Impact of interruption of CFTR modulator therapies

J Cyst Fibros. 2024 Sep;23(5):947-949. doi: 10.1016/j.jcf.2024.05.006. Epub 2024 May 18.

Abstract

Novel drug therapy targeting the defective cystic fibrosis transmembrane conductance regulator protein has the potential to significantly enhance the quality of life for numerous patients with cystic fibrosis. However, in some countries social insurance does not pay for modulators because these drugs are extremely expensive. This study sought to understand the impact on the health of children whose modulator treatments were interrupted because of legal procedures and delivery processes. Our study identified that the significant increase in percent-predicted forced expiratory volume levels (FEV1) and BMI z-score values associated with modulator therapies decreased sharply with their discontinuation. Significant worsening in FEV1, BMI z-scores, and BW z-scores were detected in the first follow-up visit after therapy discontinuation within 1 month. Eight patients had a reduction of FEV1 of more than 10%. The findings suggest that modulatory treatment continuation is important, and it is crucial that treatment is not interrupted.

Keywords: CFTR modulator drugs; Cystic fibrosis; Pseudomonas aeruginosa.

MeSH terms

  • Adolescent
  • Body Mass Index
  • Child
  • Chloride Channel Agonists / therapeutic use
  • Cystic Fibrosis Transmembrane Conductance Regulator* / genetics
  • Cystic Fibrosis* / drug therapy
  • Cystic Fibrosis* / physiopathology
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Quality of Life
  • Quinolones / administration & dosage
  • Quinolones / therapeutic use
  • Withholding Treatment

Substances

  • Cystic Fibrosis Transmembrane Conductance Regulator
  • Chloride Channel Agonists
  • Quinolones