Evolving cystic fibrosis care models in the modulator era

The advent of CFTR modulators and the adoption of telemedicine during the COVID-19 pandemic have prompted reconsideration of cystic fibrosis (CF) care models. This review explores how care delivery may evolve in response to these changes.

Emerging evidence highlights the heterogeneity in response to CFTR modulators, with some patients continuing to experience disease progression. Preliminary trial data have explored therapy de-escalation, but long-term safety remains uncertain. Challenges in microbiological surveillance, particularly due to reduced sputum production, complicate monitoring. Early efforts to define "stability" have led to position statements advocating risk-stratified, hybrid care models.

CF care models should shift toward individualized, flexible approaches that prioritize equity and safety. Clinical trials and registry analyses will be essential to validate such models. Until then, conservative implementation with continued multidisciplinary support and objective monitoring are advised.