Clinical and radiological improvement of cavitary Mycobacteroides abscessus disease in cystic fibrosis following initiation of elexacaftor/tezacaftor/ivacaftor

J Cyst Fibros. 2024 Sep;23(5):1024-1026. doi: 10.1016/j.jcf.2024.05.008. Epub 2024 May 21.

Abstract

Elexacaftor/tezacaftor/ivacaftor (ETI) is a CFTR modulator therapy that has dramatically improved the health outcomes for many people with cystic fibrosis (pwCF). There is increasing interest in the role of CFTR modulators in the prevention and treatment of respiratory infections in pwCF. A male patient with F508del homozygous cystic fibrosis developed cavitary Mycobacteroides abscessus subspecies bolletii & massiliense respiratory infection. Antimycobacterial treatment was not given as, in discussion with the patient's family, it was deemed unlikely that the intensive regimen would be tolerated by the patient on account of his autism spectrum disorder. Following initiation of ETI, there was a rapid clinical and radiological improvement in this patient's cavitary lung disease. This case adds to the evidence base that suggests CFTR modulators, particularly ETI, may restore innate immune function leading to improved outcomes for pulmonary infection in pwCF.

Keywords: Cystic fibrosis; Elexacaftor/tezacaftor/ivacaftor; Mycobacterioides abscessus; Nontuberculous mycobacterium.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aminophenols* / therapeutic use
  • Benzodioxoles* / therapeutic use
  • Cystic Fibrosis Transmembrane Conductance Regulator / genetics
  • Cystic Fibrosis* / complications
  • Cystic Fibrosis* / drug therapy
  • Cystic Fibrosis* / microbiology
  • Drug Combinations
  • Humans
  • Indoles* / therapeutic use
  • Male
  • Mycobacterium Infections, Nontuberculous* / diagnosis
  • Mycobacterium Infections, Nontuberculous* / drug therapy
  • Mycobacterium Infections, Nontuberculous* / etiology
  • Mycobacterium abscessus
  • Pyrazoles / therapeutic use
  • Pyridines* / administration & dosage
  • Pyridines* / therapeutic use
  • Pyrroles / administration & dosage
  • Pyrroles / adverse effects
  • Pyrroles / therapeutic use
  • Pyrrolidines
  • Quinolones* / therapeutic use
  • Respiratory Tract Infections / diagnosis
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / etiology
  • Respiratory Tract Infections / microbiology

Substances

  • Indoles
  • Benzodioxoles
  • Aminophenols
  • Quinolones
  • Pyridines
  • Pyrazoles
  • Drug Combinations
  • Pyrroles
  • elexacaftor
  • Cystic Fibrosis Transmembrane Conductance Regulator
  • Pyrrolidines