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在患有苯丙氨酸508缺失CFTR突变且患有严重肺部疾病的纯合子成年囊性纤维化患者中,现实生活中启动鲁马卡托/依伐卡托联合治疗。

Real-life initiation of lumacaftor/ivacaftor combination in adults with cystic fibrosis homozygous for the Phe508del CFTR mutation and severe lung disease.

作者信息

Hubert Dominique, Chiron Raphaël, Camara Boubou, Grenet Dominique, Prévotat Anne, Bassinet Laurence, Dominique Stéphane, Rault Gilles, Macey Julie, Honoré Isabelle, Kanaan Reem, Leroy Sylvie, Desmazes Dufeu Nadine, Burgel Pierre-Régis

机构信息

Pulmonary Department and Adult CF Centre, Cochin Hospital, AP-HP, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France.

Pulmonary Department, Arnaud de Villeneuve Hospital, Montpellier, France.

出版信息

J Cyst Fibros. 2017 May;16(3):388-391. doi: 10.1016/j.jcf.2017.03.003. Epub 2017 Mar 18.

Abstract

OBJECTIVE

To investigate the short-term adverse events and effectiveness of lumacaftor/ivacaftor combination treatment in adults with cystic fibrosis (CF) and severe lung disease in a real life setting.

METHODS

A multicentre observational study investigated adverse events, treatment discontinuation, FEV and body mass index (BMI) one month and three months after lumacaftor/ivacaftor initiation in adults with CF and FEV below 40% predicted.

RESULTS

Respiratory adverse events (AEs) were reported by 27 of 53 subjects (51%) and 16 (30%) discontinued treatment. The mean absolute change in FEV was +2.06% after one month of treatment (P=0.086) and +3.19% after 3 months (P=0.009). BMI was unchanged.

CONCLUSIONS

Treatment with lumacaftor/ivacaftor in patients with CF and severe lung disease was discontinued more frequently than reported in clinical trials, due to respiratory AEs. Nevertheless, the patients who continued treatment had an increase in lung function comparable to what was observed in pivotal trials.

摘要

目的

在现实生活环境中,研究鲁马卡托/依伐卡托联合治疗对患有囊性纤维化(CF)和严重肺部疾病的成人患者的短期不良事件及疗效。

方法

一项多中心观察性研究,调查了CF且预测第一秒用力呼气容积(FEV)低于40%的成人患者在开始使用鲁马卡托/依伐卡托治疗1个月和3个月后的不良事件、治疗中断情况、FEV及体重指数(BMI)。

结果

53名受试者中有27名(51%)报告了呼吸道不良事件(AE),16名(30%)停止治疗。治疗1个月后FEV的平均绝对变化为+2.06%(P = 0.086),3个月后为+3.19%(P = 0.009)。BMI未发生变化。

结论

由于呼吸道不良事件,CF和严重肺部疾病患者使用鲁马卡托/依伐卡托治疗的停药频率高于临床试验报告。然而,继续治疗的患者肺功能的改善与关键试验中观察到的情况相当。

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