Journal article
The rapid reduction of infection-related visits and antibiotic use among people with cystic fibrosis after starting Elexacaftor-Tezacaftor-Ivacaftor
Clinical infectious diseases, Vol.75(7), pp.1115-1122
02/10/2022
DOI: 10.1093/cid/ciac117
PMCID: PMC9525072
PMID: 35142340
Abstract
People with cystic fibrosis (CF) routinely suffer from recurrent sino-pulmonary infections. Such infections require frequent courses of antimicrobials and often involve multidrug-resistant organisms. The goal of this study was to identify real-world evidence for the effectiveness of Elexacaftor-Tezacaftor-Ivacaftor (ELX/TEZ/IVA) at decreasing infection-related visits and antimicrobial use in people with CF.
Using IBM MarketScan data, we identified 389 enrollees with CF who began taking ELX/TEZ/IVA prior to 12/1/2019 and were enrolled from 7/1/2019-3/14/2020. We also identified a comparison population who did not begin ELX/TEZ/IVA during the study period. We compared the following outcomes in the 15 weeks before and after medication initiation: total healthcare visits, inpatient visits, infection-related visits, and antimicrobial prescriptions. We analyzed outcomes using both a case-crossover analysis and a difference-in-differences analysis, to control for underlying trends.
For the case-crossover analysis, ELX/TEZ/IVA initiation was associated with 2.20 (95% CI: -3.26, -1.14) fewer overall healthcare visit-days, 0.16 (95% CI: -0.22, -0.11) fewer inpatient admissions, 0.33 (95% CI: -0.59, -0.07) fewer infection-related visit-days, and 0.78 (95% CI: -1.03, -0.54) fewer antibiotic prescriptions over a 15 week period. Results from the difference-in-differences approach were similar.
We show a rapid reduction of infection-related visits and antimicrobial use among people with CF after starting a therapy that was not explicitly designed to treat infections. Currently, there are over 30,000 people living with CF in the United States alone. Given that this therapy is effective for approximately 90% of people with CF, the impact on respiratory infections and antimicrobial use may be substantial.
Details
- Title: Subtitle
- The rapid reduction of infection-related visits and antibiotic use among people with cystic fibrosis after starting Elexacaftor-Tezacaftor-Ivacaftor
- Creators
- Aaron C Miller - University of IowaLogan M Harris - University of IowaJoseph E Cavanaugh - University of IowaMahmoud Abou Alaiwa - University of IowaDavid A Stoltz - University of IowaDouglas B Hornick - University of IowaPhilip M Polgreen - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.75(7), pp.1115-1122
- DOI
- 10.1093/cid/ciac117
- PMID
- 35142340
- PMCID
- PMC9525072
- NLM abbreviation
- Clin Infect Dis
- ISSN
- 1058-4838
- eISSN
- 1537-6591
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health, award: R01 AI143671-01A1
- Language
- English
- Electronic publication date
- 02/10/2022
- Academic Unit
- Statistics and Actuarial Science; Roy J. Carver Department of Biomedical Engineering; Molecular Physiology and Biophysics; Pulmonary, Critical Care, and Occupational Medicine; Infectious Diseases; Epidemiology; Biostatistics; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984227043702771
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