Correction: Dagenais et al. Real-World Safety of CFTR Modulators in the Treatment of Cystic Fibrosis: A Systematic Review. J. Clin. Med. 2021, 10, 23
Reference
- Dagenais, R.V.E.; Su, V.C.; Quon, B.S. Real-World Safety of CFTR Modulators in the Treatment of Cystic Fibrosis: A Systematic Review. J. Clin. Med. 2021, 10, 23. [Google Scholar] [CrossRef]
Ref | Study Design & Location | Population a | n | Recruitment Period & Follow-Up Duration | Overall Adverse Events (AE) b,c | Dose Modification, Interruption, or Discontinuation Due to AE b,c | ||||
---|---|---|---|---|---|---|---|---|---|---|
Ivacaftor | ||||||||||
[29] | Prospective Cohort d United States | Baseline Age Pediatric and Adult - Mean: 33 yr - Range: 10–61 yr CFTR Genotype ≥1 copy G551D Baseline ppFEV1 Mean: 30% | 44 | Recruitment Period Prior to commercial availability Follow-Up Duration NS | AE in n = 38 (86%): | n | % | Discontinuation: | n | % |
- Pulmonary exacerbation - Hemoptysis - Increased sputum - Increased cough - URTI - Dyspnea - Abnormal respiration - Respiratory tract congestion - Headache - Rash | 20 7 7 6 6 3 3 3 5 4 | 45 16 16 14 14 7 7 7 11 9 | - Severe abdominal pain - Dizziness/tinnitus | 1 1 | 2 2 | |||||
SAE in n = 14 (32%): | ||||||||||
- Pulmonary exacerbation - Hemoptysis - Pneumothorax - Acute respiratory failure - URTI - Abdominal pain - Gastroenteritis - Abnormal LFTs - Syncope - Secondary adrenocortical insufficiency | NS NS NS NS NS NS NS NS NS NS | - - - - - - - - - - | ||||||||
[55] | Prospective Cohort United States Canada Italy | Baseline Age Pediatric and Adult - Mean: 17 yr - Range: 5–61 yr CFTR Genotype ≥1 gating mutation Baseline ppFEV1 Mean: 86% | 23 | Recruitment Period Mar 2014 to Aug 2015 Follow-Up Duration 3 mo | 49 AE in n = 21 (91%): | n | % | None reported | ||
- Respiratory, unspecified - Gastrointestinal, unspecified - Infection, unspecified - Headache - Weakness - Dizziness - Fatigue | NS NS NS NS NS NS NS | - - - - - - - | ||||||||
5 SAE in n = 3 (13%): | n | % | ||||||||
- Respiratory infection - Acute changes in metabolic and liver status | 4 1 | 17 4 | ||||||||
[56] | Retrospective Cohort United Kingdom (1 center) | Baseline Age Pediatric - Mean: 9 yr - Range: 6–14 yr CFTR Genotype 1 copy G551D Baseline ppFEV1 Mean: 68% e | 4 | Recruitment Period Jan 2013 to Jun 2015 Follow-Up Duration Mean: 24 mo | - Transaminitis (<3 x ULN) | n 1 | % 25 | None reported | ||
[57] | Retrospective Cohort Scotland (11 centers) | Baseline Age Pediatric - Median: 9 yr CFTR Genotype ≥1 copy G551D Baseline ppFEV1 Mean: 85% | 26 | Recruitment Period NS (Jan 2013 to Mar 2013 for 85%) Follow-Up Duration Mean: 17 mo | n | % | None reported | |||
- Headache - Swollen ear - Cataracts | 1 1 2 | 4 4 17 f | ||||||||
[58] | Retrospective Cohort France (25 centers) | Baseline Age Pediatric and Adult - Median: 18 yr - Range: 6–52 yr CFTR Genotype ≥1 copy G551D Baseline ppFEV1 Mean: 72% | 57 | Recruitment Period Pre-1 Jun 2013 up to 30 Sep 2014 Follow-Up Duration Up to 2 yr | 34 AE in n = 21 (37%): | n | % | Interruption in n = 7 (12%): | n | % |
- Transaminitis - Rhinopharyngitis - Asthma - Fever - Chest pain - Abdominal pain - Nausea or vomiting - Intestinal dysmotility - Headache - Fatigue - Rash or eczema - Depression - Myalgia - Arthritis - Breast hypertrophy - Orchitis - Atrial fibrillation | 3 NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS | 5 - - - - - - - - - - - - - - - - | - Hepatitis - Rhinopharyngitis - Abdominal pain - Vomiting - Headache - Rash - Severe depression | NS NS NS NS NS NS NS | - - - - - - - | |||||
