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回顾性观察研究:在真实环境中,1 年和 2 年后使用 ivacaftor 治疗法治疗囊性纤维化和 Gly551Asp-CFTR 突变的法国患者。

Retrospective observational study of French patients with cystic fibrosis and a Gly551Asp-CFTR mutation after 1 and 2years of treatment with ivacaftor in a real-world setting.

机构信息

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

Vaincre la Mucoviscidose, Paris, France.

出版信息

J Cyst Fibros. 2018 Jan;17(1):89-95. doi: 10.1016/j.jcf.2017.07.001. Epub 2017 Jul 12.

Abstract

BACKGROUND

Ivacaftor has been shown to improve lung function and body weight in patients with CF and a gating mutation. Real-world evaluation is warranted to examine its safety and effectiveness over the long term.

METHODS

A retrospective observational multicentre study collected clinical data in the year before and the 2years after ivacaftor initiation in patients with CF and a Gly551Asp-CFTR mutation.

RESULTS

Fifty-seven patients were included. Mean absolute change in FEV% predicted improved from baseline to Year 1 (8.4%; p<0.001) and Year 2 (7.2%; p=0.006). Statistically significant benefits were observed with increased body mass index, fewer Pseudomonas aeruginosa and Staphylococcus aureus positive cultures, and decreased IV antibiotics and maintenance treatment prescriptions (including azithromycin, Dornase alpha and nutritional supplements). No significant adverse events were reported.

CONCLUSION

The clinical benefits of ivacaftor reported in previous clinical trials were confirmed in a real-world setting two years post-initiation, also reducing treatment burden.

摘要

背景

依伐卡托已被证明可改善 CF 伴门控突变患者的肺功能和体重。需要进行真实世界评估,以长期检查其安全性和有效性。

方法

一项回顾性观察性多中心研究收集了 CF 伴 Gly551Asp-CFTR 突变患者依伐卡托起始治疗前 1 年和 2 年的临床数据。

结果

共纳入 57 例患者。与基线相比,FEV%预测值的绝对变化在第 1 年(8.4%;p<0.001)和第 2 年(7.2%;p=0.006)均有所改善。体重指数增加、铜绿假单胞菌和金黄色葡萄球菌阳性培养减少以及 IV 抗生素和维持治疗处方(包括阿奇霉素、Dornase alpha 和营养补充剂)减少均观察到具有统计学意义的获益。未报告明显不良事件。

结论

在起始治疗两年后,真实世界环境中证实了依伐卡托在先前临床试验中报告的临床获益,同时还降低了治疗负担。

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