Tomlinson Owen W, Mitchelmore Philip, Williams Craig A
Department of Clinical and Biomedical Science, University of Exeter Medical School, University of Exeter, Heavitree Road, Exeter, EX1 2LU, UK.
Academic Department of Respiratory Medicine, Royal Devon University Healthcare NHS Foundation Trust, Exeter, EX2 5DW, UK.
Pulm Ther. 2024 Dec;10(4):427-438. doi: 10.1007/s41030-024-00274-y. Epub 2024 Sep 27.
Advances in development of cystic fibrosis transmembrane conductance regulator modulator (CFTRm) therapies mean that now people who are heterozygous (instead of having to be homozygous) for the common F508del variant can benefit from these therapies. Recent economic estimates suggest only approximately 15% of the global population have CFTRm access, yet it is unknown how prevalence of F508del and economic factors may affect this availability.
Data related to prevalence of cystic fibrosis (CF), CFTRm usage, and prevalence of F508del in 10 countries were extracted from publicly accessible registry reports from 2021. National gross domestic product (GDP) was obtained via open access World Bank data. Descriptive statistics and correlation coefficients assessed relationships.
Notable discrepancies were noted in the equity of availability of data between national registries-only four countries reported number of patients eligible for CFTRm. Registry data represented 70,694 patients, with 42,858 found to be using CFTRm (60.6%). Prevalence of CFTRm usage ranged from 1.8% to 76.7% and prevalence of F508del ranged from 35.2% to 94.4%. The correlation between prevalence of CFTRm usage and F508del is positive (r = 0.56, p = 0.10), and the correlation between CFTRm usage and GDP (per capita) was also positive, and significant (r = 0.72, p = 0.02).
Both F508del prevalence and GDP are associated with variable CFTRm usage rates, although a predominant reason is unclear as a result of poor consistency in registry reporting. Urgent action is needed to create uniform reporting of registry data and increase availability of novel CFTRm therapies to the global CF population.
囊性纤维化跨膜传导调节因子调节剂(CFTRm)疗法的发展进展意味着,现在对于常见的F508del变异为杂合子(而非必须是纯合子)的人也可以从这些疗法中获益。最近的经济评估表明,全球仅有约15%的人口能够使用CFTRm,但尚不清楚F508del的患病率和经济因素如何影响其可及性。
从2021年公开可获取的登记报告中提取了10个国家与囊性纤维化(CF)患病率、CFTRm使用情况以及F508del患病率相关的数据。通过开放获取的世界银行数据获取各国国内生产总值(GDP)。采用描述性统计和相关系数评估关系。
各国登记处之间的数据可及性公平性存在显著差异——只有四个国家报告了符合CFTRm治疗条件的患者数量。登记数据涵盖70694名患者,其中42858人正在使用CFTRm(60.6%)。CFTRm的使用率在1.8%至76.7%之间,F508del的患病率在35.2%至94.4%之间。CFTRm使用率与F508del之间的相关性为正(r = 0.56,p = 0.10),CFTRm使用率与(人均)GDP之间的相关性也为正且具有显著性(r = 0.72,p = 0.02)。
F508del患病率和GDP均与CFTRm使用率的差异有关,不过由于登记报告的一致性较差,尚不清楚主要原因。需要采取紧急行动,实现登记数据的统一报告,并提高新型CFTRm疗法在全球CF患者中的可及性。