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承诺:与 CF 社区合作,了解接受高效 CFTR 调节剂治疗的患者的新兴临床和研究需求。

PROMISE: Working with the CF community to understand emerging clinical and research needs for those treated with highly effective CFTR modulator therapy.

机构信息

Seattle Children's Research Institute, Department of Pediatrics, University of Washington, USA.

Department of Medicine, Univ. North Carolina at Chapel Hill, USA.

出版信息

J Cyst Fibros. 2021 Mar;20(2):205-212. doi: 10.1016/j.jcf.2021.02.003. Epub 2021 Feb 19.

DOI:10.1016/j.jcf.2021.02.003
PMID:33619012
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8686210/
Abstract

Highly effective CFTR modulator drug therapy is increasingly available to those with cystic fibrosis. Multiple observational research studies are now being conducted to better understand the impacts of this important therapeutic milestone on long-term outcomes, patient care needs, and future research priorities. PROMISE is a large, multi-disciplinary academic study focused on the broad impacts of starting elexacaftor/tezacaftor/ivacaftor in the US population age 6 years and older. The many areas of investigation and rationale for each are discussed by organ systems, along with recognition of remaining important questions that will not be addressed by this study alone. Knowledge gained through this and multiple complementary studies around the world will help to understand important health outcomes, clinical care priorities, and research needs for a large majority of people treated with these or similarly effective medications targeting the primary cellular impairment in cystic fibrosis.

摘要

对于囊性纤维化患者,高效的 CFTR 调节剂药物治疗越来越普及。目前正在进行多项观察性研究,以更好地了解这一重要治疗里程碑对长期结果、患者护理需求和未来研究重点的影响。PROMISE 是一项大型多学科学术研究,重点关注在美国 6 岁及以上人群中开始使用 elexacaftor/tezacaftor/ivacaftor 的广泛影响。本文按器官系统讨论了每个系统的调查领域和原理,同时认识到单凭这项研究无法解决的一些重要问题。通过这项研究以及世界各地的多项补充研究获得的知识,将有助于了解大多数接受这些或类似针对囊性纤维化主要细胞缺陷的有效药物治疗的人群的重要健康结果、临床护理重点和研究需求。

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PROMISE: Working with the CF community to understand emerging clinical and research needs for those treated with highly effective CFTR modulator therapy.承诺:与 CF 社区合作,了解接受高效 CFTR 调节剂治疗的患者的新兴临床和研究需求。
J Cyst Fibros. 2021 Mar;20(2):205-212. doi: 10.1016/j.jcf.2021.02.003. Epub 2021 Feb 19.
2
Patients eligible for modulator drugs: Data from cystic fibrosis registry of Turkey.适合调节剂药物的患者:来自土耳其囊性纤维化登记处的数据。
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Efficacy and safety of the elexacaftor plus tezacaftor plus ivacaftor combination regimen in people with cystic fibrosis homozygous for the F508del mutation: a double-blind, randomised, phase 3 trial.在纯合子 F508del 突变的囊性纤维化患者中,elexacaftor 加 tezacaftor 加 ivacaftor 联合治疗方案的疗效和安全性:一项双盲、随机、3 期临床试验。
Lancet. 2019 Nov 23;394(10212):1940-1948. doi: 10.1016/S0140-6736(19)32597-8. Epub 2019 Oct 31.
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Rapid Improvement after Starting Elexacaftor-Tezacaftor-Ivacaftor in Patients with Cystic Fibrosis and Advanced Pulmonary Disease.在患有囊性纤维化和晚期肺部疾病的患者中开始使用 Elexacaftor-Tezacaftor-Ivacaftor 后的快速改善。
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Pediatr Pulmonol. 2021 Feb;56 Suppl 1:S79-S89. doi: 10.1002/ppul.24968.
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VX-445-Tezacaftor-Ivacaftor in Patients with Cystic Fibrosis and One or Two Phe508del Alleles.VX-445-泰泽卡托维瓦卡托联合治疗伴有一个或两个 Phe508del 等位基因的囊性纤维化患者。
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N Engl J Med. 2018 Oct 25;379(17):1599-1611. doi: 10.1056/NEJMoa1807119. Epub 2018 Oct 18.
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A phase 3, randomized, double-blind, parallel-group study to evaluate tezacaftor/ivacaftor in people with cystic fibrosis heterozygous for F508del-CFTR and a gating mutation.一项评估特扎卡托/依伐卡托治疗携带 F508del-CFTR 杂合突变和门控突变的囊性纤维化患者的 3 期、随机、双盲、平行组研究。
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J Cyst Fibros. 2025 Jul;24(4):792-800. doi: 10.1016/j.jcf.2025.05.006. Epub 2025 Jun 6.
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本文引用的文献

