P228 Multicentre review of lung microbiome for patients with cystic fibrosis treated with elexacaftor/tezacaftor/ivacaftor

Published Date: 01st June 2024

Publication Authors: Rajkumar. D, Ramachandran. S, Redfern. S, Kandasamy. S, Chilukuri. L, Prasad. A

Background
Respiratory tract infections are a leading cause of morbidity in children with cystic fibrosis(CF). The introduction of the highly effective modulator elexacaftor-tezacaftor-ivacaftor (ETI) has been shown to be clinically effective in terms of improved lung function, decreased symptoms and improved CFTR function. The results on the microbiome are less clear. The aim of this reviewwas to assess the impact of ETI on lung microbiome in our population.

Methodology
Retrospective data were collected from each of the 11 centres within our CF network. CF patients with lung microbiome results available 12 months prior to and 15 months after commencing ETI were included. The 3-month period after initiation was treated as a washout period and excluded. Completed data sets (available for 8/11 centers) were analysed using GraphPad Prism 10, with Fisher's exact test.

Results
A total of 142 patients were analysed. Mean (range) age at initiation was 11.2(2.5-17.2) years. A total of 1,208 samples (947 cough swabs, 225 sputum, 36 bronchoalveolar lavage(BAL)) were analysed pre and 927 samples (827 cough swabs, 79 sputum, 21 BAL) post. No. of patients who isolated organisms on sampling in the 12 month pre ETI an 2 months after ETI initiation. There was a statistically significant reduction in patients with growths of PA, SM, AF and CS.

Conclusion
This review identified a statically significant reduction for specific lung microbiome with commencement of ETI. This warrants ongoing review to assess sustained benefits on the microbiome. [Formula presented]

 

Rajkumar, D; Ramachandran, S; Redfern, S; Kandasamy, S; Chilukuri. L; Prasad, A. (2024). P228 Multicentre review of lung microbiome for patients with cystic fibrosis treated with elexacaftor/tezacaftor/ivacaftor. Journal of Cystic Fibrosis. 23(Suppl 1), p.S139. [Online]. Available at: https://doi.org/10.1016/S1569-1993(24)00532-0 [Accessed 12 June 2024]

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