Impact of Elexacaftor/Tezacaftor/Ivacaftor on Fecal Elastase-1 in Children With Cystic Fibrosis.

IF 2.7 3区 医学 Q1 PEDIATRICS
Senthilkumar Sankararaman, Leesa Prunty, Catherine Pamer, Aravind Thavamani, Erica Roesch, Teresa Schindler
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引用次数: 0

Abstract

Background: Prior studies have documented improvement in pancreatic status after ivacaftor and lumacaftor/ivacaftor in a small number of patients with cystic fibrosis (CF). There is paucity of data with similar improvement after initiation of elexacaftor/tezacaftor/ivacaftor (ETI).

Methods: In this cross-sectional study, we retrospectively reviewed the change in fecal elastase-1 (FE-1) at least 6 months after initiation of ETI in children less than 12 years of age. Children who demonstrated a change in FE-1 of ≥ 100 µg/g from the baseline after ETI therapy (post-ETI FE-1 minus pre-ETI FE-1) were termed as responders and those with a change in FE-1 < 100 µg/g post-ETI (or no change in FE-1) were termed as nonresponders.

Results: Thirty-five children had post-ETI FE-1 value at least 6 months after its initiation and were included for final review. The mean change (±SD) in FE-1 post-ETI from the baseline in the entire cohort was 47.2 ± 89.5. Seven children had a change in FE-1 of ≥ 100 µg/g or more post-ETI (responders). Two of these seven patients had a change in FE-1 of ≥ 200 µg/g post-ETI. Twenty-three had no change or change < 100 µg/g post-ETI (nonresponders). Another five children who did not have a baseline FE-1 and had post-ETI FE-1 < 10 µg/g were also added to the nonresponders cohort increasing the total number to 28. The pre- and post-ETI body mass index was significantly higher in the responder group compared to the nonresponders.

Conclusion: In our cohort of 35 children, 7 (20%) were noted to have a positive change in FE-1 from the baseline value of ≥ 100 µg/g post-ETI. Further prospective multicenter studies will help identify predictive factors associated with improvement in FE-1 after initiation of CFTR-directed modulator therapies.

elexaftor /Tezacaftor/Ivacaftor对囊性纤维化患儿粪便弹性酶-1的影响。
背景:先前的研究表明,在少数囊性纤维化(CF)患者中,ivacaftor和lumacaftor/ivacaftor治疗后胰腺状况有所改善。在开始使用体外提取器/ tezacftor /ivacaftor (ETI)后,缺乏类似改善的数据。方法:在这项横断面研究中,我们回顾性回顾了12岁以下儿童开始ETI至少6个月后粪便弹性酶-1 (FE-1)的变化。ETI治疗后FE-1变化(ETI后FE-1减去ETI前FE-1)较基线变化≥100 μ g/g的儿童被称为反应者,而FE-1变化的儿童被称为反应者。结果:35名儿童在ETI治疗开始后至少6个月具有ETI后FE-1值,并被纳入最终审查。在整个队列中,eti后FE-1与基线相比的平均变化(±SD)为47.2±89.5。7名儿童在eti后FE-1变化≥100µg/g(应答者)。7例患者中有2例在eti后FE-1变化≥200µg/g。结论:在我们的35名儿童队列中,7名(20%)被注意到eti后FE-1较基线值≥100 μ g/g有阳性变化。进一步的前瞻性多中心研究将有助于确定与cftr定向调节剂治疗开始后FE-1改善相关的预测因素。
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来源期刊
Pediatric Pulmonology
Pediatric Pulmonology 医学-呼吸系统
CiteScore
6.00
自引率
12.90%
发文量
468
审稿时长
3-8 weeks
期刊介绍: Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.
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