Bringing new treatments to the bedside in cystic fibrosis

The discovery of the cystic fibrosis transmembrane conductance regulator gene in 1989 led to a dramatic increase in the understanding of the molecular basis of CF. Increased knowledge has provided the opportunity to target drug development at correcting the basic defect either by gene therapy or pharmacological modulation of the abnormal physiological processes. Development of new medications for the CF population poses many challenges. The discovery and development of new medications is always time consuming and expensive. Since CF affects a small population worldwide, the potential for a drug company to profit from a new treatment is limited. In addition, each new therapy must have an additional and proven benefit to be attractive to clinicians and consumers, otherwise it will not be commercially viable. Demonstrating clinical benefit is problematic as a limited number of patients are available to participate in clinical trails and outcome measures, such as length of life, are hard to measure. In this review we will illustrate these challenges by discussing the development of treatments which have successfully reached the bedside and those that were unsuccessful.