Gruber Wolfgang, Welsner Matthias, Blosch Christopher, Dillenhoefer Stefanie, Olivier Margarete, Brinkmann Folke, Koerner-Rettberg Cordula, Sutharsan Sivagurunathan, Mellies Uwe, Taube Christian, Stehling Florian
Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University of Duisburg-Essen, 45147 Essen, Germany.
Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, 24118 Kiel, Germany.
Healthcare (Basel). 2023 Oct 31;11(21):2873. doi: 10.3390/healthcare11212873.
Longitudinal data on changes in health-related quality of life (HRQoL) in adult people with cystic fibrosis (pwCF) and the longitudinal effects of Elexacaftor/Tezacaftor/Ivacaftor therapy (ETI) on HRQoL or HRQoL domains are currently scarce. This study aimed to investigate the effects of ETI on HRQoL and compare them with those of pwCF who did not receive highly effective CFTR modulators over a longer period.
Baseline assessment and follow-up data for 5.6 years in pwCF with ( = 21) and 6.5 years in pwCF without ( = 6) ETI (≥18 years) were evaluated. The assessment of HRQoL and clinical parameters was identical at both time points. HRQoL was assessed using the CFQ-R, and clinical outcomes included BMI, ppFEV1, and FEV1 z-score.
ETI was found to improve all HRQoL domains at more than four points over time, and their increases were significant except for vitality, digestion, treatment burden, and social functioning ( < 0.05). Without ETI, psychosocial domains remained almost constant, whereas most physical domains decreased over time.
The results of the present study show that ETI therapy has a positive effect on HRQoL and clinical outcomes over time but not in pwCF without ETI treatment. Furthermore, our results suggest that disease progression over time affects the physical domains of HRQoL more than the psychosocial domains. Due to the small sample size and the heterogeneity of the study population (CFTR mutation genotype), the results should be interpreted with some caution.
目前,关于成年囊性纤维化患者(pwCF)健康相关生活质量(HRQoL)变化的纵向数据以及依列卡福妥/替扎卡福妥/艾伐卡福妥疗法(ETI)对HRQoL或HRQoL领域的纵向影响较为匮乏。本研究旨在调查ETI对HRQoL的影响,并将其与长期未接受高效CFTR调节剂治疗的pwCF患者的影响进行比较。
对接受ETI治疗的21例pwCF患者(≥18岁)进行了5.6年的基线评估和随访数据评估,对未接受ETI治疗的6例pwCF患者进行了6.5年的基线评估和随访数据评估。两个时间点对HRQoL和临床参数的评估相同。使用CFQ-R评估HRQoL,临床结局包括BMI、ppFEV1和FEV1 z评分。
发现ETI随着时间的推移使所有HRQoL领域改善超过4分,除活力、消化、治疗负担和社会功能外,其改善具有显著性(P<0.05)。未接受ETI治疗时,心理社会领域几乎保持不变,而大多数身体领域随时间下降。
本研究结果表明,随着时间的推移,ETI疗法对HRQoL和临床结局有积极影响,但对未接受ETI治疗的pwCF患者没有影响。此外,我们的结果表明,随着时间的推移,疾病进展对HRQoL身体领域的影响大于心理社会领域。由于样本量小且研究人群(CFTR突变基因型)存在异质性,对结果的解释应谨慎。