Journal of Cystic Fibrosis最新文献

{"title":"A phase I study assessing the safety and tolerability of SPL84, an inhaled antisense oligonucleotide for treatment of cystic fibrosis patients with the 3849 +10kb C->T","authors":"Yoseph Caraco ,&nbsp;Maor Wanounou ,&nbsp;Simcha Blotnick ,&nbsp;Lital Friedman ,&nbsp;Asaf Cohen ,&nbsp;Gili Hart ,&nbsp;Eitan Kerem","doi":"10.1016/j.jcf.2024.10.004","DOIUrl":"10.1016/j.jcf.2024.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Antisense Oligonucleotides (ASOs) are small synthetic nucleic acid molecules able to bind specific sequences within target Ribonucleic Acid (RNA) molecules. SPL84 is an ASO drug developed for treatment of cystic fibrosis (CF) patients carrying the 3849 + 10 kb C-&gt;T Cystic Fibrosis Transmembrane Conductance Regulator (<em>CFTR</em>) splicing mutation. The 3849 + 10 kb C-&gt;T variant leads to inclusion of cryptic exon harboring stop codon leading to the production of truncated non-functional <em>CFTR</em> proteins. <em>in vitro</em>, SPL84 treatment results in splicing modulation, which leads to an increase of correctly spliced <em>CFTR</em> RNA and higher levels of functional <em>CFTR</em> proteins.</div></div><div><h3>Methods</h3><div>SPL84 was tested in a blinded, placebo-controlled phase 1 study in thirty two (32) healthy volunteers (HVs), each received a single dose of either SPL84 or placebo by inhalation. A total of 8 participants were randomized to each of the 4 escalating cohorts in a 3:1 ratio (active: placebo). Safety and tolerability were evaluated by monitoring adverse events (AEs), vital signs, physical exam findings, spirometry, electrocardiograms (ECG), and analyses of safety laboratories. Blood samples were obtained periodically over 24 h for measurement of systemic exposure.</div></div><div><h3>Results</h3><div>There were no significant changes from baseline in vital signs, clinical laboratory values, ECG, physical examination, or pulmonary function. There were no Serious Adverse Events (SAEs) in the study, and there were no significant adverse events. The systemic exposure to SPL84 was low and tended to be dose dependent. The exposure, expressed in terms of area under the curve to infinity (AUC_inf), at the no observed adverse effect level (NOAEL) in 9-week toxicological mice study was 7.51 µg/ml*hrs, which is ∼20 times higher than the exposure at the 160 mg dose (444 ng/ml*hrs).</div></div><div><h3>Conclusions</h3><div>SPL84 was safe and well-tolerated when administered as a single inhaled dose to HVs at doses up to 160 mg, with minimal systemic exposure. There were no safety issues observed, no SAEs, no significant related AEs, and, importantly, no significant effect on pulmonary function. The successful completion of the study enabled the initiation of multi-dosing of CF patients in a phase 2 clinical study.</div></div>","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":"24 1","pages":"Pages 66-71"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"News article","authors":"","doi":"10.1016/j.jcf.2025.01.003","DOIUrl":"10.1016/j.jcf.2025.01.003","url":null,"abstract":"","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":"24 1","pages":"Pages 1-2"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A W1282X cystic fibrosis mouse allows the study of pharmacological and gene-editing therapeutics to restore CFTR function","authors":"Margaret Michicich,&nbsp;Zachary Traylor,&nbsp;Caitlan McCoy,&nbsp;Dana M. Valerio,&nbsp;Alma Wilson,&nbsp;Molly Schneider,&nbsp;Sakeena Davis,&nbsp;Amanda Barabas,&nbsp;Rachel J. Mann,&nbsp;David F. LePage,&nbsp;Weihong Jiang,&nbsp;Mitchell L. Drumm,&nbsp;Thomas J. Kelley,&nbsp;Ronald A. Conlon,&nbsp;Craig A. Hodges","doi":"10.1016/j.jcf.2024.10.008","DOIUrl":"10.1016/j.jcf.2024.10.008","url":null,"abstract":"<div><h3>Background</h3><div>People with cystic fibrosis carrying two nonsense alleles lack CFTR-specific treatment. Growing evidence supports the hypothesis that nonsense mutation identity affects therapeutic response, calling for mutation-specific CF models. We describe a novel <em>W1282X</em> mouse model and compare it to an existing <em>G542X</em> mouse.