Long-Term Outcomes in Real Life of Lumacaftor–Ivacaftor Treatment in Adolescents With Cystic Fibrosis
Background: The combination of the CFTR corrector lumacaftor (LUM) and potentiator ivacaftor (IVA) has been labeled in France since 2015 for F508del homozygote cystic fibrosis (CF) patients over 12 years. In this real-life study, we aimed (i) to compare the changes in lung function, clinical (e.g.,...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:cf2af5d930334a16a3f31dfa40ab41d42021-11-15T14:08:50ZLong-Term Outcomes in Real Life of Lumacaftor–Ivacaftor Treatment in Adolescents With Cystic Fibrosis2296-236010.3389/fped.2021.744705https://doaj.org/article/cf2af5d930334a16a3f31dfa40ab41d42021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fped.2021.744705/fullhttps://doaj.org/toc/2296-2360Background: The combination of the CFTR corrector lumacaftor (LUM) and potentiator ivacaftor (IVA) has been labeled in France since 2015 for F508del homozygote cystic fibrosis (CF) patients over 12 years. In this real-life study, we aimed (i) to compare the changes in lung function, clinical (e.g., body mass index and pulmonary exacerbations) and radiological parameters, and in sweat chloride concentration before and after initiation of LUM/IVA treatment; (ii) to identify factors associated with response to treatment; and (iii) to assess the tolerance to treatment.Materials and Methods: In this tri-center, non-interventional, and observational cohort study, children (12–18 years old) were assessed prospectively during the 2 years of therapy, and retrospectively during the 2 years preceding treatment. Data collected and analyzed for the study were exclusively extracted from the medical electronic system records of the patients.Results: Forty adolescents aged 12.0–17.4 years at LUM/IVA initiation were included. The lung function decreased significantly during and prior to treatment and increased after LUM/IVA initiation, becoming significant after 2 years of treatment. LUM/IVA significantly improved the BMI Z-score and sweat chloride concentration. By contrast, there was no significant change in exacerbation rates, antibiotic use, or CT scan scores. Age at LUM/IVA initiation was lower in good responders and associated with greater ppFEV1 change during the 2 years of treatment. LUM/IVA was well-tolerated.Conclusion: In F508del homozygote adolescents, real-life long-term LUM/IVA improved the ppFEV1 trajectory, particularly in the youngest patients, nutritional status, and sweat chloride concentration but not exacerbation rates or radiological scores. LUM/IVA was generally well-tolerated and safe.Stéphanie BuiAlexandra MassonRaphaël EnaudRaphaël EnaudLéa RoditisGaël DournesFrançois GalodeCyrielle ColletEmmanuel MasJeanne LanguepinMichael FayonMichael FayonFabien BeaufilsFabien BeaufilsMarie MittaineFrontiers Media S.A.articlecystic fibrosischildCFTR potentiatorCFTR correctorlung function testingnutritional statusPediatricsRJ1-570ENFrontiers in Pediatrics, Vol 9 (2021) |
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cystic fibrosis child CFTR potentiator CFTR corrector lung function testing nutritional status Pediatrics RJ1-570 |
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cystic fibrosis child CFTR potentiator CFTR corrector lung function testing nutritional status Pediatrics RJ1-570 Stéphanie Bui Alexandra Masson Raphaël Enaud Raphaël Enaud Léa Roditis Gaël Dournes François Galode Cyrielle Collet Emmanuel Mas Jeanne Languepin Michael Fayon Michael Fayon Fabien Beaufils Fabien Beaufils Marie Mittaine Long-Term Outcomes in Real Life of Lumacaftor–Ivacaftor Treatment in Adolescents With Cystic Fibrosis |
| description |
Background: The combination of the CFTR corrector lumacaftor (LUM) and potentiator ivacaftor (IVA) has been labeled in France since 2015 for F508del homozygote cystic fibrosis (CF) patients over 12 years. In this real-life study, we aimed (i) to compare the changes in lung function, clinical (e.g., body mass index and pulmonary exacerbations) and radiological parameters, and in sweat chloride concentration before and after initiation of LUM/IVA treatment; (ii) to identify factors associated with response to treatment; and (iii) to assess the tolerance to treatment.Materials and Methods: In this tri-center, non-interventional, and observational cohort study, children (12–18 years old) were assessed prospectively during the 2 years of therapy, and retrospectively during the 2 years preceding treatment. Data collected and analyzed for the study were exclusively extracted from the medical electronic system records of the patients.Results: Forty adolescents aged 12.0–17.4 years at LUM/IVA initiation were included. The lung function decreased significantly during and prior to treatment and increased after LUM/IVA initiation, becoming significant after 2 years of treatment. LUM/IVA significantly improved the BMI Z-score and sweat chloride concentration. By contrast, there was no significant change in exacerbation rates, antibiotic use, or CT scan scores. Age at LUM/IVA initiation was lower in good responders and associated with greater ppFEV1 change during the 2 years of treatment. LUM/IVA was well-tolerated.Conclusion: In F508del homozygote adolescents, real-life long-term LUM/IVA improved the ppFEV1 trajectory, particularly in the youngest patients, nutritional status, and sweat chloride concentration but not exacerbation rates or radiological scores. LUM/IVA was generally well-tolerated and safe. |
| format |
article |
| author |
Stéphanie Bui Alexandra Masson Raphaël Enaud Raphaël Enaud Léa Roditis Gaël Dournes François Galode Cyrielle Collet Emmanuel Mas Jeanne Languepin Michael Fayon Michael Fayon Fabien Beaufils Fabien Beaufils Marie Mittaine |
| author_facet |
Stéphanie Bui Alexandra Masson Raphaël Enaud Raphaël Enaud Léa Roditis Gaël Dournes François Galode Cyrielle Collet Emmanuel Mas Jeanne Languepin Michael Fayon Michael Fayon Fabien Beaufils Fabien Beaufils Marie Mittaine |
| author_sort |
Stéphanie Bui |
| title |
Long-Term Outcomes in Real Life of Lumacaftor–Ivacaftor Treatment in Adolescents With Cystic Fibrosis |
| title_short |
Long-Term Outcomes in Real Life of Lumacaftor–Ivacaftor Treatment in Adolescents With Cystic Fibrosis |
| title_full |
Long-Term Outcomes in Real Life of Lumacaftor–Ivacaftor Treatment in Adolescents With Cystic Fibrosis |
| title_fullStr |
Long-Term Outcomes in Real Life of Lumacaftor–Ivacaftor Treatment in Adolescents With Cystic Fibrosis |
| title_full_unstemmed |
Long-Term Outcomes in Real Life of Lumacaftor–Ivacaftor Treatment in Adolescents With Cystic Fibrosis |
| title_sort |
long-term outcomes in real life of lumacaftor–ivacaftor treatment in adolescents with cystic fibrosis |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/cf2af5d930334a16a3f31dfa40ab41d4 |
| work_keys_str_mv |
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