Effectiveness of ivacaftor in cystic fibrosis patients with non-G551D gating mutations

被引:29
作者
Guimbellot, Jennifer [1 ,2 ]
Solomon, George M. [1 ,3 ]
Baines, Arthur [4 ]
Heltshe, Sonya L. [4 ,5 ]
VanDalfsen, Jill [4 ]
Joseloff, Elizabeth [6 ]
Sagel, Scott D. [7 ]
Rowe, Steven M. [1 ,2 ,3 ]
机构
[1] UAB, Gregory Fleming James Cyst Fibrosis Res Ctr, Birmingham, AL USA
[2] UAB, Div Pulm & Sleep Med, Dept Pediat, Birmingham, AL USA
[3] UAB, Div Pulm Allergy & Crit Care Med, Dept Med, Birmingham, AL USA
[4] Seattle Childrens Res Inst, CFF Therapeut Dev Network Coordinating Ctr, Seattle, WA 98105 USA
[5] Univ Washington, Dept Pediat, Div Pulm & Sleep Med, Seattle, WA 98195 USA
[6] Cyst Fibrosis Fdn, Bethesda, MD USA
[7] Univ Colorado, Childrens Hosp Colorado, Sch Med, Dept Pediat, Aurora, CO USA
关键词
Ivacaftor; Gating mutation; CFTR potentiator; Clinical trials; LUNG CLEARANCE INDEX; SWEAT CHLORIDE; CFTR POTENTIATOR; CLINICAL-RESPONSE; EFFICACY; SAFETY; DISEASE;
D O I
10.1016/j.jcf.2018.04.004
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: The cystic fibrosis transmembrane conductance regulator (CFTR) potentiator ivacaftor is approved for patients with CF with gating and residual function CFTR mutations. We report the results of an observational study investigating its effects in CF patients with non-G551D gating mutations. Methods: Patients with non-G551D gating mutations were recruited to an open-label study evaluating ivacaftor. Primary outcomes included: lung function, sweat chloride, weight gain, and quality of life scores. Results: Twenty-one subjects were enrolled and completed 6 months follow-up on ivacaftor; mean age was 25.6 years with 52% <18. Baseline ppFEVI was 68% and mean sweat chloride 89.6 mEq/L. Participants experienced significant improvements in ppFEVi (mean absolute increase of 10.9% 95% CI = [2.6,19.3], p = 0.0134), sweat chloride (-48.6 95% CI = [-67.4,-29.9], p < 0.0001), and weight (5.1 kg, 95% CI = [2.8, 7.3], p = 0.0002). Conclusions: Patients with non-G551D gating mutations experienced improved lung function, nutritional status, and quality of life. This study supports ongoing use of ivacaftor for patients with these mutations. (C) 2018 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:102 / 109
页数:8
相关论文
共 33 条
[1]   Sweat chloride as a biomarker of CFTR activity: Proof of concept and ivacaftor clinical trial data [J].
Accurso, Frank J. ;
Van Goor, Fredrick ;
Zha, Jiuhong ;
Stone, Anne J. ;
Dong, Qunming ;
Ordonez, Claudia L. ;
Rowe, Steven M. ;
Clancy, John Paul ;
Konstan, Michael W. ;
Hoch, Heather E. ;
Heltshe, Sonya L. ;
Ramsey, Bonnie W. ;
Campbell, Preston W. ;
Ashlock, Melissa A. .
JOURNAL OF CYSTIC FIBROSIS, 2014, 13 (02) :139-147
[2]   Effect of VX-770 in Persons with Cystic Fibrosis and the G551D-CFTR Mutation [J].
Accurso, Frank J. ;
Rowe, Steven M. ;
Clancy, J. P. ;
Boyle, Michael P. ;
Dunitz, Jordan M. ;
Durie, Peter R. ;
Sagel, Scott D. ;
Hornick, Douglas B. ;
Konstan, Michael W. ;
Donaldson, Scott H. ;
Moss, Richard B. ;
Pilewski, Joseph M. ;
Rubenstein, Ronald C. ;
Uluer, Ahmet Z. ;
Aitken, Moira L. ;
Freedman, Steven D. ;
Rose, Lynn M. ;
Mayer-Hamblett, Nicole ;
Dong, Qunming ;
Zha, Jiuhong ;
Stone, Anne J. ;
Olson, Eric R. ;
Ordonez, Claudia L. ;
Campbell, Preston W. ;
Ashlock, Melissa A. ;
Ramsey, Bonnie W. .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (21) :1991-2003
[4]   Sweat chloride is not a useful marker of clinical response to Ivacaftor [J].
Barry, Peter J. ;
Jones, Andrew M. ;
Webb, Anthony K. ;
Horsley, Alexander R. .
THORAX, 2014, 69 (06) :586-U149
[5]   CFTR and lung homeostasis [J].
Collawn, James F. ;
Matalon, Sadis .
AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY, 2014, 307 (12) :L917-L923
[6]   Cystic fibrosis genetics: from molecular understanding to clinical application [J].
Cutting, Garry R. .
NATURE REVIEWS GENETICS, 2015, 16 (01) :45-56
[7]   Assessment of clinical response to ivacaftor with lung clearance index in cystic fibrosis patients with a G551D-CFTR mutation and preserved spirometry: a randomised controlled trial [J].
Davies, Jane ;
Sheridan, Helen ;
Bell, Nicholas ;
Cunningham, Steve ;
Davis, Stephanie D. ;
Elborn, J. Stuart ;
Milla, Carlos E. ;
Starner, Timothy D. ;
Weiner, Daniel J. ;
Lee, Po-Shun ;
Ratjen, Felix .
LANCET RESPIRATORY MEDICINE, 2013, 1 (08) :630-638
[8]   Safety, pharmacokinetics, and pharmacodynamics of ivacaftor in patients aged 2-5 years with cystic fibrosis and a CFTR gating mutation (KIWI): an open-label, single-arm study [J].
Davies, Jane C. ;
Cunningham, Steve ;
Harris, William T. ;
Lapey, Allen ;
Regelmann, Warren E. ;
Sawicki, Gregory S. ;
Southern, Kevin W. ;
Robertson, Sarah ;
Green, Yulia ;
Cooke, Jon ;
Rosenfeld, Margaret .
LANCET RESPIRATORY MEDICINE, 2016, 4 (02) :107-115
[9]   Efficacy and Safety of Ivacaftor in Patients Aged 6 to 11 Years with Cystic Fibrosis with a G551D Mutation [J].
Davies, Jane C. ;
Wainwright, Claire E. ;
Canny, Gerard J. ;
Chilvers, Mark A. ;
Howenstine, Michelle S. ;
Munck, Anne ;
Mainz, Jochen G. ;
Rodriguez, Sally ;
Li, Haihong ;
Yen, Karl ;
Ordonez, Claudia L. ;
Ahrens, Richard .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2013, 187 (11) :1219-1225
[10]   Efficacy and safety of ivacaftor in patients with cystic fibrosis and a non-G551D gating mutation [J].
De Boeck, Kris ;
Munck, Anne ;
Walker, Seth ;
Faro, Albert ;
Hiatt, Peter ;
Gilmartin, Geoffrey ;
Higgins, Mark .
JOURNAL OF CYSTIC FIBROSIS, 2014, 13 (06) :674-680