Lopes-Pacheco Miquéias, Winters Ashlyn G, Jackson JaNise J, Olson Rd John A, Kim Minsoo, Ledwitch Kaitlyn V, Tedman Austin, Jhangiani Ashish R, Schlebach Jonathan P, Meiler Jens, Plate Lars, Oliver Kathryn E
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
Center for Cystic Fibrosis & Airways Disease Research, Emory University & Children's Healthcare of Atlanta, Atlanta, GA, USA.
Expert Opin Drug Discov. 2025 May;20(5):659-682. doi: 10.1080/17460441.2025.2490250. Epub 2025 Apr 13.
The advent of variant-specific disease-modifying drugs into clinical practice has provided remarkable benefits for people with cystic fibrosis (PwCF), a multi-organ life-limiting inherited disease. However, further efforts are needed to maximize therapeutic benefits as well as to increase the number of PwCF taking CFTR modulators.
The authors discuss some of the key limitations of the currently available CFTR modulator therapies (e.g. adverse reactions) and strategies in development to increase the number of available therapeutics for CF. These include novel methods to accelerate theratyping and identification of novel small molecules and cellular targets representing alternative or complementary therapies for CF.
While the CF therapy development pipeline continues to grow, there is a critical need to optimize strategies that will accelerate testing and approval of effective therapies for (ultra)rare CFTR variants as traditional assays and trials are not suitable to address such issues. Another major barrier that needs to be solved is the restricted access to currently available modulator therapies, which remains a significant burden for PwCF who are from racial and ethnic minorities and/or living in underprivileged regions.
针对特定变异的疾病修正药物进入临床实践,为患有囊性纤维化(CF)的患者带来了显著益处。CF是一种多器官受累、危及生命的遗传性疾病。然而,仍需进一步努力以最大化治疗益处,并增加服用CFTR调节剂的CF患者数量。
作者讨论了当前可用的CFTR调节剂疗法的一些关键局限性(如不良反应),以及正在研发的旨在增加CF可用治疗方法数量的策略。这些策略包括加速治疗分型的新方法,以及鉴定代表CF替代或补充疗法的新型小分子和细胞靶点。
虽然CF治疗研发渠道持续拓展,但迫切需要优化策略,以加速针对(超)罕见CFTR变异的有效疗法的测试和批准,因为传统检测和试验并不适合解决此类问题。另一个需要解决的主要障碍是目前可用的调节剂疗法获取受限,这对于来自少数种族和族裔群体及/或生活在贫困地区的CF患者而言仍是一项重大负担。