Literature DB >> 35054167

Correction: Dagenais et al. Real-World Safety of CFTR Modulators in the Treatment of Cystic Fibrosis: A Systematic Review. J. Clin. Med. 2021, 10, 23.

Renée V E Dagenais1,2, Victoria C Su1,2, Bradley S Quon1,3,4.   

Abstract

In the original article [...].

Entities:  

Year:  2022        PMID: 35054167      PMCID: PMC8779097          DOI: 10.3390/jcm11020318

Source DB:  PubMed          Journal:  J Clin Med        ISSN: 2077-0383            Impact factor:   4.241


In the original article [1], there was a mistake in Table 1 as published. Reference citation [34] was wrong. The corrected Table 1 appears below. The authors state that the scientific conclusions are unaffected. The original article has been updated.
Table 1

Summary of characteristics and results of cohort or survey studies with full manuscript.

RefStudy Design & LocationPopulation a n Recruitment Period & Follow-Up DurationOverall Adverse Events (AE) b,cDose Modification, Interruption, or Discontinuation Due to AE b,c
Ivacaftor
[29]Prospective Cohort d United StatesBaseline AgePediatric and Adult- Mean: 33 yr- Range: 10–61 yr CFTR Genotype≥1 copy G551D Baseline ppFEV1Mean: 30%44Recruitment PeriodPrior to commercial availability Follow-Up DurationNS AE in n = 38 (86%): n % Discontinuation: n %
- Pulmonary exacerbation- Hemoptysis- Increased sputum- Increased cough- URTI- Dyspnea- Abnormal respiration - Respiratory tract congestion- Headache- Rash207766333544516161414777119- Severe abdominal pain- Dizziness/tinnitus1122
SAE in n = 14 (32%):
- Pulmonary exacerbation- Hemoptysis- Pneumothorax- Acute respiratory failure- URTI- Abdominal pain- Gastroenteritis- Abnormal LFTs- Syncope- Secondary adrenocortical insufficiencyNSNSNSNSNSNSNSNSNSNS----------
[55]Prospective Cohort United StatesCanadaItalyBaseline AgePediatric and Adult- Mean: 17 yr- Range: 5–61 yr CFTR Genotype≥1 gating mutation Baseline ppFEV1Mean: 86%23Recruitment Period Mar 2014 to Aug 2015 Follow-Up Duration3 mo 49 AE in n = 21 (91%): n % None reported
- Respiratory, unspecified- Gastrointestinal, unspecified- Infection, unspecified- Headache- Weakness- Dizziness- Fatigue NSNSNSNSNSNSNS-------
5 SAE in n = 3 (13%): n %
- Respiratory infection- Acute changes in metabolic and liver status41174
[56]Retrospective Cohort United Kingdom(1 center)Baseline AgePediatric - Mean: 9 yr- Range: 6–14 yr CFTR Genotype1 copy G551D Baseline ppFEV1Mean: 68% e4Recruitment PeriodJan 2013 to Jun 2015 Follow-Up DurationMean: 24 mo- Transaminitis (<3 x ULN)n1%25None reported
[57]Retrospective Cohort Scotland(11 centers)Baseline AgePediatric - Median: 9 yr CFTR Genotype≥1 copy G551D Baseline ppFEV1Mean: 85%26Recruitment PeriodNS (Jan 2013 to Mar 2013 for 85%) Follow-Up DurationMean: 17 mo n % None reported
- Headache - Swollen ear - Cataracts 1124417 f
[58]Retrospective Cohort France(25 centers)Baseline AgePediatric and Adult- Median: 18 yr- Range: 6–52 yr CFTR Genotype≥1 copy G551D Baseline ppFEV1Mean: 72%57Recruitment PeriodPre-1 Jun 2013 up to 30 Sep 2014  Follow-Up DurationUp to 2 yr 34 AE in n = 21 (37%): n % Interruption in n = 7 (12%): n %
- Transaminitis- Rhinopharyngitis- Asthma- Fever- Chest pain- Abdominal pain- Nausea or vomiting- Intestinal dysmotility- Headache- Fatigue- Rash or eczema- Depression- Myalgia- Arthritis- Breast hypertrophy- Orchitis- Atrial fibrillation3NSNSNSNSNSNSNSNSNSNSNSNSNSNSNSNS5----------------- Hepatitis- Rhinopharyngitis- Abdominal pain- Vomiting- Headache- Rash- Severe depression NSNSNSNSNSNSNS -------
Discontinuation:
- Transaminitis- Liver cirrhosis diagnosis1122
[30]Retrospective Cohort d Germany(multicenter)Baseline AgeAdult - Mean: 34 yr CFTR Genotype≥1 copy G551D Baseline ppFEV1Mean: 25%14Recruitment PeriodSep 2012 to Apr 2013 Follow-Up DurationMean: 235 days - Increased bronchial and nasal secretions - Headache- Worsening RLS- Abdominal pain- Hyperbilirubinemia (mild)- Transaminitis (<3 to 4x ULN)n311111%2177777Discontinuation:- Increased bronchial and nasal secretions * * Trial of reduced dose before discontinuationn1%7
Lumacaftor/Ivacaftor
[41]Prospective Cohort France (1 center)Baseline AgePediatric- Mean: 16 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 87%32Recruitment PeriodMar 2016 to Dec 2016 Follow-Up Duration4 h post-first dose- Acute drop in ppFEV1- Wheeze n323 %1009 None reported
[42]Prospective Cohort  France(47 centers)Baseline AgePediatric and Adult- Mean: 22 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 65%845Recruitment Period1 Jan 2016 to 31 Dec 2016 Follow-Up Duration12 mo AE in n = 494 (59%): n % Interruption: n %
- Respiratory- Digestive- Menstrual abnormality- Fatigue- Headache- CK > 5xULN - Transaminitis (> 3xULN)316181533719205372164220.6- Respiratory- ‘Non-respiratory’ Discontinuation:Respiratory - Chest tightness/dyspnea- Bronchospasm- Increased cough/sputum- Hemoptysis- Pneumothorax Non-respiratory- Diarrhea, abdominal pain- CK >10xULN + myalgia - Fatigue- Headache- Depression- Metrorrhagia- Transaminitis (>6xULN) - Cutaneous rash- Tachycardia168 n 3824921  185544321121 % 5310.20.1  20.60.60.50.50.40.20.10.1
