The rapid reduction of infection-related visits and antibiotic use among people with cystic fibrosis after starting Elexacaftor-Tezacaftor-Ivacaftor

Aaron C Miller; Logan M Harris; Joseph E Cavanaugh; Mahmoud Abou Alaiwa; David A Stoltz; Douglas B Hornick; Philip M Polgreen

doi:10.1093/cid/ciac117

Back

The rapid reduction of infection-related visits and antibiotic use among people with cystic fibrosis after starting Elexacaftor-Tezacaftor-Ivacaftor

Journal article

Open access

Peer reviewed

The rapid reduction of infection-related visits and antibiotic use among people with cystic fibrosis after starting Elexacaftor-Tezacaftor-Ivacaftor

Aaron C Miller, Logan M Harris, Joseph E Cavanaugh, Mahmoud Abou Alaiwa, David A Stoltz, Douglas B Hornick and Philip M Polgreen

Clinical infectious diseases, Vol.75(7), pp.1115-1122

10/01/2022

DOI: 10.1093/cid/ciac117

PMCID: PMC9525072

PMID: 35142340

Files and links (1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9525072View

Published (Version of record) Open Access

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.

Cystic Fibrosis

ELX/TEZ/IVA

Trikafta

CFTR modulators

CFTR

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 Iowa
Logan M Harris - University of Iowa
Joseph E Cavanaugh - University of Iowa
Mahmoud Abou Alaiwa - University of Iowa
David A Stoltz - University of Iowa
Douglas B Hornick - University of Iowa
Philip 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
Date published: 10/01/2022
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

Metrics

73 Record Views

40 Times Cited - Web of Science