A European regulatory perspective on cystic fibrosis: current treatments, trends in drug development and translational challenges for CFTR modulators

Eur Respir Rev. 2018 Apr 13;27(148):170124. doi: 10.1183/16000617.0124-2017. Print 2018 Jun 30.

Abstract

In this article we analyse the current authorised treatments and trends in early drug development for cystic fibrosis (CF) in the European Union for the time period 2000-2016. The analysis indicates a significant improvement in the innovation and development of new potential medicines for CF, shifting from products that act on the symptoms of the disease towards new therapies targeting the cause of CF. However, within these new innovative medicines, results for CF transmembrane conductance regulator (CFTR) modulators indicate that one major challenge for turning a CF concept product into an actual medicine for the benefit of patients resides in the fact that, although pre-clinical models have shown good predictability for certain mutations, a good correlation to clinical end-points or biomarkers (e.g. forced expiratory volume in 1 s and sweat chloride) for all mutations has not yet been achieved. In this respect, the use of alternative end-points and innovative nonclinical models could be helpful for the understanding of those translational discrepancies. Collaborative endeavours to promote further research and development in these areas as well as early dialogue with the regulatory bodies available at the European competent authorities are recommended.

Publication types

  • Review

MeSH terms

  • Animals
  • Cystic Fibrosis / diagnosis
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / metabolism
  • Cystic Fibrosis / physiopathology
  • Cystic Fibrosis Transmembrane Conductance Regulator / drug effects*
  • Cystic Fibrosis Transmembrane Conductance Regulator / metabolism
  • Drug Approval / legislation & jurisprudence
  • Drug Discovery / legislation & jurisprudence
  • Drug Discovery / trends*
  • Europe
  • Government Regulation
  • Humans
  • Lung / drug effects*
  • Lung / metabolism
  • Lung / physiopathology
  • Membrane Transport Modulators / adverse effects
  • Membrane Transport Modulators / therapeutic use*
  • Molecular Targeted Therapy
  • Policy Making
  • Respiratory System Agents / adverse effects
  • Respiratory System Agents / therapeutic use*
  • Translational Research, Biomedical / legislation & jurisprudence
  • Translational Research, Biomedical / trends*
  • Treatment Outcome

Substances

  • CFTR protein, human
  • Membrane Transport Modulators
  • Respiratory System Agents
  • Cystic Fibrosis Transmembrane Conductance Regulator