Kaftrio treatment associated with fewer sinus surgeries

In the study, only one of 44 patients on the therapy had the procedure

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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People with cystic fibrosis (CF) who have chronic inflammation in the nose are less likely to need sinus surgery if they are taking the triple-combination CFTR modulator treatment Kaftrio (elexacaftor/tezacaftor/ivacaftor).

That’s according to “Triple combination CFTR modulator therapy reduces the need for endoscopic sinus surgery in adult patients with cystic fibrosis,” which was published in Clinical Otolaryngology.

CF characteristically causes inflammation in the airways and people with the condition frequently have chronic rhinosinusitis, inflammation in the nose and sinuses, which can lead to a persistently stuffy or runny nose. The disease is caused by mutations that disrupt the production or function of the CFTR protein.

Vertex Pharmaceuticals‘ Kaftrio (sold as Trikafta in the U.S.) contains a combination of three CFTR modulators — molecules that can boost the functionality of the defective CFTR protein where certain CF-causing mutations are present.

The therapy is authorized in Europe for children as young as 2 who carry either two copies of F508del, the most common CF-causing mutation, or one copy of F508del and a mutation in which the resulting CFTR protein works poorly.

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Can taking Kaftrio ease chronic rhinosinusitis?

Since Kaftrio was approved, some studies have reported it can help ease rhinosinusitis in people with CF.

Here, scientists in Italy reviewed data for 89 adults with CF, ages 18 to 73, all with chronic rhinosinusitis, to see if taking Kaftrio lowered the need for sinus surgeries, which are sometimes performed when polyps or blockages in the nose cause problems with air flowing through the sinuses. Forty-four of the patients were treated with Kaftrio. The rest were not.

“To our knowledge, this is the first study that evaluated the association between triple combination CFTR modulating therapy and the number of [sinus surgery] procedures performed in CF patients,” they wrote.

Over more than a year of follow-up, only one patient on Kaftrio underwent a sinus surgery compared to eight who weren’t on treatment.

“Our study shows that in the [Kaftrio] group, a statistically significant lower number of patients underwent [sinus surgery],” the researchers wrote.

Consistent with previous studies, the results suggested Kaftrio helped ease nose and sinus disease. For example, scores on the 22-item SinoNasal Outcome Test (SNOT-22), a standardized assessment of sinonasal-related life quality, improved significantly after a year. Sinus disease severity also eased with Kaftrio.

This result “confirms the usefulness of these therapies for chronic rhinosinusitis in CF patients,” said the scientists, who acknowledged the study was limited by a relatively small group of patients. “Probably, future larger prospective studies are warranted in order to properly evaluate the potential role of triple combination CFTR modulating therapy in reducing the need to perform [sinus surgery].”