2024
Improved Nutritional Outcomes and Gastrointestinal Symptoms in Adult Cystic Fibrosis Patients Treated with Elexacaftor/Tezacaftor/Ivacaftor
ŠŤASTNÁ, Nela, Lumír KUNOVSKÝ, Michal SVOBODA, Eva POKOJOVÁ, Lukáš HOMOLA et. al.Basic information
Original name
Improved Nutritional Outcomes and Gastrointestinal Symptoms in Adult Cystic Fibrosis Patients Treated with Elexacaftor/Tezacaftor/Ivacaftor
Authors
ŠŤASTNÁ, Nela (203 Czech Republic, belonging to the institution), Lumír KUNOVSKÝ (203 Czech Republic, belonging to the institution), Michal SVOBODA (203 Czech Republic, belonging to the institution), Eva POKOJOVÁ (203 Czech Republic, belonging to the institution), Lukáš HOMOLA (203 Czech Republic, belonging to the institution), Miriam MALÁ (203 Czech Republic, belonging to the institution), Žaneta GRÁCOVÁ (203 Czech Republic), Barbora JEŘÁBKOVÁ (203 Czech Republic), Jana SKŘIČKOVÁ (203 Czech Republic, belonging to the institution) and Jan TRNA (203 Czech Republic, belonging to the institution)
Edition
Digestive Diseases, BASEL, KARGER, 2024, 0257-2753
Other information
Language
English
Type of outcome
Article in a journal
Field of Study
30219 Gastroenterology and hepatology
Country of publisher
Switzerland
Confidentiality degree
is not subject to a state or trade secret
References:
Impact factor
Impact factor: 2.000 in 2023
Organization unit
Faculty of Medicine
UT WoS
001243080000001
Keywords in English
Cystic fibrosis; Elexacaftor/tezacaftor/ivacaftor; Nutrition; Exocrine pancreas function; Pancreatic enzyme replacement therapy
Tags
International impact, Reviewed
Changed: 3/2/2025 11:06, Mgr. Tereza Miškechová
Abstract
V originále
Introduction: Cystic fibrosis transmembrane conductance regulator modulator therapy improves nutritional status and quality of life. Clinical trials have shown pancreatic insufficiency conversion, mostly in pediatric patients treated with ivacaftor. Studies with elexacaftor/tezacaftor/ivacaftor (ETI) in older patients have not suggested restoration of exocrine pancreas function, but quality data in adults are lacking. Our aim was to show the effect of ETI in adults with cystic fibrosis (CF) on nutritional status and digestive function. We hypothesized improvement of nutritional parameters and gastrointestinal symptoms, reduction of pancreatic enzyme replacement therapy, but uncertain improvement in exocrine pancreatic function. Methods: We prospectively enrolled adults with CF treated with ETI from August 2021 to June 2022. We measured anthropometric parameters, laboratory nutritional markers, change of fecal elastase, pancreatic enzymes replacement therapy needs, and gastrointestinal symptoms. Results: In the cohort of 29 patients (mean age 29.1 years), 82.8% suffered exocrine pancreatic insufficiency. After ETI, 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). Only 1 patient, initially pancreatic insufficient (4.5%, p < 0.001), developed pancreatic sufficiency, indicated by increased fecal elastase from 45 μg/g to 442.1 μg/g. Mean change in lipase substitution decreased by 1,969 units/kg/day (p < 0.001) and stools frequency by 1.18 per day (p < 0.001). Conclusion: Our data suggest increased nutritional parameters, lower pancreatic substitution requirements, and improved defecation in adult CF patients on ETI. Improvement in exocrine pancreatic function might be mutation-specific and needs further study.