EFFECT OF ELEXACAFTOR/TEZACAFTOR/IVACAFTOR ON ANNUAL RATE OF LUNG FUNCTION DECLINE IN PEOPLE WITH CYSTIC FIBROSIS

J Cyst Fibros. 2023 May;22(3):402-406. doi: 10.1016/j.jcf.2022.12.009. Epub 2022 Dec 27.

Abstract

Elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) was shown to be safe and efficacious in people with cystic fibrosis (CF) with ≥ 1 F508del-CFTR allele in Phase 3 clinical trials. ELX/TEZ/IVA treatment led to improved lung function, with increases in percent predicted forced expiratory volume in 1 second (ppFEV1) and Cystic Fibrosis Questionnaire-Revised respiratory domain score. Here, we evaluated the impact of ELX/TEZ/IVA on the rate of lung function decline over time by comparing changes in ppFEV1 in participants from the Phase 3 trials with a matched group of people with CF from the US Cystic Fibrosis Foundation Patient Registry not eligible for cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy. Participants treated with ELX/TEZ/IVA had on average no loss of pulmonary function over a 2-year period (mean annualized rate of change in ppFEV1, +0.39 percentage points [95% CI, -0.06 to 0.85]) compared with a 1.92 percentage point annual decline (95% CI, -2.16 to -1.69) in ppFEV1 in untreated controls. ELX/TEZ/IVA is the first CFTR modulator therapy shown to halt lung function decline over an extended time period.

Keywords: Cystic fibrosis; Cystic fibrosis transmembrane conductance regulator modulator; Elexacaftor/tezacaftor/ivacaftor; F508del-CFTR; Lung function.

MeSH terms

  • Aminophenols / adverse effects
  • Benzodioxoles / therapeutic use
  • Chloride Channel Agonists / therapeutic use
  • Cystic Fibrosis Transmembrane Conductance Regulator / genetics
  • Cystic Fibrosis Transmembrane Conductance Regulator / therapeutic use
  • Cystic Fibrosis* / drug therapy
  • Cystic Fibrosis* / genetics
  • Double-Blind Method
  • Humans
  • Lung
  • Mutation

Substances

  • Cystic Fibrosis Transmembrane Conductance Regulator
  • elexacaftor
  • ivacaftor
  • tezacaftor
  • Aminophenols
  • Benzodioxoles
  • Chloride Channel Agonists