Lima Eliandra da Silveira, Pezzin Luíse Sgarabotto, Fensterseifer Ana Carolina, Pinto Leonardo Araújo
Pontifícia Universidade Católica do Rio Grande do Sul, Pós-graduação em Pediatria e Saúde da Criança, Porto Alegre, RS, Brazil.
Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Medicina, Porto Alegre, RS, Brazil.
Genet Mol Biol. 2021 Dec 6;45(1):e20200275. doi: 10.1590/1678-4685-GMB-2020-0275. eCollection 2021.
This is a descriptive cross-sectional study that aims to determine the distribution of the CFTR causing variant in a group of patients at a cystic fibrosis (CF) center in southern Brazil, as well as to describe causing variants that are treatable with mutation-specific drugs. Ninety-two patients from a CF reference center were assessed in this research, all of them with a clinical diagnosis of CF and both alleles identified with pathogenic variants. The most prevalent causing variants were F508del, R1162X, G542X, and N1303K. As for patients with a mutation-specific drug indication, 69.6 % were candidates for the use of Elexacaftor/Tezacaftor/Ivacaftor (Trikafta®), 44.6 % for the use of Tezacaftor/Ivacaftor (Symdeko®), and 35.9 % for the use of Lumacaftor/Ivacaftor (Orkambi®). For the use of Ivacaftor (Kalydeco®), only two patients (2.2 %) were candidates following the Brazilian agency approval. According to the FDA, 10 patients would be candidates for Ivacaftor (10.9 %). Causing variants of classes I and II, which are related to a major severity of the illness, were identified in 135 of 184 alleles (73.3 %). In this study, more than 2/3 of the patients were candidates for the use of CFTR modulators therapy.
这是一项描述性横断面研究,旨在确定巴西南部一家囊性纤维化(CF)中心的一组患者中导致CFTR变异的分布情况,并描述可用针对特定突变的药物治疗的致病变异。本研究评估了来自一家CF参考中心的92名患者,他们均有CF的临床诊断且两个等位基因均鉴定为致病变异。最常见的致病变异是F508del、R1162X、G542X和N1303K。至于有使用针对特定突变药物指征的患者,69.6%有使用依列卡福/替扎卡福/依伐卡福(Trikafta®)的指征,44.6%有使用替扎卡福/依伐卡福(Symdeko®)的指征,35.9%有使用鲁马卡福/依伐卡福(Orkambi®)的指征。对于使用依伐卡福(Kalydeco®),在巴西机构批准后仅有两名患者(2.2%)有使用指征。根据美国食品药品监督管理局(FDA)的数据,有10名患者(10.9%)有使用依伐卡福的指征。在184个等位基因中的135个(73.3%)中鉴定出与疾病严重程度相关的I类和II类致病变异。在本研究中,超过2/3的患者有使用CFTR调节剂治疗的指征。