Spoletini, G, Gillgrass, L, Pollard, K et al. (5 more authors) (2022) Dose adjustments of Elexacaftor/Tezacaftor/Ivacaftor in response to mental health side effects in adults with cystic fibrosis. Journal of Cystic Fibrosis, 21 (6). pp. 1061-1065. ISSN 1569-1993
Abstract
Introduction
Deterioration in mental health has been reported in a minority of individuals with cystic fibrosis starting elexacafor/tezacaftor/ivacaftor (ELX/TEZ/IVA). We report our experience of using sweat chloride and markers of clinical stability to titrate dose reduction with the aim of minimising adverse events and maintaining clinical stability.
Method
Adults (n = 266) prescribed ELX/TEZ/IVA, were included. Adverse events, sweat chloride, lung function and clinical data were collected.
Results
Nineteen (7.1%) individuals reported anxiety, low mood, insomnia and “brain fog” with reduced attention and concentration span. Thirteen underwent dose reduction with sweat chloride remained normal (<30 mmol l-1) or borderline (30–60 mmol l-1) in six (46.2%) and seven (53.2%) cases respectively. Improvement or resolution of AEs occurring in 10 of the 13 cases.
Conclusion
Dose adjustment of ELX/TEZ/IVA was associated with improvement in mental health AEs without significant clinical deterioration. Sweat chloride concentration may prove useful as a surrogate marker of CFTR function.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 The Author(s). Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Pharmacy (Leeds) |
Funding Information: | Funder Grant number Leeds Hospitals Charity 5T02 & 4M04/A2001064 |
Depositing User: | Symplectic Publications |
Date Deposited: | 26 May 2022 11:17 |
Last Modified: | 03 Jan 2023 11:33 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.jcf.2022.05.001 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:187285 |