[59]Prospective Cohort United States(1 center) Baseline AgePediatric and Adult- Mean: 23 yr- Range: 12–48 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 70%26Recruitment PeriodNS Follow-Up Duration6 moSee DiscontinuationDiscontinuation:- Transaminitis- Unspecified AE n14%415
[31]Prospective Cohort d Switzerland(1 center)Baseline AgeAdult- Mean NR CFTR Genotype∆F508/∆F508 Baseline ppFEV1Median: 30%20Recruitment PeriodJan 2016 to Jan 2017 Follow-Up Duration1 mo n % Reduced dose: n %
- Dyspnea - 3 h - 24 h - 1 mo- Chest tightness - 3 h - 24 h - 1 mo- Increased sputum  - 3 h - 24 h - 1 mo- Pulmonary exacerbation - 1 mo011 1101 183 2-55 5505 54015 10- Respiratory intolerance Discontinuation:- Chest tightness (at 24 h) 3  115  5
[32]Prospective Cohort Australia(1 center)Baseline AgeAdult- Mean: 27 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Median: 36%12Recruitment PeriodJan 2016 to Oct 2016 Follow-Up Duration1 mo n % Discontinuation: n %
- Acute drop in ppFEV1- Respiratory AE overall - 4 h - 24 h - 1 mo- Dyspnea - 4 h - 24 h - 1 mo- Chest tightness - 4 h - 24 h - 1 mo- Increased sputum - 4 h - 24 h - 1 mo- Pulmonary exacerbation12 5108 267 485 0216100 428367 175058 336742 -17850- Chest tightness/dyspnea * * n = 2 discontinued after 1mo follow-up (5 wk and 9 wk)325
[33]Prospective Cohort France(11 centers)Baseline AgeAdult- Mean: 31 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 32%53Recruitment PeriodJan 2016 to Jun 2016  Follow-Up Duration3 moAE in n = 34 (63%): n % Discontinuation: n %
- Abnormal respiration- Dyspnea- Increased cough- Abdominal pain, nausea, diarrhea, or vomiting- Fatigue- Rash- Pruritus- Breast tension131139 21112521617 4222- Respiratory intolerance- Vomiting- Fatigue13112522
[25]Prospective Cohort d,g Australia(1 center)Baseline AgeAdult- Mean: 27 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 36% 10Recruitment PeriodNS Follow-Up Duration52 wk AE in n = 6 (60%): n % None reported
- Chest tightness/dyspnea- Headache626020
[43]Retrospective CohortIreland (1 center)Baseline AgePediatric- Mean: 14 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 77% 15Recruitment PeriodSep 2016 to Aug 2017 Follow-Up DurationNS n % None reported
- Acute drop in ppFEV1- Chest tightness- Increased sputum 1422931313
[44]Retrospective Cohort  United States(1 center)Baseline AgePediatric and Adult- Mean: 25 yr- Range: 12–59 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 67%116Recruitment PeriodNS Follow-Up DurationUp to 11 mo AE in n = 46 (40%): n % Reduced dose: n %
- Chest tightness- Dyspnea- Increased cough- Diarrhea- Nausea- Decreased appetite- Rash2312105322201094322- AE not specified Discontinuation:- Reasons not specified h10  209  17
[60]Retrospective Cohort Greece(1 center)Baseline AgePediatric and Adult- Mean: 16 yr i- Range: 12–23 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean 92% i62Recruitment PeriodMar 2016 to Aug 2017 Follow-Up Duration12 mo- Chest tightnessn2%3Discontinuation:- Transaminitis- Cataractn11%22
[34]Retrospective Cohort d Spain(multicenter)Baseline Age Pediatric and Adult- Mean: 27 yr- Range: 10–45 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 32%20Recruitment Period2016 Follow-Up Duration6 mo AE in n = 15 (75%): n % Discontinuation: n %
- Chest tightness- Dyspnea- Headache- Weight loss- ‘Sickness’ (not defined)- Asthenia- Abdominal pain- Transaminitis985533224540252515151010- Decreased ppFEV1- AE not specified     16     530   
[45]Retrospective Cohort Canada(1 center)Baseline AgeAdult- Median: 32 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Median: 40%22Recruitment PeriodApr 2016 to Jun 2018 Follow-Up DurationMedian: 10 mo AE in n = 19 (86%): n % Discontinuation: n %
- Chest tightness- Wheeze- Dyspnea- Increased sputum- Increased cough- Flu-like symptoms- Elevated blood pressure- Headache- Nausea- Elevated AST- Anxiety- Bradycardia - Pleuritic chest pain144332154211116418141495231895555- Respiratory symptoms- Asymptomatic hypertension- Symptomatic hypertension - Headache - Hypertensive emergency- Anxiety32 111149 555
[61]Retrospective Cohort United States(1 center)Baseline AgeAdult- Mean NR CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR82Recruitment PeriodJul 2015 to Jun 2016 Follow-Up Duration12 moSee Discontinuation Discontinuation:Total overall:- Chest tightness * - Diarrhea **- Abdominal pain- Nausea **- Dysphagia- Elevated LFTs- Pericarditis- Allergic reaction **- Suspected Stevens–Johnson syndrome * n = 3 also had significant drop in ppFEV1** n = 1 also discontinued due to chest tightnessn171121111111%211321111111
[26]Retrospective Cohort d,g Australia(7 centers)Baseline AgeAdult- Mean: 31 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 37%72Recruitment PeriodNov 2015 to Mar 2017 Follow-Up Duration12 mo n % Discontinuation: n %
- Chest tightness/dyspnea- Increased sputum- Decrease in ppFEV1- Headache- Fatigue- Nausea- Rash4042251256633713- Chest tightness/dyspnea2231
[27]Case Series (Survey) j International (31 centers)Baseline AgeAdult - Mean: 30 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 59%26Recruitment PeriodQuestionnaire sent in 2018–2019 Follow-Up DurationNS n % Discontinuation: n %
- Pulmonary exacerbation- Post-partum acute myelocytic leukemia 1144- Chest tightness28