</div></div><div><h3>Methods</h3><div>The <em>W1282X</em> mouse was created using CRISPR/Cas9 to edit mouse <em>Cftr</em>. In this model, <em>Cftr</em> transcription was assessed using qRT-PCR and CFTR function was measured in the airway by nasal potential difference and in the intestine by short circuit current. Growth, survival, and intestinal motility were examined as well. Correction of <em>W1282X</em> CFTR was assessed pharmacologically and by gene-editing using a forskolin-induced swelling (FIS) assay in small intestine-derived organoids.</div></div><div><h3>Results</h3><div>Homozygous <em>W1282X</em> mice demonstrate decreased <em>Cftr</em> mRNA, little to no CFTR function, and reduced survival, growth, and intestinal motility. <em>W1282X</em> organoids treated with various combinations of pharmacologic correctors display a significantly different amount of CFTR function than that of organoids from <em>G542X</em> mice. Successful gene editing of <em>W1282X</em> to wildtype sequence in intestinal organoids was achieved leading to restoration of CFTR function.</div></div><div><h3>Conclusions</h3><div>The <em>W1282X</em> mouse model recapitulates common human manifestations of CF similar to other CFTR null mice. Despite the similarities between the congenic <em>W1282X</em> and <em>G542X</em> models, they differ meaningfully in their response to identical pharmacological treatments. This heterogeneity highlights the importance of studying therapeutics across genotypes.</div></div>","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":"24 1","pages":"Pages 164-174"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Process and validity of linking cystic fibrosis patient registry with national Medicaid databases","authors":"Charles R. Esther Jr ,&nbsp;Melanie Rua ,&nbsp;Haoqian Chen ,&nbsp;Elizabeth Cromwell ,&nbsp;Soko Setoguchi","doi":"10.1016/j.jcf.2024.10.012","DOIUrl":"10.1016/j.jcf.2024.10.012","url":null,"abstract":"<div><h3>Background</h3><div>The Cystic Fibrosis Foundation Patient Registry (CFFPR) provides valuable clinical and demographic data but includes limited information on health services and medications provided outside of CF Care Centers. Linking CFFPR to claims databases such as national Medicaid data could address these data gaps.</div></div><div><h3>Methods</h3><div>Linkage algorithms based on state of residence, gender, and date of birth were utilized to match individuals with CF diagnostic codes in national Medicaid databases (2016) to individuals in the CFFPR (2015–2016). Subsets of individuals with partial social security numbers or residing in the state of North Carolina were utilized to validate the accuracy of linkages and perform exploratory analyses on care utilization and costs.</div></div><div><h3>Results</h3><div>Of the 32,152 individuals in CFFPR, 10,616 were uniquely linked to national Medicaid databases. The 372 linked individuals within the NC extract had 8.0 ± 7.6 visits to outpatient providers, substantially higher than the 4.2 ± 2.4 CF Care Center outpatient visits documented within CFFPR. Similarly, linked individuals had 2.1 ± 1.7 oral antibiotic prescriptions within CMS pharmacy databases versus 0.5 ± 1.9 oral antibiotic prescriptions in CFFPR. Total pharmacy costs for the linked individuals in NC were $16.4 million, with pancrealipase (19 %), dornase alfa (24 %), and CFTR modulators (29 %) the largest expenditures. Total non-pharmacy costs were $7.5 million, with inpatient hospitalization representing 53 % of costs.</div></div><div><h3>Conclusion</h3><div>Linkage of data from Medicaid and CFFPR can produce valid comprehensive data on low-income people with CF and provide opportunities to examine utilization/adherence or comparative effectiveness and safety of medications as well as conduct economic analyses in the low-income CF population.