Discontinuation: | ||||||||||
- Transaminitis - Liver cirrhosis diagnosis | 1 1 | 2 2 | ||||||||
[30] | Retrospective Cohort d Germany (multicenter) | Baseline Age Adult - Mean: 34 yr CFTR Genotype ≥1 copy G551D Baseline ppFEV1 Mean: 25% | 14 | Recruitment Period Sep 2012 to Apr 2013 Follow-Up Duration Mean: 235 days | - Increased bronchial and nasal secretions - Headache - Worsening RLS - Abdominal pain - Hyperbilirubinemia (mild) - Transaminitis (<3 to 4x ULN) | n 3 1 1 1 1 1 | % 21 7 7 7 7 7 | Discontinuation: - Increased bronchial and nasal secretions * * Trial of reduced dose before discontinuation | n 1 | % 7 |
Lumacaftor/Ivacaftor | ||||||||||
[41] | Prospective Cohort France (1 center) | Baseline Age Pediatric - Mean: 16 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 87% | 32 | Recruitment Period Mar 2016 to Dec 2016 Follow-Up Duration 4 h post-first dose | - Acute drop in ppFEV1 - Wheeze | n 32 3 | % 100 9 | None reported | ||
[42] | Prospective Cohort France (47 centers) | Baseline Age Pediatric and Adult - Mean: 22 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 65% | 845 | Recruitment Period 1 Jan 2016 to 31 Dec 2016 Follow-Up Duration 12 mo | AE in n = 494 (59%): | n | % | Interruption: | n | % |
- Respiratory - Digestive - Menstrual abnormality - Fatigue - Headache - CK > 5xULN - Transaminitis (> 3xULN) | 316 181 53 37 19 20 5 | 37 21 6 4 2 2 0.6 | - Respiratory - ‘Non-respiratory’ Discontinuation: Respiratory - Chest tightness/dyspnea - Bronchospasm - Increased cough/sputum - Hemoptysis - Pneumothorax Non-respiratory - Diarrhea, abdominal pain - CK >10xULN + myalgia - Fatigue - Headache - Depression - Metrorrhagia - Transaminitis (>6xULN) - Cutaneous rash - Tachycardia | 16 8 n 38 24 9 2 1 18 5 5 4 4 3 2 1 1 | 2 1 % 5 3 1 0.2 0.1 2 0.6 0.6 0.5 0.5 0.4 0.2 0.1 0.1 | |||||
[59] | Prospective Cohort United States (1 center) | Baseline Age Pediatric and Adult - Mean: 23 yr - Range: 12–48 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 70% | 26 | Recruitment Period NS Follow-Up Duration 6 mo | See Discontinuation | Discontinuation: - Transaminitis - Unspecified AE | n 1 4 | % 4 15 | ||
[31] | Prospective Cohort d Switzerland (1 center) | Baseline Age Adult - Mean NR CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Median: 30% | 20 | Recruitment Period Jan 2016 to Jan 2017 Follow-Up Duration 1 mo | n | % | Reduced dose: | n | % | |
- Dyspnea - 3 h - 24 h - 1 mo - Chest tightness - 3 h - 24 h - 1 mo - Increased sputum - 3 h - 24 h - 1 mo - Pulmonary exacerbation - 1 mo | 0 1 1 1 10 1 1 8 3 2 | - 5 5 5 50 5 5 40 15 10 | - Respiratory intolerance Discontinuation: - Chest tightness (at 24 h) | 3 1 | 15 5 | |||||
[32] | Prospective Cohort Australia (1 center) | Baseline Age Adult - Mean: 27 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Median: 36% | 12 | Recruitment Period Jan 2016 to Oct 2016 Follow-Up Duration 1 mo | n | % | Discontinuation: | n | % | |
- Acute drop in ppFEV1 - Respiratory AE overall - 4 h - 24 h - 1 mo - Dyspnea - 4 h - 24 h - 1 mo - Chest tightness - 4 h - 24 h - 1 mo - Increased sputum - 4 h - 24 h - 1 mo - Pulmonary exacerbation | 12 5 10 8 2 6 7 4 8 5 0 2 1 6 | 100 42 83 67 17 50 58 33 67 42 - 17 8 50 | - Chest tightness/dyspnea * * n = 2 discontinued after 1mo follow-up (5 wk and 9 wk) | 3 | 25 | |||||
