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Review
. 2023 Oct;11(10):916-931.
doi: 10.1016/S2213-2600(23)00324-7. Epub 2023 Sep 9.

Understanding and addressing the needs of people with cystic fibrosis in the era of CFTR modulator therapy

Affiliations
Review

Understanding and addressing the needs of people with cystic fibrosis in the era of CFTR modulator therapy

Katherine B Hisert et al. Lancet Respir Med. 2023 Oct.

Abstract

Cystic fibrosis is a multiorgan disease caused by impaired function of the cystic fibrosis transmembrane conductance regulator (CFTR). Since the introduction of the CFTR modulator combination elexacaftor-tezacaftor-ivacaftor (ETI), which acts directly on mutant CFTR to enhance its activity, most people with cystic fibrosis (pwCF) have seen pronounced reductions in symptoms, and studies project marked increases in life expectancy for pwCF who are eligible for ETI. However, modulator therapy has not cured cystic fibrosis and the success of CFTR modulators has resulted in immediate questions about the new state of cystic fibrosis disease and clinical challenges in the care of pwCF. In this Series paper, we summarise key questions about cystic fibrosis disease in the era of modulator therapy, highlighting state-of-the-art research and clinical practices, knowledge gaps, new challenges faced by pwCF and the potential for future health-care challenges, and the pressing need for additional therapies to treat the underlying genetic or molecular causes of cystic fibrosis.

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Conflict of interest statement

Declaration of interests KBH reports funding from the National Institutes of Health (NIH) National Heart, Lung, and Blood Institute (NHLBI) and the Cystic Fibrosis Foundation (CFF), outside of the submitted work. SEB reports funding from NIH NHLBI and CFF, outside of the submitted work. DGD reports funding from Chiesi Farmaceutici and CFF to Queen's University Belfast; consulting fees from Vertex and Insmed; honoraria from Chiesi and Gilead; support for travel from the European Cystic Fibrosis Society (ECFS) and CFF; and participation on data and safety monitoring boards (DSMBs) for Nomab trial and CSL Behring, outside of the submitted work. DGD is Director of the ECFS Clinical Trials Network. JFE reports funding from NIH NHLBI and the National Institute of Diabetes and Digestive Kidney Diseases (R01 HL165404, RC2 DK124207, and NHLBI Contract 75N92019C00010) paid to the University of Iowa, outside of the submitted work. IF reports funding from AbbVie, Bayer, Boehringer Ingelheim, Insmed, Vertex, and ECFS to AP-HP-Université Paris Cité; and honoraria from AbbVie, Boehringer Ingelheim, Vertex, and Kither Biotech, outside of the submitted work. RDG reports honoraria for lectures from Vertex, outside of the submitted work. NM-H reports funding from CFF, NIH, and the Food and Drug Administration to Seattle Children's Research Institute, University of Washington; consulting fees from Enterprise Therapeutics; and honoraria for NIH DSMB participation, outside of the submitted work. CEW reports editorial support from Articulate Science outside of the submitted work; income on a per-patient basis to the University of Queensland for participation in pharmaceutical studies; participating on steering committees and international advisory boards for Vertex; and participation as a consultant and presenter at several medical education events sponsored by Vertex, outside of the submitted work. CEW has served as an Associate Editor for Respirology and Associate Editor for Thorax. KDB reports consulting fees from Arcturus, Splisense, Translate Bio, and Vertex; and honoraria from Vertex, outside of the submitted work. JPC, MEL-S, PT, and KLT declare no competing interests.

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