1
Evaluating the Impact of Stopping Chronic Therapies after Modulator Drug Therapy in Cystic Fibrosis: The SIMPLIFY Clinical Trial Study Design.评估囊性纤维化调制药物治疗后停止慢性治疗的影响:SIMPLIFY 临床试验研究设计。
Ann Am Thorac Soc. 2021 Aug;18(8):1397-1405. doi: 10.1513/AnnalsATS.202010-1336SD.
2
Changes in fecal microbiota with CFTR modulator therapy: A pilot study.粪便微生物群随 CFTR 调节剂治疗的变化:一项初步研究。
J Cyst Fibros. 2021 Sep;20(5):742-746. doi: 10.1016/j.jcf.2020.12.002. Epub 2020 Dec 31.
3
Long term clinical effectiveness of ivacaftor in people with the G551D CFTR mutation.
囊性纤维化相关骨病:筛查、诊断及治疗的最新进展
Ther Adv Endocrinol Metab. 2025 Apr 2;16:20420188251328210. doi: 10.1177/20420188251328210. eCollection 2025.
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Evolutionary loss of an antibiotic efflux pump increases quorum sensing mediated virulence .抗生素外排泵的进化性缺失增强了群体感应介导的毒力。
Res Sq. 2024 Nov 12:rs.3.rs-5391023. doi: 10.21203/rs.3.rs-5391023/v1.
5
Ivacaftor ameliorates mucus burden, bacterial load, and inflammation in acute but not chronic P. aeruginosa infection in hG551D rats.依伐卡托改善 hG551D 大鼠急性但非慢性铜绿假单胞菌感染中的黏液负担、细菌负荷和炎症。
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The ageing of people living with cystic fibrosis: what to expect now?囊性纤维化患者的老龄化:现在有哪些预期?
Eur Respir Rev. 2024 Oct 30;33(174). doi: 10.1183/16000617.0071-2024. Print 2024 Oct.
7
Therapeutic Drug Monitoring of Elexacaftor, Tezacaftor, and Ivacaftor in Adult People with Cystic Fibrosis.对成年囊性纤维化患者进行依列卡福、替扎卡福和依伐卡福的治疗药物监测。
J Pers Med. 2024 Oct 17;14(10):1065. doi: 10.3390/jpm14101065.
8
Current landscape of cystic fibrosis gene therapy.囊性纤维化基因治疗的现状
Front Pharmacol. 2024 Oct 8;15:1476331. doi: 10.3389/fphar.2024.1476331. eCollection 2024.
9
Impaired intestinal free fatty acid transport followed by chylomicron malformation, not pancreatic insufficiency, cause metabolic defects in cystic fibrosis.肠内游离脂肪酸转运受损,继以乳糜微粒形成异常,而非胰腺功能不全,导致囊性纤维化的代谢缺陷。
J Lipid Res. 2024 Jul;65(7):100551. doi: 10.1016/j.jlr.2024.100551. Epub 2024 Jul 13.
10
Anti-inflammatory effects of elexacaftor/tezacaftor/ivacaftor in adults with cystic fibrosis heterozygous for F508del.依伐卡托/泰它卡托/艾美卡替三联复方干糖浆治疗 F508del 杂合子成人囊性纤维化的抗炎作用。
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G551D 突变型 CFTR 患者使用伊伐卡托的长期临床疗效。
J Cyst Fibros. 2021 Mar;20(2):213-219. doi: 10.1016/j.jcf.2020.11.008. Epub 2020 Nov 25.
4
Maintenance tobramycin primarily affects untargeted bacteria in the CF sputum microbiome.维持妥布霉素主要影响 CF 痰液微生物组中未靶向的细菌。
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Changes in LCI in F508del/F508del patients treated with lumacaftor/ivacaftor: Results from the prospect study.F508del/F508del 患者接受 lumacaftor/ivacaftor 治疗后的 LCI 变化:前瞻性研究结果。
J Cyst Fibros. 2020 Nov;19(6):931-933. doi: 10.1016/j.jcf.2020.05.010. Epub 2020 Jun 6.
6
Human Nasal Epithelial Organoids for Therapeutic Development in Cystic Fibrosis.人鼻腔类器官在囊性纤维化治疗中的应用。
Genes (Basel). 2020 May 29;11(6):603. doi: 10.3390/genes11060603.
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Correlation between Ivacaftor-induced CFTR Activation in Airway Epithelial Cells and Improved Lung Function: A Proof-of-Concept Study.依伐卡托诱导气道上皮细胞中CFTR激活与肺功能改善之间的相关性:一项概念验证研究。
Ann Am Thorac Soc. 2020 Aug;17(8):1024-1027. doi: 10.1513/AnnalsATS.202001-082RL.
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Age and environmental exposures influence the fecal bacteriome of young children with cystic fibrosis.年龄和环境暴露影响囊性纤维化幼儿的粪便细菌组。
Pediatr Pulmonol. 2020 Jul;55(7):1661-1670. doi: 10.1002/ppul.24766. Epub 2020 Apr 10.
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Fecal dysbiosis in infants with cystic fibrosis is associated with early linear growth failure.囊性纤维化患儿粪便菌群失调与早期线性生长发育不良有关。
Nat Med. 2020 Feb;26(2):215-221. doi: 10.1038/s41591-019-0714-x. Epub 2020 Jan 20.
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Cystic Fibrosis: Emergence of Highly Effective Targeted Therapeutics and Potential Clinical Implications.囊性纤维化:高效靶向治疗药物的出现及其潜在的临床意义。
Am J Respir Crit Care Med. 2020 May 15;201(10):1193-1208. doi: 10.1164/rccm.201910-1943SO.