CF treatment helps patients be more productive at work, in daily life
Patients in Canada reported benefits after one year of Trikafta
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One year of Trikafta treatment boosted work productivity and daily activities for people with cystic fibrosis (CF), a real-world study from Canada showed.
The gains stemmed from improvements in lung function, physical functioning, and the ability to engage in daily responsibilities.
“These findings suggest that the clinical benefits of [Trikafta] extend beyond traditional physiologic outcomes and translate into meaningful improvements in day-to-day functioning and workforce participation,” the researchers wrote in the study, “Assessing the impact of elexacaftor/tezacaftor/ivacaftor on work productivity and activity impairment in people living with cystic fibrosis in Canada,” published in the Journal of Cystic Fibrosis.
Treatment with CFTR modulator therapies like Trikafta has transformed the clinical outcomes of people with CF. Benefits include improvements in lung function, nutritional status, and health-related quality of life, as well as fewer pulmonary exacerbations (flare-ups of lung symptoms) and lung transplants.
These improvements have allowed some people with CF to attend school, complete academic milestones, and work. Despite this, outcomes related to work productivity and daily activities remain poorly characterized in the CFTR modulator era.
Data from prospective, retrospective studies
Researchers across Canada came together to examine the real-world effects of Trikafta on these outcomes and their association with quality of life.
Data came from CAN-IMPACT-CF, a prospective study (a study that follows participants forward in time) across five Canadian CF clinics, and REAL-ETI-CF, a retrospective study (one that looks back in time at data) group from the St. Paul’s Hospital Adult CF Clinic in Vancouver. The study included those who completed the Work Productivity and Activity Impairment questionnaire at the study’s start and after 12 months of Trikafta.
Of the 146 participants, the mean age was 33, and 60% were boys or men. Slightly more than half (53%) were actively working, one in six (16%) were in school, one-fourth (25%) were neither working nor in school, and a few (6%) did both. The group doing neither was older, included more female patients, and had worse lung function than those who were working and/or in school.
Among working participants, absenteeism — defined as the proportion of work missed due to health issues — dropped from 13.1% to 3.3%. Presenteeism, the reduced productivity from not functioning at full capacity while at work, decreased from 24.9% to 8.8%. Work productivity loss, which combines absenteeism and presenteeism, dropped from 30% to 10.8%.
Among students, absenteeism, presenteeism, and school productivity loss decreased, but the differences were not statistically significant, meaning the results may reflect chance. The team attributed this to the smaller sample size in this subgroup.
Changes in work productivity were due to improvements in nine of the 12 domains on the CF Questionnaire-Revised (CFQ-R), a quality-of-life assessment. The strongest impacts on work or school productivity were due to improved physical functioning, eased respiratory symptoms, and better role functioning (engaging in daily responsibilities).
Activity impairment, which reflects limitations on regular daily activities, such as housework and shopping, decreased from 30.1% to 15.1%. Reductions were again most strongly correlated with improvements in physical, respiratory, and role domains of the CFQ-R.
The researchers noted that in 2021, the year Trikafta was approved in Canada, the indirect costs related to lost productivity, absenteeism, and time spent on intensive daily treatments in Canada were estimated at CA$174 million ($122 million) annually.
Following a broader availability of Trikafta, indirect costs fell to an estimated CA$98 million ($69 million), a reduction of about 45%, which “coincided with reductions in hospitalizations, treatment time, and time away from work or school,” the team wrote.
The researchers said the study “demonstrates that initiation of [Trikafta] is associated with significant improvements in work productivity and reductions in activity impairment after one year of therapy.”
“Longer-term follow-up in larger cohorts will be important to define the durability of productivity gains and to understand how work and activity outcomes evolve over time in the [Trikafta] era,” they added.
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