</div></div>","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":"24 1","pages":"Pages 118-124"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of LAU-7b in a Phase 2 trial in adults with cystic fibrosis","authors":"Michael W. Konstan ,&nbsp;Deepika Polineni ,&nbsp;James F. Chmiel ,&nbsp;Lara Bilodeau ,&nbsp;Peter G. Middleton ,&nbsp;Elias Matouk ,&nbsp;Jean-Marie Houle ,&nbsp;Radu Pislariu ,&nbsp;Patrick Colin ,&nbsp;Irenej Kianicka ,&nbsp;Diane Potvin ,&nbsp;Danuta Radzioch ,&nbsp;Tom Kotsimbos ,&nbsp;Jonathan B. Zuckerman ,&nbsp;Samya Z. Nasr ,&nbsp;Theodore G. Liou ,&nbsp;Larry C. Lands ,&nbsp;study Investigators","doi":"10.1016/j.jcf.2024.07.004","DOIUrl":"10.1016/j.jcf.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><div>Lung inflammation is associated with tissue damage in cystic fibrosis (CF). LAU-7b, a novel oral drug candidate, was shown to control inflammation and stabilize CFTR protein in the epithelial membrane during inflammatory stress in preclinical models of CF.</div></div><div><h3>Methods</h3><div>A double-blind, randomized, placebo-controlled Phase 2 study was conducted to evaluate efficacy and safety of LAU-7b in adults with CF. LAU-7b or placebo was administered over 24 weeks as six 21-day treatment cycles each separated by 7 days. The primary efficacy endpoint was the absolute change from baseline in percent predicted forced expiratory volume in 1 second (ppFEV₁) at 24 weeks.</div></div><div><h3>Results</h3><div>A total of 166 subjects received at least one dose of study drug (Intent-To-Treat population, ITT), of which 122 received ≥5 treatment cycles (Per-Protocol population, PP). Both treatment arms showed a mean lung function loss at 24 weeks of 1.18 ppFEV₁ points with LAU-7b and 1.95 ppFEV₁ with placebo, a 0.77 ppFEV₁ (40 s) difference, p=0.345, and a 0.95 ppFEV₁ (49 %) difference in the same direction in PP population, p=0.263. Primary analysis of mean ppFEV₁ through 24 weeks showed differences of 1.01 and 1.23 ppFEV₁, in the ITT (65 % less loss, p=0.067) and PP populations (78 % less loss, reaching statistical significance p=0.049), respectively. LAU-7b had an acceptable safety profile.</div></div><div><h3>Conclusion</h3><div>Although the study did not meet its primary efficacy endpoint in the ITT population, LAU-7b was generally well tolerated and showed evidence of preservation of lung function to support further development.</div></div>","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":"24 1","pages":"Pages 83-90"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What does it mean to be “healthy” when taking elexacaftor/tezacaftor/ivacaftor (ETI)? A qualitative study","authors":"Robin S. Everhart ,&nbsp;Emma McWilliams ,&nbsp;Jill Maggs ,&nbsp;Gregory S. Sawicki ,&nbsp;Takeera Sconiers ,&nbsp;Kyle Smith ,&nbsp;Dana Yablon ,&nbsp;Jennifer Butcher ,&nbsp;Michelle Prickett ,&nbsp;Callie Bacon ,&nbsp;Andrea Goodman ,&nbsp;Alex H. Gifford ,&nbsp;Nicole Mayer-Hamblett ,&nbsp;David P. Nichols ,&nbsp;Kristin A. Riekert","doi":"10.1016/j.jcf.2024.11.003","DOIUrl":"10.1016/j.jcf.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Elexacaftor/tezacaftor/ivacaftor (ETI) has profoundly affected the health and lives of many people with CF (pwCF). The rapid change in health for pwCF taking ETI provided them an opportunity to reflect on what “being healthy” means. The goal of this secondary analysis was to document changes in the health and well-being of pwCF after starting ETI, beyond the expected physical benefits.</div></div><div><h3>Methods</h3><div>The Qualitative Understanding of Experiences with the SIMPLIFY Trial (QUEST) study evaluated pwCF's experiences on ETI, including participation in a withdrawal study, treatment burden, and experiences of health. Two sixty-minute interviews were conducted approximately four months apart, audio-recorded and transcribed. A phenomenological approach was used to identify text of interest and create a formal codebook.</div></div><div><h3>Results</h3><div>Ninety-one pwCF (mean age=27.8 years; range 14–67; 51 % male) and 23 caregivers of the teenagers completed at least one interview. Beyond the expected benefits of ETI, four themes were identified: (1) Night and Day Change in Health, (2) Reduced Cognitive Burden, (3) Shifting to Managing Overall Wellness and Co-Morbidities, and (4) Social/Self Identity Changes.