年中,囊性纤维化(CF)的治疗取得了进展。这一进展很大程度上归功于基因检测的进步,从而能够精确识别囊性纤维化跨膜传导调节因子(CFTR)功能障碍的根本原因。然而,由于有超过1900种突变可导致CFTR出现缺陷,CF的管理仍然是一项挑战。美国食品药品监督管理局最近批准的几种创新药物,即所谓的基因调节剂,通过调节CFTR缺陷来针对潜在疾病。本综述为医生提供了一个既定的简单分类方案,以指导他们使用这些药物。1900种CFTR突变的治疗挑战已被简化为6种生理类别,每类都有相应的可用疗法,以给患者带来最大程度的功能改善。还必须考虑药物治疗监测、不良反应及停药指征。