University of Waterloo, Kitchener, ON, Canada.
St. Michael's Hospital, Toronto, ON, Canada.
J Cyst Fibros. 2023 May;22(3):478-483. doi: 10.1016/j.jcf.2023.01.005. Epub 2023 Jan 16.
The combination of CFTR modulators ivacaftor, tezacaftor and elexacaftor (Trikafta®, Kaftrio®) significantly improve outcomes, including survival in a broad range of cystic fibrosis patients. These drugs have complicated metabolic profiles that make the potential for drug interactions an important consideration for prescribers, care providers and patients. Prolonged survival also increases risk of age-related disease and their associated pharmacotherapy, further increasing the risk of drug interactions and the need for increased vigilance amongst care providers. We systematically searched the literature for studies identifying and evaluating pharmacokinetic and pharmacodynamic drug interactions involving the components of Trikafta®/Kaftrio®. We also searched electronic databases of drugs for possible drug interactions based on metabolic profiles. We identified 86 potential drug interactions of which 13 were supported by 14 studies. There is a significant need for research to describe the likelihood, magnitude and clinical impact of the drug interactions proposed here.
CFTR 调节剂 ivacaftor、tezacaftor 和 elexacaftor（Trikafta®、Kaftrio®）的联合使用显著改善了包括广泛囊性纤维化患者生存率在内的结局。这些药物具有复杂的代谢特征，这使得药物相互作用的潜在风险成为处方者、护理提供者和患者的一个重要考虑因素。延长的生存也增加了与年龄相关的疾病及其相关药物治疗的风险，进一步增加了药物相互作用的风险，需要护理提供者提高警惕。我们系统地搜索了文献，以确定和评估涉及 Trikafta®/Kaftrio®成分的药代动力学和药效学药物相互作用。我们还根据代谢特征搜索了电子药物数据库，以寻找可能的药物相互作用。我们确定了 86 种潜在的药物相互作用，其中 13 种得到了 14 项研究的支持。这里提出的药物相互作用的可能性、程度和临床影响需要进行大量研究来描述。
