Carnovale Vincenzo, Iacotucci Paola, Terlizzi Vito, Colangelo Carmela, Ferrillo Lorenza, Pepe Angela, Francalanci Michela, Taccetti Giovanni, Buonaurio Serena, Celardo Assunta, Salvadori Laura, Marsicovetere Giovanni, D'Andria Michele, Ferrara Nicola, Salvatore Donatello
Cystic Fibrosis Centre, Adult Unit, Department of Translational Medical Science, University of Naples "Federico II", 80131 Naples, Italy.
Cystic Fibrosis Centre, Department of Paediatric Medicine, Anna Meyer Children's University Hospital, 50139 Florence, Italy.
J Clin Med. 2022 Feb 16;11(4):1021. doi: 10.3390/jcm11041021.
Elexacaftor/tezacaftor/ivacaftor (ETI) is the newest cystic fibrosis transmembrane conductance regulator () modulator drug approved for the treatment of patients with cystic fibrosis (pwCF) aged ≥6 years with at least one copy of the mutation () in the gene or another mutation that is responsive to treatment with ETI. This study determined the effectiveness and safety of ETI in a cohort of severely affected pwCF with an genotype.
Retrospective observational study in pwCF treated for 48 weeks, enrolled in an ETI managed access program available to subjects with advanced lung disease (ppFEV < 40). Twenty-six patients from three centres were included. The main outcomes included lung function, sweat chloride concentration (SCC), nutrition, frequency of pulmonary exacerbations (PEx), CFQ-R, and safety.
ppFEV improved by 12.06 (95%CI 8.54, 15.57) from baseline after 4 weeks of treatment with ETI, 15.32 (11.3, 19.34) after 24 weeks, and 14.48 (10.64, 18.32) after 48 weeks. The increase in FEV was accompanied by a decrease in SCC, improvement of BMI, and noticeable reduction in PEx. An overall good safety profile was observed.
In pwCF with advanced lung disease with an genotype, ETI was safe and associated with clinical improvement.
依列卡福妥/替扎卡福妥/依伐卡福妥(ETI)是最新获批用于治疗年龄≥6岁、囊性纤维化跨膜传导调节因子(CFTR)基因至少有一个拷贝F508del突变(F508del)或对ETI治疗有反应的其他突变的囊性纤维化患者(pwCF)的药物。本研究确定了ETI在一组F508del基因型严重受影响的pwCF中的有效性和安全性。
对纳入ETI管理性准入项目(适用于晚期肺病患者(ppFEV1<40%))接受48周治疗的pwCF进行回顾性观察研究。纳入了来自三个中心的26名患者。主要结局包括肺功能、汗液氯化物浓度(SCC)、营养状况、肺部加重发作频率(PEx)、CFQ-R以及安全性。
ETI治疗4周后,ppFEV1较基线改善了12.06(95%CI 8.54,15.57),24周后改善了15.32(11.3,19.34),48周后改善了14.48(10.64,18.32)。FEV1的增加伴随着SCC的降低、BMI的改善以及PEx的显著减少。观察到总体安全性良好。
在F508del基因型的晚期肺病pwCF中,ETI安全且与临床改善相关。