Jeffrey S Wagener1, Stefanie J Millar2, Nicole Mayer-Hamblett3, Gregory S Sawicki4, Edward F McKone5, Christopher H Goss6, Michael W Konstan7, Wayne J Morgan8, David J Pasta2, Richard B Moss9. 1. Department of Pediatrics, University of Colorado, Aurora, CO, USA. Electronic address: jeffrey.wagener@ucdenver.edu. 2. ICON Clinical Research, San Francisco, CA, USA. 3. US CFF Patient Registry Committee, Bethesda, MD, USA; Department of Pediatrics and Biostatistics, University of Washington, Seattle, WA, USA. 4. US CFF Patient Registry Committee, Bethesda, MD, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA. 5. Thoracic Medicine, St. Vincent's University Hospital, Dublin, Ireland. 6. US CFF Patient Registry Committee, Bethesda, MD, USA; Department of Medicine, University of Washington, Seattle, WA, USA. 7. Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA. 8. US CFF Patient Registry Committee, Bethesda, MD, USA; Department of Pediatrics, University of Arizona, Tucson, AZ, USA. 9. Department of Pediatrics, Stanford University, Palo Alto, CA, USA.
Abstract
BACKGROUND: Patients with cystic fibrosis (CF) experience variable lung disease phenotypes. The R117H mutation is often associated with preserved lung function. Our objective was to compare the rate of lung function decline in patients with the R117H mutation and patients homozygous for the F508del mutation. METHODS: Rate of decline in percentage-of-predicted FEV1 (ppFEV1) was analyzed using the 2006-2010 US CF Foundation Patient Registry. RESULTS: 4-year rate of decline was slower in 156 R117H patients compared with 6251 F508del patients (-0.61 vs -2.03 ppFEV1/year, P<0.001). Rates of decline in children were slower in R117H vs F508del patients (6-12-year-olds: +0.73 vs -1.91 ppFEV1/year, P<0.001 and 13-17-year-olds: -1.55 vs -2.66 ppFEV1/year, P=0.046), whereas rates in adults were not significantly different (18-24-year-olds: -1.52 vs -2.12, P=0.26 and ≥25-year-olds: -1.17 vs -1.40, P=0.33). CONCLUSIONS: These findings are consistent with a delayed onset, but ultimately similar progression, of lung disease in R117H compared with homozygous F508del patients.
BACKGROUND:Patients with cystic fibrosis (CF) experience variable lung disease phenotypes. The R117H mutation is often associated with preserved lung function. Our objective was to compare the rate of lung function decline in patients with the R117H mutation and patients homozygous for the F508del mutation. METHODS: Rate of decline in percentage-of-predicted FEV1 (ppFEV1) was analyzed using the 2006-2010 US CF Foundation Patient Registry. RESULTS: 4-year rate of decline was slower in 156 R117Hpatients compared with 6251 F508delpatients (-0.61 vs -2.03 ppFEV1/year, P<0.001). Rates of decline in children were slower in R117H vs F508delpatients (6-12-year-olds: +0.73 vs -1.91 ppFEV1/year, P<0.001 and 13-17-year-olds: -1.55 vs -2.66 ppFEV1/year, P=0.046), whereas rates in adults were not significantly different (18-24-year-olds: -1.52 vs -2.12, P=0.26 and ≥25-year-olds: -1.17 vs -1.40, P=0.33). CONCLUSIONS: These findings are consistent with a delayed onset, but ultimately similar progression, of lung disease in R117H compared with homozygous F508delpatients.
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