Managing cystic fibrosis in children aged 6-11yrs: a critical review of elexacaftor/tezacaftor/ivacaftor combination therapy

Introduction: Cystic fibrosis is a life-limiting, autosomal recessive genetic disorder resulting in multi-organ disease due to CF transmembrane conductance regulator (CFTR) protein dysfunction. CF treatment previously focused on mitigation of disease signs and symptoms. The recent introduction of highly effective CFTR modulators, for which similar to 90% of people with CF are CFTR variant-eligible, has resulted in substantial health improvements. Areas covered: In this review, we will describe the clinical trials leading to approval of the highly effective CFTR modulator, elexacaftor-tezacaftor-ivacaftor (ETI), with a focus on the safety and efficacy of this treatment in children aged 6-11 years. Expert opinion: The use of ETI in variant-eligible children aged 6-11 is associated with marked clinical improvements with a favorable safety profile. We anticipate that introduction of ETI in early childhood may result in the prevention of pulmonary, gastrointestinal, and endocrine complications from CF, consequently leading to previously unimaginable gains in the quality and quantity of life. However, there is an urgent need to develop effective treatments for the remaining 10% of people with CF who are not eligible or unable to tolerate ETI treatment, and to increase access of ETI to more pwCF across the world.

Automated summary

Cystic fibrosis is a genetic disorder that causes multi-organ disease due to dysfunctional CFTR protein. Previous treatments focused on symptom relief, but the introduction of highly effective CFTR modulators has improved the health of 90% of CF patients. Studies have shown that the use of elexacaftor-tezacaftor-ivacaftor (ETI) in children aged 6-11 leads to significant clinical improvements with a favorable safety profile.