Cystic fibrosis triple therapy likely contributed to exacerbation decrease during pandemic
A new study highlighted a decrease in pulmonary exacerbations during the COVID-19 pandemic among patients with cystic fibrosis receiving triple therapy with elexacaftor/tezacaftor/ivacaftor.
“Highly effective elexacaftor/tezacaftor/ivacaftor therapy likely contributed to a considerable decrease in documented exacerbations beyond that attributable to the COVID-19 pandemic and the observed trends of health care avoidance within this context,” Elizabeth Menten, a first-year medical student at New York University Grossman School of Medicine, said during a presentation at the virtual North American Cystic Fibrosis Conference.
Researchers reviewed clinic and telehealth visit patient encounters and pulmonary exacerbations among patients who were enrolled in the Cystic Fibrosis Foundation Patient Registry at the Columbia University adult CF program in 2019 and 2020.
From 2019 to 2020, there was a 24% decrease in the number of patient encounters overall, a 55.9% decrease in in-person clinic visits and a 60.6% decrease in reported pulmonary exacerbations, Menten said. The number of patient encounters in 2020 was similar among patients who started elexacaftor/tezacaftor/ivacaftor (Trikafta, Vertex Pharmaceuticals) before or within the first quarter of 2020 compared with those who were receiving other modulator therapies or who initiated triple therapy after first quarter 2020.
Researchers also observed a greater reduction in overall pulmonary exacerbation incidence rates among those who received triple therapy compared with those who did not (80.2% vs. 29.5%). Results showed a greater reduction in severe exacerbations from 2019 to 2020, compared with mild and moderate exacerbations, among both those who received triple therapy (76% vs. 88.5%) and those who did not (26% vs. 36.4%). Across all pulmonary exacerbation types, between-group differences were significant (P < .001), according to the researchers.
“The exacerbation incidence rate within the elexacaftor/tezacaftor/ivacaftor population is more significantly reduced, indicating that highly effective elexacaftor/tezacaftor/ivacaftor therapy has positive therapeutic impacts for this population,” Menten said.