</div></div><div><h3>Conclusion</h3><div>ETI has raised pwCF's expectations for their health and well-being. Current symptom and QOL measures may no longer capture the less perceptible ways pwCF on ETI experience changes in symptoms or health. CF care may need to adapt to focus more on general health, managing other comorbidities, and planning for the future.</div></div>","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":"24 1","pages":"Pages 187-192"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gap: Challenging lung infections and clinical trial development in cystic fibrosis","authors":"Damian G. Downey ,&nbsp;Nicholas J. Simmonds ,&nbsp;Silke van-Koningsbruggen-Rietschel ,&nbsp;Jutta Bend ,&nbsp;Fiona Dunlevy ,&nbsp;Kate Hill ,&nbsp;Lieven Dupont","doi":"10.1016/j.jcf.2024.11.001","DOIUrl":"10.1016/j.jcf.2024.11.001","url":null,"abstract":"","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":"24 1","pages":"Pages 79-82"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiometabolic risk factors in adults with cystic fibrosis undergoing elexacaftor/tezacaftor/ivacaftor therapy","authors":"Andrea Gramegna ,&nbsp;Massimiliano Ruscica ,&nbsp;Gloria Leonardi ,&nbsp;Chiara Macchi ,&nbsp;Isabella Fichtner ,&nbsp;Gianmarco Putti ,&nbsp;Margherita Carnevale Schianca ,&nbsp;Leonardo Terranova ,&nbsp;Gianfranco Alicandro ,&nbsp;Francesco Blasi","doi":"10.1016/j.jcf.2024.11.009","DOIUrl":"10.1016/j.jcf.2024.11.009","url":null,"abstract":"<div><div>The introduction of elexacaftor/tezacaftor/ivacaftor (ETI) therapy has further extended life expectancy of adults with cystic fibrosis (awCF), highlighting the need for increased attention to potential long-term health issues. Given the increasing prevalence of cardiovascular diseases in the ageing population and the presence of cardiovascular risk factors associated with CF, understanding the impact of ETI on cardiometabolic risk factors is a crucial clinical concern. The aim of our prospective observational study was to explore early changes in cardiac and metabolic biomarkers after 6 months of ETI therapy. A total of 58 consecutive awCF were enrolled during clinical stability at the Adult CF Center of the Policlinico Hospital in Milan, Italy between January 2021 and June 2022. Blood samples were obtained before ETI initiation and after 6 months, and underwent central processing for an extended panel of cardiometabolic biomarkers. We observed a rise in cholesterol, triglycerides, apolipoprotein-B and adipokine levels, while inflammatory markers decreased. The direct relationship between leptin and adiponectin suggest a disruption in the normal regulatory mechanisms that control these hormones, potentially leading to metabolic imbalances, such as increased risk of obesity and cardiovascular events. The impact of ETI on cardiovascular risk in awCF is heterogeneous and while it improves some risk factors, such as chronic inflammation, it has a worsening effect on lipoproteins. Our findings suggest that the dysregulation of adipokines could be a potential cause of the metabolic disturbances observed in awCF.</div></div>","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":"24 1","pages":"Pages 53-56"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidal behaviour and CFTR modulators: A case series and WHO database disproportionality analysis","authors":"Inès Nidegger ,&nbsp;Julie Macey ,&nbsp;Marine Ferey ,&nbsp;Allison Singier ,&nbsp;Marie Tournier ,&nbsp;Justine Perino ,&nbsp;Francesco Salvo","doi":"10.1016/j.jcf.2024.09.020","DOIUrl":"10.1016/j.jcf.2024.09.020","url":null,"abstract":"<div><h3>Background</h3><div>A highly effective therapy involving elexacaftor, tezacaftor, and ivacaftor (ETI) for cystic fibrosis (CF) patients has recently raised safety concerns regarding potential psychiatric disorders. The manuscript reports cases of suicide attempts in patients receiving ETI and investigates putative causality using the WHO spontaneous reporting database.