Three-year adherence to elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis

Résumé fourni par la source

Objectives: Adherence to cystic fibrosis transmembrane conductance regulator (CFTR) modulators is important, but long-term adherence data on elexacaftor/tezacaftor/ivacaftor (ETI) are limited. We aimed to explore three-year adherence to ETI. Methods: Adherence to ETI in people with cystic fibrosis (pwCF) eligible for ETI was retrospectively analysed over a 3-year period after ETI initiation, using Dutch single-centre pharmacy refill data. Monthly stock assessments were conducted. PwCF initiating ETI were followed-up for a maximum of three years. PwCF with dose adjustments or who discontinued ETI before the first year of follow-up were excluded. Adherence was calculated for ETI and the evening dose ivacaftor (IVA) separately. Proportion of Days Covered (PDC) was used as measure of adherence. PDC was calculated at 1, 2 and 3 years after initiating ETI. In addition, the number of non-adherent patients (defined as PDC<0.80) was determined. Differences in adherence over time were assessed. Results: Of 153 eligible pwCF, 25 fulfilled exclusion criteria, resulting in inclusion of 128 pwCF (75 male (59%), mean age 28.8 ± 15.5 years). PDC for ETI and IVA at 1 year (N = 128 and 113) were (median, range) 0.98 (0.69-1.0) and 0.98 (0.68 – 1.0); at 2 years (N = 104 and 95) 0.99 (0.54-1.0) and 1.0 (0.69-1.0) and at 3 years (N = 57 and 51) 0.98 (0.49-1.0) and 0.99 (0.54-1.0). 7 pwCF were nonadherent to ETI and 4 to IVA. A significant decline over time was found (p = 0.01 (ETI) and p = 0.003 (IVA)). Conclusion: Three-year adherence to ETI and IVA based on refill data was high, possibly due to the high efficacy of ETI and/or the monthly stock assessment, but appeared to decline in time.

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