a When adult and pediatric patients both included, age range reported when possible; b Rates not reported for all AE, as indicated by ‘NS’; c To avoid redundancy, if AE only reported in context of dose modification, interruption, and/or discontinuation of therapy, it was not listed in overall AE; d Study population part of a compassionate, ‘expanded access’, ‘managed access’, or ‘named patient’ program; e Mean calculated from n = 3 (75%) of study subjects, as baseline not reported for n = 1 (25%); f Frequency of 17% based on n = 12 screened; 8% frequency for overall cohort of n = 26; g Study was case-control, but only LUM/IVA-treated participants included in systematic review; therefore, assessed as cohort study; h Reason for discontinuation was not consistently assessed, and may include reasons unrelated to AE; i Mean baseline age and ppFEV1 based on n = 52 in final analysis of outcomes assessing effectiveness; n = 10 excluded from this analysis; j This case series is included in Table 1 due to results being presented in aggregate. AST, aspartate aminotransferase; CFTR, cystic fibrosis transmembrane conductance regulator; CK, creatine kinase; h, hour(s); LFT, liver function test; mo, month(s); NR, not reported; NS, not specified; ppFEV, percent predicted Forced Expiratory Volume in 1 sec; RLS, restless leg syndrome; SAE, serious adverse events; ULN, upper limit of normal; URTI, upper respiratory tract infection; wk, week(s); yr, year(s).