</div></div><div><h3>Methods</h3><div>First, four cases of suicide attempts/self-injury are described. Second, a disproportionality analysis was conducted using spontaneous reports collected in Vigibase through the standardised MedDRA Query (narrow version) \"Suicide/Self-injury\" and ETI exposure. Reporting Odds Ratio (ROR) was calculated for the main and subgroup (i/suicide attempt, ii/suicidal ideation) analyses. Sensitivity analyses were performed with variations in exposure, to ivacaftor/lumacaftor to assess the intrinsic psychiatric risk of CF patients, and paracetamol as a positive control for suicide attempt and a negative one for suicidal ideation. Exposure to reduced-dose ETI was studied to evaluate the dose-gradient effect.</div></div><div><h3>Results</h3><div>Four cases of suicide attempt/self-injury occurred 3 to 13 months after ETI initiation in CF patients and were reported to the Bordeaux Pharmacovigilance centre. Aside, in Vigibase, ETI is associated with an increased likelihood of reporting suicidal behaviour (ROR 2.5, 95 % CI[2.1; 2.8]). A signal of disproportionate reporting was found for the subgroup of suicide attempts (1.4, 95 % CI[1.2; 1.8]), unlike ivacaftor/lumacaftor, which was associated only with the risk of reporting suicidal ideation. Significant ROR values were also found for reduced-dose ETI for all psychiatric effects studied except suicide attempt.</div></div><div><h3>Conclusions</h3><div>ETI exposure is related with increased reporting of suicidal behaviour. A potential dose-dependent effect merits further investigation.</div></div>","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":"24 1","pages":"Pages 33-39"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ETD001: A novel inhaled ENaC blocker with an extended duration of action in vivo","authors":"Henry Danahay ,&nbsp;Clive McCarthy ,&nbsp;Thomas Schofield ,&nbsp;Roy Fox ,&nbsp;Holly Charlton ,&nbsp;Sarah Lilley ,&nbsp;Juan Sabater ,&nbsp;Matthias Salathe ,&nbsp;Nathalie Baumlin ,&nbsp;Stephen P Collingwood ,&nbsp;Martin Gosling","doi":"10.1016/j.jcf.2024.06.002","DOIUrl":"10.1016/j.jcf.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Inhibiting ENaC in the airways of people with cystic fibrosis (pwCF) is hypothesized to enhance mucociliary clearance (MCC) and provide clinical benefit. Historically, inhaled ENaC blockers have failed to show benefit in pwCF challenging this hypothesis. It is however unknown whether the clinical doses were sufficient to provide the required long duration of action in the lungs and questions whether a novel candidate could offer advantages where others have failed?</div></div><div><h3>Methods</h3><div>Dose-responses with the failed ENaC blockers (VX-371, BI 1265162, AZD5634, QBW276) together with ETD001 (a novel long acting inhaled ENaC blocker) were established in a sheep model of MCC and were used to predict clinically relevant doses that would provide a long-lasting enhancement of MCC in pwCF. In each case, dose predictions were compared with the selected clinical dose.</div></div><div><h3>Results</h3><div>Each of the failed candidates enhanced MCC in the sheep model. Translating these dose-response data to human equivalent doses, predicted that substantially larger doses of each candidate, than were evaluated in clinical studies, would likely have been required to achieve a prolonged enhancement of MCC in pwCF. In contrast, ETD001 displayed a long duration of action (≥16 h) at a dose level that was well tolerated in Phase 1 clinical studies.</div></div><div><h3>Conclusions</h3><div>These data support that the ENaC blocker hypothesis is yet to be appropriately tested in pwCF. ETD001 has a profile that enables dosing at a level sufficient to provide a long duration of action in a Phase 2 clinical study in pwCF scheduled for 2024.</div></div>","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":"24 1","pages":"Pages 72-78"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}