Ivacaftor May Reduce Common Infections in Patients With Cystic Fibrosis

July 24, 2019

Patients with cystic fibrosis (CF) who take ivacaftor appear to have fewer respiratory infections over time than those not taking the drug, according to a study published online in the Annals of the American Thoracic Society.

The study also showed that ivacaftor may also reduce some of the most common lung infections in patients with CF, including Pseudomonas aeruginosa.

“People with CF notice improvement in lung function and quality of life soon after they start taking ivacaftor, but they still have to live with a considerable treatment burden from all the other medications they take,” said Freddy Frost, Liverpool Heart & Chest Hospital, Liverpool, United Kingdom. “At present, we simply don’t know whether it’s safe to stop some of those other treatments. The fact we have seen reduced infections in this study suggests there may be some people who can safely discontinue medications targeted towards those infections.”

Using data from a CF registry in the United Kingdom, the researchers compared patients with CF aged 6 years and older who took ivacaftor with those patients who did not take the drug over a 3-year period.

The study found that ivacaftor was associated with a 32% reduction in the number of people infected with P aeruginosa and a 15% reduction in Staphylococcus aureus. These reductions resulted from both increased clearance of the infection in those already infected and in reduced acquisition in those not infected.

The authors said that with people starting ivacaftor and other drugs that correct defects in the CF gene from an early age, the possibility of preventing these infections is particularly exciting.

“If these drugs are taken before chronic infection starts, the risk of developing infection in the future may be reduced considerably,” said Dr. Frost.

Ivacaftor was also associated with reduced Aspergillus species infections. The drug did not appear to reduce Burkholderia cepacia complex infections.

Dr. Frost said that the study adds to the increasing evidence of the long-term benefits of ivacaftor, “however, randomised, controlled trials will be needed to know if it is safe to reduce the overall treatment burden of CF by decreasing antibiotic use in patients taking ivacaftor or other drugs that target defects in the CF gene.”

Reference: https://www.ncbi.nlm.nih.gov/pubmed/31319678

SOURCE: American Thoracic Society