In the original article [1], there was a mistake in Table 2 as published. Subtitle “Lumacaftor/Ivacaftor” was wrong. The corrected Table 2 appears below. The authors state that the scientific conclusions are unaffected. The original article has been updated.
Table 2

Summary of characteristics and results of cohort or survey studies in abstract form.

RefStudy DesignPopulation n Overall Adverse Events (AE) a,bDose Modification, Interruption, or Discontinuation Due to AE a,b
Ivacaftor
[62]Prospective CohortBaseline AgePediatric- Mean: 5 yr CFTR Genotype≥1 gating mutation Baseline ppFEV1Mean NR4 AE in n = 2 (50%): n % None reported
- URTI- Nasal congestion- HeadacheNSNSNS---
[63]Retrospective CohortBaseline AgePediatric - Mean: 6 yr CFTR Genotype≥1 gating mutation Baseline ppFEV1Median: 87%10- Transient rash- Increased obesity    n21    %2010    None reported               
[64]Prospective CohortBaseline AgePediatric and Adult- Mean NR CFTR Genotype≥1 copy S549R Baseline ppFEV1Mean: 54%15- Liver enzyme derangement n % None reported
213
[65]Cross-sectional SurveyBaseline AgeAdult- Mean: 26 yr CFTR Genotype≥1G551D Baseline ppFEV1Mean: 62%11 d AE in n = 8 (73%) d:- Transient rash- Dizziness- Unspecified AEnNSNSNS%---None reported
Lumacaftor/Ivacaftor
[66]Prospective CohortBaseline AgePediatric - Mean: 13 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 91%14 n % Reduced dose *: n %
- Acute drop in ppFEV1 (asymptomatic)- Chest tightness, tachypnea (requiring oxygen)1 17 7- Chest tightness, tachypnea * Eventual titration to full dose17
[67]Prospective CohortBaseline AgePediatric - Mean: 14 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 87%13 n % None reported
- Drop in ppFEV1 requiring salbutamol 7   54
[68]Prospective CohortBaseline AgePediatric and Adult- Mean: 23 yr e CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean 61% e369 n % Discontinuation: n %
- Bronchospasm- Dyspnea- Abnormal respiration - Unspecified respiratory AE- Unspecified AE  151274120432133- Unspecified AE 16 4 
[69]Prospective Cohort Baseline AgePediatric and Adult- Mean: 25 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR311379 AE in n = 213 (68%):- Dyspnea- Cough- GI discomfort (e.g., diarrhea, nausea, abdominal pain)- Headache- Fatigue- Unspecifiedn fNSNSNS NSNSNS%31631 65NRInterruption (stop/restart):- Unspecified AE and other reasons g Discontinuation:- Unspecified AE and other reasons gn12  42%4  14
[35]Prospective Cohort c Baseline AgeAdult - Median: 31 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Median: 28%14 n % Discontinuation: n %
- Chest tightness, breathless- Rash71507- Respiratory AE and/or rash429
[70]Prospective CohortBaseline AgeAdult - Mean NR CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR29 n % Reduced dose: n %
- Chest tightness * * n = 4 cases severe, requiring hospitalization for IV steroids and antibiotics 13 45 - Chest tightness  Discontinuation:- Chest tightness2  57  17
[36]Prospective Cohort cBaseline AgeMean NR h CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR32AE in 88%: n f % Interruption (stop/restart): n %
- Respiratory AE- Drop in ppFEV1    NSNS    87-    - Unspecified AEA Discontinuation:- Unspecified AE  1  8  3  25  
[71]Retrospective CohortBaseline AgePediatric and Adult - Mean NR  CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR34AE in n = 29 (85%):- Pulmonary exacerbation- Chest tightness- Dyspnea- Diarrhea- Abdominal painn169333%4726999Discontinuation:- Unspecified AEn10%29
Serious AE in n = 8 (24%):
- Respiratory failure i- Unspecified AE17321
[72]Retrospective CohortBaseline AgePediatric and Adult - Mean: 26 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 68%103See Discontinuation Interruption/discontinuation j: n %
- Chest tightness and/or pain- Elevated LFTs 17NS17-
[73]Retrospective CohortBaseline AgeAdult - Mean: 31 yr  CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 50%71 AE in n = 41 (58%): n % Discontinuation: n %
- Chest tightness- Dyspnea- Increased cough- GI (pain, constipation, or diarrhea)- Rash- Pruritus- Irregular menses or metrorrhagia- Breast tension- Headache- Myalgia22846413211311169614311- Dyspnea- Chest tightness- Increased cough- Fatigue763110941
[74]Retrospective CohortBaseline AgeMean NR h CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR54 See Discontinuation Discontinuation: n %
- Chest tightness, dyspnea, and/or drop in ppFEV1 8  15  