[33] | Prospective Cohort France (11 centers) | Baseline Age Adult - Mean: 31 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 32% | 53 | Recruitment Period Jan 2016 to Jun 2016 Follow-Up Duration 3 mo | AE in n = 34 (63%): | n | % | Discontinuation: | n | % |
- Abnormal respiration - Dyspnea - Increased cough - Abdominal pain, nausea, diarrhea, or vomiting - Fatigue - Rash - Pruritus - Breast tension | 13 11 3 9 2 1 1 1 | 25 21 6 17 4 2 2 2 | - Respiratory intolerance - Vomiting - Fatigue | 13 1 1 | 25 2 2 | |||||
[25] | Prospective Cohort d,g Australia (1 center) | Baseline Age Adult - Mean: 27 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 36% | 10 | Recruitment Period NS Follow-Up Duration 52 wk | AE in n = 6 (60%): | n | % | None reported | ||
- Chest tightness/dyspnea - Headache | 6 2 | 60 20 | ||||||||
[43] | Retrospective Cohort Ireland (1 center) | Baseline Age Pediatric - Mean: 14 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 77% | 15 | Recruitment Period Sep 2016 to Aug 2017 Follow-Up Duration NS | n | % | None reported | |||
- Acute drop in ppFEV1 - Chest tightness - Increased sputum | 14 2 2 | 93 13 13 | ||||||||
[44] | Retrospective Cohort United States (1 center) | Baseline Age Pediatric and Adult - Mean: 25 yr - Range: 12–59 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 67% | 116 | Recruitment Period NS Follow-Up Duration Up to 11 mo | AE in n = 46 (40%): | n | % | Reduced dose: | n | % |
- Chest tightness - Dyspnea - Increased cough - Diarrhea - Nausea - Decreased appetite - Rash | 23 12 10 5 3 2 2 | 20 10 9 4 3 2 2 | - AE not specified Discontinuation: - Reasons not specified h | 10 20 | 9 17 | |||||
[60] | Retrospective Cohort Greece (1 center) | Baseline Age Pediatric and Adult - Mean: 16 yr i - Range: 12–23 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean 92% i | 62 | Recruitment Period Mar 2016 to Aug 2017 Follow-Up Duration 12 mo | - Chest tightness | n 2 | % 3 | Discontinuation: - Transaminitis - Cataract | n 1 1 | % 2 2 |
[34] | Retrospective Cohort d Spain (multicenter) | Baseline Age Pediatric and Adult - Mean: 27 yr - Range: 10–45 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 32% | 20 | Recruitment Period 2016 Follow-Up Duration 6 mo | AE in n = 15 (75%): | n | % | Discontinuation: | n | % |
- Chest tightness - Dyspnea - Headache - Weight loss - ‘Sickness’ (not defined) - Asthenia - Abdominal pain - Transaminitis | 9 8 5 5 3 3 2 2 | 45 40 25 25 15 15 10 10 | - Decreased ppFEV1 - AE not specified | 1 6 | 5 30 | |||||
[45] | Retrospective Cohort Canada (1 center) | Baseline Age Adult - Median: 32 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Median: 40% | 22 | Recruitment Period Apr 2016 to Jun 2018 Follow-Up Duration Median: 10 mo | AE in n = 19 (86%): | n | % | Discontinuation: | n | % |
- Chest tightness - Wheeze - Dyspnea - Increased sputum - Increased cough - Flu-like symptoms - Elevated blood pressure - Headache - Nausea - Elevated AST - Anxiety - Bradycardia - Pleuritic chest pain | 14 4 3 3 2 1 5 4 2 1 1 1 1 | 64 18 14 14 9 5 23 18 9 5 5 5 5 | - Respiratory symptoms - Asymptomatic hypertension - Symptomatic hypertension - Headache - Hypertensive emergency - Anxiety | 3 2 1 1 1 | 14 9 5 5 5 | |||||
