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CFTR Modulator Therapy and Glycemic Control: A Meta-Analysis.

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This summary is machine-generated.

Elexacaftor/tezacaftor/ivacaftor (ETI) therapy significantly improves glycemic control in cystic fibrosis (CF) patients, lowering HbA1c and glucose levels. Early ETI initiation is linked to better outcomes, highlighting its importance for CF care.

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Area of Science:

  • Endocrinology
  • Pulmonology
  • Pharmacology

Background:

  • Cystic fibrosis-related diabetes (CFRD) adversely affects health outcomes in individuals with cystic fibrosis (CF).
  • Understanding the impact of CF transmembrane conductance regulator modulator (CFTRm) therapies on glycemic control is vital for enhancing overall health in CF patients.

Purpose of the Study:

  • To evaluate the effects of CFTRm therapy on glycemic control in people diagnosed with CF.

Main Methods:

  • A comprehensive literature search was performed across PubMed, Embase, and Cochrane Central Register of Controlled Trials from January 2011 to September 2024.
  • Included studies were interventional trials comparing CFTRm therapy to placebo/no treatment and observational studies assessing glycemic outcomes via oral glucose tolerance tests or continuous glucose monitoring.
  • Data extraction was conducted independently by two authors following the Cochrane Handbook guidelines.

Main Results:

  • Elexacaftor/tezacaftor/ivacaftor (ETI) therapy demonstrated significant improvements in 120-minute glucose levels (mean difference: -24.30 mg/dL) and reduced HbA1c (mean difference: -0.44%).
  • Earlier initiation of ETI therapy correlated with lower HbA1c values (P=.03).
  • Lumacaftor/ivacaftor, tezacaftor/ivacaftor, and ivacaftor monotherapy did not show significant changes in assessed glycemic outcomes.

Conclusions:

  • ETI therapy substantially improves glycemic control in CF, especially when started at a younger age.
  • The study may underestimate the full endocrine effects of CFTRm therapies due to the pre- vs. on-therapy assessment design.
  • Further research is warranted to validate and elaborate on these findings regarding CFTRm therapy's impact on glycemic control.