[75]Retrospective CohortBaseline AgeAdult - Mean: 31 yr  CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR28- Increased work of breathing or chest tightness- Drop in ppFEV1n12 5%43 18Discontinuation- Respiratory intolerance vs. pulmonary exacerbation- Persistent respiratory intolerance/chest tightness- Rash and swelling of face- Increased anxietyn1 3 11%4 11 44
[76]Retrospective CohortBaseline AgeAdult - Mean NR CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR46 n % Discontinuation: n %
- Drop in ppFEV1 - Transaminitis 212464- Dyspnea, cough, CFPEx, and/or chest tightness- Transaminitis- Headache- Muscle ache- Fatigue- Rash4 1NSNSNSNS9 2----
[77]Retrospective CohortBaseline AgeAdult - Mean NR CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR28See Discontinuation Discontinuation: n %
- SOB and/or drop in ppFEV11554
[78]Retrospective CohortBaseline AgeMean: 32 yr h CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 62%20Overall AE: n % Interruption (stop/restart): n %
- Chest tightness- Elevated LFTs- Upset stomach- Increased stool output- Rash- Elevated thyroid function test- RA exacerbationNSNSNSNSNSNSNS-------- Unspecified AE - full-dose restart - half-dose restart Discontinuation: - Unspecified AE24  21020  10
[79]Retrospective CohortBaseline AgeMean NR h CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR60- Heartburn/reflux- Abdominal pain- Loose/oily stoolsn201917%333228None reported
[80]Retrospective CohortBaseline AgeMean: 29 yr h,k CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 80% k34See Discontinuation Discontinuation: n %
Overall total: - Respiratory AE (70%) f - Unspecified reasons g11NSNS32--
[81]Cohort lBaseline AgePediatric- Mean NR CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR39 n % None reported
- AST >3x ULN25
[82]Cohort lBaseline AgePediatric and Adult - Range: 13–48 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR47 See Discontinuation Discontinuation: n %
- Thoracic oppression and unspecified AE49
[83]Cohort lBaseline AgeAdult - Mean: 28 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 61%46See Discontinuation Discontinuation: n %
- Dyspnea, increased sputum, and unspecified AE613
[37]Cohort c,lBaseline AgeAdult - Mean: 31 yr CFTR Genotype∆F508/∆F508Baseline ppFEV1Mean: 28%30- Drop in ppFEV1- Dyspnea, chest tightness, or chest pain- Increased sputum *Based on 31 trials of LUM/IVA in 30 patientsn30 *25 *NS%9781-Discontinuation:- Respiratory AE, unspecified- Hypertensionn31%103
[84]Cohort lBaseline AgeAdult - Mean: 31yr  CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 40%8See Interruption Interruption in n = 1 (13%): n %
- Drop in ppFEV1 - Eczema111313
[38]Cohort c,lBaseline AgeMean NR h CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR19See Discontinuation Discontinuation: n %
- Chest tightness and dyspnea4 21
[85]Cross-sectional questionnaireBaseline AgeMean NR h CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean NR11AE in n = 5 (46%):- Increased cough- Chest pain- Trouble breathing- Chest tightness- Stomach pain n % Discontinuation: n %
4221136181899- Increased cough19
Tezacaftor/Ivacaftor
[86]Prospective CohortBaseline AgePediatric- Mean: 16 yr CFTR Genotype∆F508 homozygous or heterozygous Baseline ppFEV1Mean: 82%72See Discontinuation                    Discontinuation:Overall total:- New-onset hemoptysis- Persistent nausea/vomiting- Elevated LFTs- Mental health changes- Alterations in blood glucose- Acholic stoolsn8NSNSNSNSNSNS%11------
[87]Prospective Cohort Baseline AgeMean NR h CFTR GenotypeNR Baseline ppFEV1Mean NR50 n % Discontinuation: n %
- AE not specified 510- Liver function abnormalities 12
[88]Prospective CohortBaseline AgeAdult- Mean: 34 yr CFTR Genotype∆F508/∆F508 Baseline ppFEV1Mean: 51%5 mAE in n = 5 (11%) m: n % m Discontinuation: n % m
- Sleep pattern disturbance- Out of body experience- Visual hallucination- Depersonalization- “Brain fog”- Severe migraine211111522222- Out of body experience, visual hallucination- Depersonalization, “brain fog”- Severe migraine1 112 22
[89]Retrospective CohortBaseline AgeAdult- Mean NRCFTR Genotype∆F508/∆F508Baseline ppFEV1Mean NR18See Discontinuation Discontinuation: n %
- Hair loss and fatigue16
[39]Cohort c,lBaseline AgeAdult - Mean NR CFTR GenotypeNR  Baseline ppFEV1Mean: 34%22AE in n = 3 (14%):- Rash- Blurred vision- Viral symptoms n % Discontinued: n %
211  955- Blurred vision 15
Elexacaftor/Tezacaftor/Ivacaftor
[40]Retrospective CohortBaseline AgeAdult- Mean: 36 yr CFTR Genotype≥1 copy ∆F508 Baseline ppFEV1Mean: 31%11 n % None reported
- Transaminitis436

