WS01.02Use of medications for sleep, depression, and anxiety in people with cystic fibrosis before and after initiation of elexacaftor/tezacaftor/ivacaftor

Objectives

Investigate the association between initiation of elexacaftor/tezacaftor/ivacaftor (ETI) and the use of medications for sleep, depression, and anxiety in people with cystic fibrosis (pwCF).

Methods

All pwCF aged ≥12 years initiating ETI treatment 21.08.2020-31.12.2021 in Denmark were included in a pre-post study with two years of follow-up in both the pre- and post-intervention periods. A control group from the general population was matched 1:10 on age and sex. Outcomes were prevalent user status defined as at least one redeemed prescription in the preceding year of 1) sleep-promoting medicines (SPM) and 2) antidepressants and/or anxiolytics (AA). Prescriptions were obtained from the Danish National Prescription Registry, which records all redeemed prescriptions regardless of the prescribing physician. Odds ratios (ORs) for the outcome was derived from generalized linear mixed models adjusted for age and days of COVID lockdown.

Results

286 pwCF were included in the study. In the year prior to ETI initiation, 5.2% of pwCF were prevalent users of SPM, increasing to 9.0% at the second year after ETI initiation. Conversely, pwCF using AA increased from 4.9% to 8.1%.

The adjusted ORs for being a prevalent user of SPM at year 2 compared to the pre-ETI period was 10.9 (95% CI 2.1-55.2; p=0.004) for pwCF, and this increase in odds at year 2 was significantly higher (p=0.014) in pwCF than in controls.

The adjusted ORs for being a prevalent user of AA at year 2 compared to the pre-ETI period was 11.9 (95% CI 1.8-77.0; p=0.009) for pwCF. However, this effect was not significantly different in pwCF than in controls (p=0.090).

Conclusion

We found an increase in use of SPM in pwCF after ETI initiation that was significantly higher than in the background population, strengthening the suspicion of a causal relationship between ETI and sleep disturbances. We also found an increase in use of AA in pwCF, but a similar increase was seen in the background population.