[61] | Retrospective Cohort United States (1 center) | Baseline Age Adult - Mean NR CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 82 | Recruitment Period Jul 2015 to Jun 2016 Follow-Up Duration 12 mo | See Discontinuation | Discontinuation: Total overall: - Chest tightness * - Diarrhea ** - Abdominal pain - Nausea ** - Dysphagia - Elevated LFTs - Pericarditis - Allergic reaction ** - Suspected Stevens–Johnson syndrome * n = 3 also had significant drop in ppFEV1 ** n = 1 also discontinued due to chest tightness | n 17 11 2 1 1 1 1 1 1 1 | % 21 13 2 1 1 1 1 1 1 1 | ||
[26] | Retrospective Cohort d,g Australia (7 centers) | Baseline Age Adult - Mean: 31 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 37% | 72 | Recruitment Period Nov 2015 to Mar 2017 Follow-Up Duration 12 mo | n | % | Discontinuation: | n | % | |
- Chest tightness/dyspnea - Increased sputum - Decrease in ppFEV1 - Headache - Fatigue - Nausea - Rash | 40 4 2 2 5 1 2 | 56 6 3 3 7 1 3 | - Chest tightness/dyspnea | 22 | 31 | |||||
[27] | Case Series (Survey) j International (31 centers) | Baseline Age Adult - Mean: 30 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 59% | 26 | Recruitment Period Questionnaire sent in 2018–2019 Follow-Up Duration NS | n | % | Discontinuation: | n | % | |
- Pulmonary exacerbation - Post-partum acute myelocytic leukemia | 1 1 | 4 4 | - Chest tightness | 2 | 8 |
Ref | Study Design | Population | n | Overall Adverse Events (AE) a,b | Dose Modification, Interruption, or Discontinuation Due to AE a,b | ||||
---|---|---|---|---|---|---|---|---|---|
Ivacaftor | |||||||||
[62] | Prospective Cohort | Baseline Age Pediatric - Mean: 5 yr CFTR Genotype ≥1 gating mutation Baseline ppFEV1 Mean NR | 4 | AE in n = 2 (50%): | n | % | None reported | ||
- URTI - Nasal congestion - Headache | NS NS NS | - - - | |||||||
[63] | Retrospective Cohort | Baseline Age Pediatric - Mean: 6 yr CFTR Genotype ≥1 gating mutation Baseline ppFEV1 Median: 87% | 10 | - Transient rash - Increased obesity | n 2 1 | % 20 10 | None reported | ||
[64] | Prospective Cohort | Baseline Age Pediatric and Adult - Mean NR CFTR Genotype ≥1 copy S549R Baseline ppFEV1 Mean: 54% | 15 | - Liver enzyme derangement | n | % | None reported | ||
2 | 13 | ||||||||
[65] | Cross-sectional Survey | Baseline Age Adult - Mean: 26 yr CFTR Genotype ≥1G551D Baseline ppFEV1 Mean: 62% | 11 d | AE in n = 8 (73%) d: - Transient rash - Dizziness - Unspecified AE | n NS NS NS | % - - - | None reported | ||
Lumacaftor/Ivacaftor | |||||||||
[66] | Prospective Cohort | Baseline Age Pediatric - Mean: 13 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 91% | 14 | n | % | Reduced dose *: | n | % | |
- Acute drop in ppFEV1 (asymptomatic) - Chest tightness, tachypnea (requiring oxygen) | 1 1 | 7 7 | - Chest tightness, tachypnea * Eventual titration to full dose | 1 | 7 | ||||
[67] | Prospective Cohort | Baseline Age Pediatric - Mean: 14 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 87% | 13 | n | % | None reported | |||
- Drop in ppFEV1 requiring salbutamol | 7 | 54 | |||||||
[68] | Prospective Cohort | Baseline Age Pediatric and Adult - Mean: 23 yr e CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean 61% e | 369 | n | % | Discontinuation: | n | % | |
- Bronchospasm - Dyspnea - Abnormal respiration - Unspecified respiratory AE - Unspecified AE | 15 12 7 4 120 | 4 3 2 1 33 | - Unspecified AE | 16 | 4 | ||||