a Rates not reported for all AE, as indicated by ‘NS’; b To avoid redundancy, if AE only reported in context of dose modification, interruption, and/or discontinuation of therapy, it was not listed in overall AE; c Study population part of a compassionate, ‘early access’, ‘expanded access’, ‘managed access’, or ‘named patient’ program; d Total study cohort of n = 11, but only n = 9 patients completed symptom questionnaire; AE frequency calculated based on total n = 11, e Mean baseline age and ppFEV1 based on n = 135 in final analysis of outcomes assessing effectiveness; n = 234 excluded from this analysis; f As reported, unable to accurately determine the absolute number of patients who experienced AE; g Frequency of specific reasons for interruption or discontinuation not clear and include reasons unrelated to AE; h Included age groups (i.e., pediatric and/or adult) not specified; i Respiratory failure occurred in 1 individual on two occasions, both within 24 h of initiating and reinitiating LUM/IVA; j Of the n = 25 who stopped, 9 restarted and 6 of experienced the same AE; unclear which AE the 3 who restarted experienced and whether the 6 who experienced the same AE then discontinued permanently; k Mean baseline age and ppFEV1 based on n = 23 in final analysis of outcomes assessing effectiveness; n = 11 excluded from this analysis; l Unable to discern if prospective versus retrospective based on reported information; m Total study cohort of n = 44, but focused on neurocognitive AE in n = 5; AE frequencies calculated based on total n = 44. AST, aspartate aminotransferase; CFTR, cystic fibrosis transmembrane conductance regulator; CFPEx, cystic fibrosis pulmonary exacerbation; GI, gastrointestinal; LFT, liver function test; LUM/IVA, lumacaftor/ivacaftor; NR, not reported; NS, not specified; ppFEV percent predicted forced expiratory volume in 1 sec; RA, rheumatoid arthritis; SOB, shortness of breath; ULN, upper limit of normal; URTI, upper respiratory tract infection; yr, year(s).

