Average rate of lung function decline in adults with cystic fibrosis in the United Kingdom: Data from the UK CF registry

Background: Rate of change in lung function is used as a measure of disease progression and a predictor of mortality in individuals with cystic fibrosis (CF). The aim of this study was to determine the national rate of decline in percent predicted Forced Expiratory Volume in 1 second (ppFEV(1)) in adults in the UK accounting for age, sex and pancreatic status. Methods: Data on ppFEV(1) for adults with CF, excluding those post lung transplantation, was extracted from the UK CF registry between 2015 and 2017. Multilevel modelling was conducted to calculate the annual rate of change in ppFEV(1) accounting for age, sex and pancreatic status. Results: Overall annual ppFEV(1) decline was -1.52% (95% CI: -1.66 to -1.38%) and -0.55% (95% CI: -0.86 to -0.23%) in pancreatic insufficient (PI) and sufficient (PS) adults respectively. In PI individuals, females had a greater rate of decline in ppFEV(1). There were differences between age groups. The fastest rate of decline was observed in the 18-28 years group, declining -1.76% (95% CI: -2.06 to -1.46) and -1.61% (95% CI: -1.91 to -1.31) per year in PI females and males respectively. The pattern between the sexes and age categories was more inconsistent in the PS group. Conclusions: The average annual rates of decline in lung function in adults with CF in the UK are similar to reports from other large international cohorts. Pancreatic status has a marked impact on average rate of decline. Younger adults, especially females, have a faster rate of decline and need close monitoring. (C) 2020 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Automated summary

This study aimed to determine the national rate of decline in percent predicted Forced Expiratory Volume in 1 second (ppFEV(1)) in adults with cystic fibrosis in the UK, taking into account age, sex, and pancreatic status. The results showed that pancreatic status had a significant impact on the average rate of decline in lung function, with younger adults, especially females, exhibiting a faster rate of decline.