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Cystic Fibrosis Transmembrane Conductance Regulator Modulator Use Is Associated With Reduced Pancreatitis Hospitalizations in Patients With Cystic Fibrosis.
- Source :
-
The American journal of gastroenterology [Am J Gastroenterol] 2021 Dec 01; Vol. 116 (12), pp. 2446-2454. - Publication Year :
- 2021
-
Abstract
- Introduction: Acute pancreatitis (AP) occurs among patients with pancreas-sufficient cystic fibrosis (PS-CF) but is reportedly less common among patients with pancreas-insufficient cystic fibrosis (PI-CF). The incidence of AP may be influenced by cystic fibrosis transmembrane conductance regulator (CFTR) modulator use. We hypothesized that CFTR modulators would reduce AP hospitalizations, with the greatest benefit in PS-CF.<br />Methods: MarketScan (2012-2018) was queried for AP hospitalizations and CFTR modulator use among patients with CF. Multivariable Poisson models that enabled crossover between CFTR modulator treatment groups were used to analyze the rate of AP hospitalizations on and off therapy. Pancreas insufficiency was defined by the use of pancreas enzyme replacement therapy.<br />Results: A total of 10,417 patients with CF were identified, including 1,795 who received a CFTR modulator. AP was more common in PS-CF than PI-CF (2.9% vs 0.9%, P = 0.007). Overall, the observed rate ratio of AP during CFTR modulator use was 0.33 (95% confidence interval [CI] 0.10, 1.11, P = 0.07) for PS-CF and 0.38 (95% CI 0.16, 0.89, P = 0.03) for PI-CF, indicating a 67% and 62% relative reduction in AP hospitalizations, respectively. In a subset analysis of 1,795 patients who all had some CFTR modulator use, the rate ratio of AP during CFTR modulator use was 0.36 (95% CI 0.13, 1.01, P = 0.05) for PS-CF and 0.53 (95% CI 0.18, 1.58, P = 0.26) for PI-CF.<br />Discussion: CFTR modulator use is associated with a reduction in AP hospitalizations among patients with CF. These observational data support the prospective study of CFTR modulators to reduce AP hospitalizations among patients with CF.<br /> (Copyright © 2021 by The American College of Gastroenterology.)
- Subjects :
- Adolescent
Adult
Child
Child, Preschool
Cross-Over Studies
Cystic Fibrosis complications
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Pancreatitis epidemiology
Pancreatitis etiology
Prospective Studies
United States epidemiology
Young Adult
Cystic Fibrosis drug therapy
Cystic Fibrosis Transmembrane Conductance Regulator pharmacology
Hospitalization trends
Pancreatitis therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1572-0241
- Volume :
- 116
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The American journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 34665155
- Full Text :
- https://doi.org/10.14309/ajg.0000000000001527