In the original article [1], there was a mistake in Table A2 as published. Reference citation [48,49,53,54] were wrong. “Talkwalker” was misspelled. The corrected Table A2 appears below. The authors state that the scientific conclusions are unaffected. The original article has been updated.
Table A2

Summary of methodological ratings of included case series a,b.

CriteriaMcKinzie et al., 2017 [47]Nash et al., 2020 [27]Rotolo et al., 2020 [52]Safirstein et al., 2020 [53]Talwalkar et al., 2017 [48]
1. Study objective clearly statedYYNYY
2. Study population clearly defined, using case definitionNNNNN
3. Cases consecutiveNRNRNRNRNR
4. Subjects comparableCDCDCDNN
5. Intervention clearly describedYYYYY
6. Outcome measures clearly defined, valid, reliable, implemented consistentlyNNNYN
7. Adequate length of follow-upYYYYCD
8. Statistical methods well-describedN/AN/AN/AN/AN
9. Results well-describedYNYYY
Final rating Poor Poor Fair Good Poor

a Studies were rated against the 9 criteria of the Quality Assessment for Case Series Studies from the National Institutes of Health, National Heart, Lung, and Blood Institute [24] from the standpoint of AE assessment; b Only case series with a full manuscript were assessed for quality. AE, adverse event; CD, cannot determine; N, no; N/A, not applicable; NR, not reported; Y, yes.

  1 in total

Review 1.  Real-World Safety of CFTR Modulators in the Treatment of Cystic Fibrosis: A Systematic Review.

Authors:  Renée V E Dagenais; Victoria C H Su; Bradley S Quon
Journal:  J Clin Med       Date:  2020-12-23       Impact factor: 4.241

  1 in total

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