Elexacaftor/Tezacaftor/Ivacaftor in Patients with Cystic Fibrosis Homozygous for the Mutation and Advanced Lung Disease: A 48-Week Observational Study

Overview

Journal J Clin Med

Specialty General Medicine

Date 2022 Feb 25

PMID 35207295

Authors

Vincenzo Carnovale

Paola Iacotucci

Vito Terlizzi

Carmela Colangelo

Lorenza Ferrillo

Angela Pepe

Michela Francalanci

Giovanni Taccetti

Serena Buonaurio

Assunta Celardo

Laura Salvadori

Giovanni Marsicovetere

Michele DAndria

Nicola Ferrara

Donatello Salvatore

Affiliations

Soon will be listed here.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: In pwCF with advanced lung disease with an genotype, ETI was safe and associated with clinical improvement.

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Gene expression responses of CF airway epithelial cells exposed to elexacaftor/tezacaftor/ivacaftor suggest benefits beyond improved CFTR channel function.

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