Evidence map›Paper›PMID 39452571›Full record

ArticleJournal of personalized medicine2024

Therapeutic Drug Monitoring of Elexacaftor, Tezacaftor, and Ivacaftor in Adult People with Cystic Fibrosis.

Susanne Naehrig, Christina Shad, Magdalena Breuling, Melanie Goetschke, Katharina Habler, Sarah Sieber, Johanna Kastenberger, Alexandra Katharina Kunzelmann, Olaf Sommerburg, Uwe Liebchen and 3 more

Abstract read
In one paragraph

Article in Journal of personalized medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Observational
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Susanne NaehrigCystic Fibrosis Center for Adults, Department of Medicine V, LMU University Hospital, LMU Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), 80336 Munich, Germany.
Christina ShadCystic Fibrosis Center for Adults, Department of Medicine V, LMU University Hospital, LMU Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), 80336 Munich, Germany.
Magdalena BreulingCystic Fibrosis Center for Adults, Department of Medicine V, LMU University Hospital, LMU Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), 80336 Munich, Germany.
Melanie GoetschkeCystic Fibrosis Center for Adults, Department of Medicine V, LMU University Hospital, LMU Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), 80336 Munich, Germany.
Katharina HablerInstitute of Laboratory Medicine, LMU University Hospital, LMU Munich, 813777 Munich, Germany.ORCID 0000-0002-5110-346X
Sarah SieberSTAT-UP Statistical Consulting & Data Science GmbH, 80333 Munich, Germany.
Johanna KastenbergerSTAT-UP Statistical Consulting & Data Science GmbH, 80333 Munich, Germany.
Alexandra Katharina KunzelmannDepartment of Anesthesiology, LMU University Hospital, LMU Munich, 81377 Munich, Germany.ORCID 0009-0007-9849-9901
Olaf SommerburgDivision of Pediatric Pulmonology, Allergy and Cystic Fibrosis Center, Department of Pediatrics, University Hospital Heidelberg, Member of the German Center for Lung Research (DZL), 69120 Heidelberg, Germany.ORCID 0000-0002-3941-8944
Uwe LiebchenDepartment of Anesthesiology, LMU University Hospital, LMU Munich, 81377 Munich, Germany.ORCID 0000-0002-4375-0923
Juergen BehrDepartment of Medicine V, LMU University Hospital, LMU Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), 81377 Munich, Germany.ORCID 0000-0002-9151-4829
Michael VogeserInstitute of Laboratory Medicine, LMU University Hospital, LMU Munich, 813777 Munich, Germany.
Michael PaalInstitute of Laboratory Medicine, LMU University Hospital, LMU Munich, 813777 Munich, Germany.ORCID 0000-0001-8831-0238

Funding

Deutsches Zentrum für Lungenforschung FKZ 82DZLJ73B2
6 · The paper itself

Abstract

BACKGROUND/

objectivesElexacaftor, tezacaftor, and ivacaftor (ETI) have significantly improved lung function in people with cystic fibrosis (pwCF). Despite exceptional improvements in most cases, treatment-related inter-subject variability and drug-drug interactions that complicate modulator therapy have been reported.

methodsThis retrospective analysis presents data on the serum concentration of ETI in our pwCF with full or reduced dosage from August 2021 to December 2023 via routine therapeutic drug monitoring (TDM). The data were compared with the maximum drug concentrations (Cmax) from the pharmaceutical company's summary of product characteristics.

resultsA total of 786 blood samples from 155 pwCF (41% female, 59% male) were analyzed. The examinations were divided into four groups: full dose within the given tmax (38.5% of all measurements), full dose outside the tmax (29%), reduced dose within the tmax (19.2%), and reduced dose outside the tmax (13.2%). In pwCF receiving the full dose and blood taken within the tmax, 45.3% of serum concentrations of elexacaftor, 51.1% of serum concentrations of ivacaftor, and 8.9% of serum concentrations of tezacaftor were found to be above the Cmax, respectively. For those on reduced doses within the tmax, 24.5% had a serum concentration of elexacaftor, 23.2% had a serum concentration of ivacaftor, and 2.5% had a serum concentration of tezacaftor above the Cmax, respectively.

conclusionsMany pwCF under ETI therapy have Cmax values for elexacaftor and ivacaftor above the recommended range, even on reduced doses or before the tmax was reached. This highlights the value of a TDM program. Further pharmacokinetic studies are necessary.

Indexed as

cystic fibrosiselexacaftorivacaftorserum concentrationstezacaftortherapeutic drug monitoring

Identifiers

PMID39452571
PMCPMC11508966

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.