[69] | Prospective Cohort | Baseline Age Pediatric and Adult - Mean: 25 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 311 | 379 AE in n = 213 (68%): - Dyspnea - Cough - GI discomfort (e.g., diarrhea, nausea, abdominal pain) - Headache - Fatigue - Unspecified | n f NS NS NS NS NS NS | % 31 6 31 6 5 NR | Interruption (stop/restart): - Unspecified AE and other reasons g Discontinuation: - Unspecified AE and other reasons g | n 12 42 | % 4 14 |
[35] | Prospective Cohort c | Baseline Age Adult - Median: 31 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Median: 28% | 14 | n | % | Discontinuation: | n | % | |
- Chest tightness, breathless - Rash | 7 1 | 50 7 | - Respiratory AE and/or rash | 4 | 29 | ||||
[70] | Prospective Cohort | Baseline Age Adult - Mean NR CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 29 | n | % | Reduced dose: | n | % | |
- Chest tightness * * n = 4 cases severe, requiring hospitalization for IV steroids and antibiotics | 13 | 45 | - Chest tightness Discontinuation: - Chest tightness | 2 5 | 7 17 | ||||
[36] | Prospective Cohort c | Baseline Age Mean NR h CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 32 | AE in 88%: | n f | % | Interruption (stop/restart): | n | % |
- Respiratory AE - Drop in ppFEV1 | NS NS | 87 - | - Unspecified AEA Discontinuation: - Unspecified AE | 1 8 | 3 25 | ||||
[71] | Retrospective Cohort | Baseline Age Pediatric and Adult - Mean NR CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 34 | AE in n = 29 (85%): - Pulmonary exacerbation - Chest tightness - Dyspnea - Diarrhea - Abdominal pain | n 16 9 3 3 3 | % 47 26 9 9 9 | Discontinuation: - Unspecified AE | n 10 | % 29 |
Serious AE in n = 8 (24%): | |||||||||
- Respiratory failure i - Unspecified AE | 1 7 | 3 21 | |||||||
[72] | Retrospective Cohort | Baseline Age Pediatric and Adult - Mean: 26 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 68% | 103 | See Discontinuation | Interruption/discontinuation j: | n | % | ||
- Chest tightness and/or pain - Elevated LFTs | 17 NS | 17 - | |||||||
[73] | Retrospective Cohort | Baseline Age Adult - Mean: 31 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 50% | 71 | AE in n = 41 (58%): | n | % | Discontinuation: | n | % |
- Chest tightness - Dyspnea - Increased cough - GI (pain, constipation, or diarrhea) - Rash - Pruritus - Irregular menses or metrorrhagia - Breast tension - Headache - Myalgia | 22 8 4 6 4 1 3 2 1 1 | 31 11 6 9 6 1 4 3 1 1 | - Dyspnea - Chest tightness - Increased cough - Fatigue | 7 6 3 1 | 10 9 4 1 | ||||
[74] | Retrospective Cohort | Baseline Age Mean NR h CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 54 | See Discontinuation | Discontinuation: | n | % | ||
- Chest tightness, dyspnea, and/or drop in ppFEV1 | 8 | 15 | |||||||
[75] | Retrospective Cohort | Baseline Age Adult - Mean: 31 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 28 | - Increased work of breathing or chest tightness - Drop in ppFEV1 | n 12 5 | % 43 18 | Discontinuation - Respiratory intolerance vs. pulmonary exacerbation - Persistent respiratory intolerance/chest tightness - Rash and swelling of face - Increased anxiety | n 1 3 1 1 | % 4 11 4 4 |
[76] | Retrospective Cohort | Baseline Age Adult - Mean NR CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 46 | n | % | Discontinuation: | n | % | |
