WS01.03Factors associated with persistent Pseudomonas aeruginosa infection following elexacaftor/tezacaftor/ivacaftor treatment: insights from the European Cystic Fibrosis Society Patient Registry

IF 5.4 2区医学 Q1 RESPIRATORY SYSTEM

Journal of Cystic Fibrosis Pub Date : 2025-06-01 DOI:10.1016/j.jcf.2025.03.494

M. Pollak , S. Gambazza , A. Orenti , V. De Rose , D. Prais , E. Kerem , M. Mei-Zahav , ECFSPR Steering Group

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引用次数: 0

Abstract

Objective

Elexacaftor/tezacaftor/ivacaftor (ETI) treatment was shown to reduce airway colonization rate of P. aeruginosa (Pa). We aimed to identify factors associated with sustained Pa infection, while on ETI therapy.

Methods

Using the European Cystic Fibrosis Society Patient Registry, people with CF (pwCF) who initiated ETI therapy in 2019-2021 were identified. Multivariable logistic regression was used to explore clinical and demographic factors associated with the probability of remaining Pa chronic, while changes in clinical data from one year before to one year after ETI initiation were assessed using multivariable semiparametric models.

Results

In total, 6048 pwCF from 30 countries were Pa positive one year prior to ETI initiation. Of these, 3708 remained positive one year after ETI initiation, while 2340 shifted to Pa negative. Female sex (Odds Ratio (OR) 1.51, p<001), age (OR 1.56, P<0.001), D508F heterozygous (OR 1.38, P<0.001) or other genotype vs D508F homozygous (OR 2.38, P<0.001), BMI Z-score (OR 0.82, P<0.001), ppFEV₁ (OR 0.66, P<0.001), GNI (OR 1.06, P=0.02), chronic Burkholderia (OR 0.45, P<0.001) and CF related diabetes (OR 0.82, P=0.001) were factors found associated with the probability of remaining Pa chronic. Change in ppFEV₁ following ETI was similar between those who remained Pa positive (12.0, 95% CI: 11.2–12.7) and those who did not (12.3, 95% CI: 11.5–13.0, p=0.31). BMI Z score change also showed no significant difference (0.40, 95% CI: 0.36–0.44 vs. 0.42, 95% CI: 0.38–0.46, p=0.08). The expected mean hospital days after ETI were higher in those who remained Pa positive: 1.8 (95%CI: 1.4 to 2.2) versus 1.2 (95%CI: 0.9 to 1.4, p<0.001).

Conclusion

Several factors specific of more severe CF disease were linked to a higher probability of remaining Pa positive despite ETI. Nonetheless, most clinical parameters showed similar improvement regardless of Pa status changes.

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elexaftor /tezacaftor/ivacaftor治疗后持续性铜绿假单胞菌感染的相关因素：来自欧洲囊性纤维化协会患者登记的见解

目的观察艾抽/泰扎/艾抽（ETI）治疗可降低铜绿假单胞菌（P. aeruginosa, Pa）气道定植率。我们的目的是确定在接受ETI治疗时与持续Pa感染相关的因素。方法使用欧洲囊性纤维化协会患者登记处，确定2019-2021年开始ETI治疗的CF （pwCF）患者。使用多变量逻辑回归来探索与慢性Pa残留概率相关的临床和人口因素，同时使用多变量半参数模型评估ETI开始前和开始后一年的临床数据变化。结果来自30个国家的6048例pwCF在ETI开始前1年呈Pa阳性。其中，3708个在ETI启动一年后仍保持阳性，而2340个则变为负Pa。女性（比值比（OR） 1.51, p<001）、年龄（OR 1.56, p< 0.001）、D508F杂合子（OR 1.38, p< 0.001）或其他基因型vs D508F纯合子（OR 2.38, p< 0.001）、BMI z评分（OR 0.82, p< 0.001）、ppFEV1 （OR 0.66, p< 0.001）、GNI （OR 1.06， P=0.02）、慢性伯氏杆菌（OR 0.45, p< 0.001）和CF相关糖尿病（OR 0.82， P=0.001）是发现与慢性Pa剩余概率相关的因素。ETI后ppFEV1的变化在Pa呈阳性的患者（12.0,95% CI: 11.2-12.7）和未呈阳性的患者（12.3,95% CI: 11.5-13.0, p=0.31）之间相似。BMI Z评分变化也无显著差异（0.40,95% CI: 0.36-0.44 vs. 0.42, 95% CI: 0.38-0.46, p=0.08）。在Pa呈阳性的患者中，ETI后的预期平均住院天数更高：1.8 （95%CI: 1.4至2.2）比1.2 （95%CI: 0.9至1.4,p<0.001）。结论：更严重的CF疾病特有的几个因素与ETI后Pa保持阳性的可能性更高有关。尽管如此，无论Pa状态如何改变，大多数临床参数都显示出类似的改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cystic Fibrosis 医学-呼吸系统

CiteScore

10.10

自引率

13.50%

发文量

1361

审稿时长

50 days

期刊介绍： The Journal of Cystic Fibrosis is the official journal of the European Cystic Fibrosis Society. The journal is devoted to promoting the research and treatment of cystic fibrosis. To this end the journal publishes original scientific articles, editorials, case reports, short communications and other information relevant to cystic fibrosis. The journal also publishes news and articles concerning the activities and policies of the ECFS as well as those of other societies related the ECFS.