a 2023

The positive nutritional and gastrointestinal effects of elexacaftor/tezacaftor/ivacaftor in the treatment of cystic fibrosis

KUNOVSKÝ, Lumír, Nela ŠŤASTNÁ, Lukáš HOMOLA, Michal SVOBODA, Eva POKOJOVÁ et. al.

Základní údaje

Originální název

The positive nutritional and gastrointestinal effects of elexacaftor/tezacaftor/ivacaftor in the treatment of cystic fibrosis

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Vydání

European Pancreatic Club 2023, 2023

Další údaje

Jazyk

angličtina

Typ výsledku

Konferenční abstrakt

Obor

30219 Gastroenterology and hepatology

Stát vydavatele

Nizozemské království

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 3.600 v roce 2022

Organizační jednotka

Lékařská fakulta

ISSN

Příznaky

Mezinárodní význam
Změněno: 30. 10. 2023 14:23, Mgr. Tereza Miškechová

Anotace

V originále

Background: Highly effective modulator therapy improves both nutritional status and quality of life. Clinical trials have even shown pancreatic insufficiency conversion, but mostly in paediatric patients treated with ivacaftor. Studies with elexacaftor/tezacaftor/ivacaftor (ETI) in older patients have not suggested the restoration of exocrine pancreas function, but quality data in adults are still lacking. Our aim was to show the effect of ETI therapy on the nutritional status and digestive function in adult patients with cystic fibrosis (CF). We hypothesized the improvement of nutritional parameters and gastrointestinal symptoms, and the reduction of pancreatic enzyme replacement therapy, but uncertain improvement in exocrine pancreatic function. Methods: This prospective study enrolled adult patients with CF treated with ETI from August 2021 to June 2022. We measured anthropometric parameters, laboratory nutritional markers, change of faecal elastase, changes in pancreatic enzymes replacement therapy needs, and gastrointestinal symptoms. Results: In the cohort of 29 adult patients with CF (mean age 29.1 years), 82.8% suffered exocrine pancreatic insufficiency. After ETI therapy, the mean BMI increased by 1.20 kg/m2 (p < 0.001), mean body weight by 3.51 kg (p < 0.001), albumin by 2.81 g/L, and prealbumin by 0.06 (both p < 0.001). One patient (4.5%, p < 0.001) developed pancreatic sufficiency, indicated by faecal elastase > 200 μg/g. The mean change in lipase substitution decreased by 1,969 units/kg/day (p < 0.001) and stool frequency by 1.18 per day (p < 0.001). No acute pancreatitis was observed. Conclusion: Our data suggests increased nutritional parameters, a restoration of exocrine pancreatic function, lower pancreatic substitution requirements, and improved defecation in adult CF patients on ETI therapy. Improvement in exocrine pancreatic function might be mutation-specific and requires further study.