- Drop in ppFEV1 - Transaminitis | 21 2 | 46 4 | - Dyspnea, cough, CFPEx, and/or chest tightness - Transaminitis - Headache - Muscle ache - Fatigue - Rash | 4 1 NS NS NS NS | 9 2 - - - - | ||||
[77] | Retrospective Cohort | Baseline Age Adult - Mean NR CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 28 | See Discontinuation | Discontinuation: | n | % | ||
- SOB and/or drop in ppFEV1 | 15 | 54 | |||||||
[78] | Retrospective Cohort | Baseline Age Mean: 32 yr h CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 62% | 20 | Overall AE: | n | % | Interruption (stop/restart): | n | % |
- Chest tightness - Elevated LFTs - Upset stomach - Increased stool output - Rash - Elevated thyroid function test - RA exacerbation | NS NS NS NS NS NS NS | - - - - - - - | - Unspecified AE - full-dose restart - half-dose restart Discontinuation: - Unspecified AE | 2 4 2 | 10 20 10 | ||||
[79] | Retrospective Cohort | Baseline Age Mean NR h CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 60 | - Heartburn/reflux - Abdominal pain - Loose/oily stools | n 20 19 17 | % 33 32 28 | None reported | ||
[80] | Retrospective Cohort | Baseline Age Mean: 29 yr h,k CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 80% k | 34 | See Discontinuation | Discontinuation: | n | % | ||
Overall total: - Respiratory AE (70%) f - Unspecified reasons g | 11 NS NS | 32 - - | |||||||
[81] | Cohort l | Baseline Age Pediatric - Mean NR CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 39 | n | % | None reported | |||
- AST >3x ULN | 2 | 5 | |||||||
[82] | Cohort l | Baseline Age Pediatric and Adult - Range: 13–48 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 47 | See Discontinuation | Discontinuation: | n | % | ||
- Thoracic oppression and unspecified AE | 4 | 9 | |||||||
[83] | Cohort l | Baseline Age Adult - Mean: 28 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 61% | 46 | See Discontinuation | Discontinuation: | n | % | ||
- Dyspnea, increased sputum, and unspecified AE | 6 | 13 | |||||||
[37] | Cohort c,l | Baseline Age Adult - Mean: 31 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 28% | 30 | - Drop in ppFEV1 - Dyspnea, chest tightness, or chest pain - Increased sputum *Based on 31 trials of LUM/IVA in 30 patients | n 30 * 25 * NS | % 97 81 - | Discontinuation: - Respiratory AE, unspecified - Hypertension | n 3 1 | % 10 3 |
[84] | Cohort l | Baseline Age Adult - Mean: 31yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 40% | 8 | See Interruption | Interruption in n = 1 (13%): | n | % | ||
- Drop in ppFEV1 - Eczema | 1 1 | 13 13 | |||||||
[38] | Cohort c,l | Baseline Age Mean NR h CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 19 | See Discontinuation | Discontinuation: | n | % | ||
- Chest tightness and dyspnea | 4 | 21 | |||||||
[85] | Cross-sectional questionnaire | Baseline Age Mean NR h CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 11 | AE in n = 5 (46%): - Increased cough - Chest pain - Trouble breathing - Chest tightness - Stomach pain | n | % | Discontinuation: | n | % |
4 2 2 1 1 | 36 18 18 9 9 | - Increased cough | 1 | 9 | |||||
Tezacaftor/Ivacaftor | |||||||||
[86] | Prospective Cohort | Baseline Age Pediatric - Mean: 16 yr CFTR Genotype ∆F508 homozygous or heterozygous Baseline ppFEV1 Mean: 82% | 72 | See Discontinuation | | | Discontinuation: Overall total: - New-onset hemoptysis - Persistent nausea/vomiting - Elevated LFTs - Mental health changes - Alterations in blood glucose - Acholic stools | n 8 NS NS NS NS NS NS | % 11 - - - - - - |
[87] | Prospective Cohort | Baseline Age Mean NR h CFTR Genotype NR Baseline ppFEV1 Mean NR | 50 | n | % | Discontinuation: | n | % | |
- AE not specified | 5 | 10 | - Liver function abnormalities | 1 | 2 | ||||
[88] | Prospective Cohort | Baseline Age Adult - Mean: 34 yr CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean: 51% | 5 m | AE in n = 5 (11%) m: | n | % m | Discontinuation: | n | % m |
- Sleep pattern disturbance - Out of body experience - Visual hallucination - Depersonalization - “Brain fog” - Severe migraine | 2 1 1 1 1 1 | 5 2 2 2 2 2 | - Out of body experience, visual hallucination - Depersonalization, “brain fog” - Severe migraine | 1 1 1 | 2 2 2 | ||||
[89] | Retrospective Cohort | Baseline Age Adult - Mean NR CFTR Genotype ∆F508/∆F508 Baseline ppFEV1 Mean NR | 18 | See Discontinuation | Discontinuation: | n | % | ||
- Hair loss and fatigue | 1 | 6 | |||||||
[39] | Cohort c,l | Baseline Age Adult - Mean NR CFTR Genotype NR Baseline ppFEV1 Mean: 34% | 22 | AE in n = 3 (14%): - Rash - Blurred vision - Viral symptoms | n | % | Discontinued: | n | % |
2 1 1 | 9 5 5 | - Blurred vision | 1 | 5 | |||||
Elexacaftor/Tezacaftor/Ivacaftor | |||||||||
[40] | Retrospective Cohort | Baseline Age Adult - Mean: 36 yr CFTR Genotype ≥1 copy ∆F508 Baseline ppFEV1 Mean: 31% | 11 | n | % | None reported | |||
- Transaminitis | 4 | 36 |
Criteria | McKinzie et al., 2017 [47] | Nash et al., 2020 [27] | Rotolo et al., 2020 [52] | Safirstein et al., 2020 [53] | Talwalkar et al., 2017 [48] |
---|---|---|---|---|---|
1. Study objective clearly stated | Y | Y | N | Y | Y |
2. Study population clearly defined, using case definition | N | N | N | N | N |
3. Cases consecutive | NR | NR | NR | NR | NR |
4. Subjects comparable | CD | CD | CD | N | N |
5. Intervention clearly described | Y | Y | Y | Y | Y |
6. Outcome measures clearly defined, valid, reliable, implemented consistently | N | N | N | Y | N |
7. Adequate length of follow-up | Y | Y | Y | Y | CD |
8. Statistical methods well-described | N/A | N/A | N/A | N/A | N |
9. Results well-described | Y | N | Y | Y | Y |
Final rating | Poor | Poor | Fair | Good | Poor |
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Dagenais, R.V.E.; Su, V.C.; Quon, B.S. Correction: Dagenais et al. Real-World Safety of CFTR Modulators in the Treatment of Cystic Fibrosis: A Systematic Review. J. Clin. Med. 2021, 10, 23. J. Clin. Med. 2022, 11, 318. https://doi.org/10.3390/jcm11020318
Dagenais RVE, Su VC, Quon BS. Correction: Dagenais et al. Real-World Safety of CFTR Modulators in the Treatment of Cystic Fibrosis: A Systematic Review. J. Clin. Med. 2021, 10, 23. Journal of Clinical Medicine. 2022; 11(2):318. https://doi.org/10.3390/jcm11020318
Chicago/Turabian StyleDagenais, Renée V. E., Victoria C. Su, and Bradley S. Quon. 2022. "Correction: Dagenais et al. Real-World Safety of CFTR Modulators in the Treatment of Cystic Fibrosis: A Systematic Review. J. Clin. Med. 2021, 10, 23" Journal of Clinical Medicine 11, no. 2: 318. https://doi.org/10.3390/jcm11020318
APA StyleDagenais, R. V. E., Su, V. C., & Quon, B. S. (2022). Correction: Dagenais et al. Real-World Safety of CFTR Modulators in the Treatment of Cystic Fibrosis: A Systematic Review. J. Clin. Med. 2021, 10, 23. Journal of Clinical Medicine, 11(2), 318. https://doi.org/10.3390/jcm11020318