Short-Term Effects of Elexacaftor/Tezacaftor/Ivacaftor Combination on Glucose Tolerance in Young People With Cystic Fibrosis-An Observational Pilot Study

Insa Korten; Elisabeth Kieninger; Linn Krueger; Marina Bullo; Christa E Flück; Philipp Latzin; Carmen Casaulta; Claudia Boettcher

doi:10.3389/fped.2022.852551

Short-Term Effects of Elexacaftor/Tezacaftor/Ivacaftor Combination on Glucose Tolerance in Young People With Cystic Fibrosis-An Observational Pilot Study

Front Pediatr. 2022 Apr 21:10:852551. doi: 10.3389/fped.2022.852551. eCollection 2022.

Authors

Insa Korten¹, Elisabeth Kieninger¹, Linn Krueger¹, Marina Bullo¹, Christa E Flück^{2

3}, Philipp Latzin¹, Carmen Casaulta¹, Claudia Boettcher^{2

3}

Affiliations

¹ Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
² Department of Paediatric Endocrinology, Diabetology and Metabolism, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
³ Department of BioMedical Research, Bern University Hospital, University of Bern, Bern, Switzerland.

Abstract

Background: The effect of elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) on glucose tolerance and/or cystic-fibrosis-related diabetes (CFRD) is not well understood. We performed an observational study on the short-term effects of ELX/TEZ/IVA on glucose tolerance.

Methods: Sixteen adolescents with CF performed oral glucose tolerance tests (OGTT) before and 4-6 weeks after initiating ELX/TEZ/IVA therapy. A continuous glucose monitoring (CGM) system was used 3 days before until 7 days after starting ELX/TEZ/IVA treatment.

Results: OGTT categories improved after initiating ELX/TEZ/IVA therapy (p = 0.02). Glucose levels of OGTT improved at 60, 90, and 120 min (p < 0.05), whereas fasting glucose and CGM measures did not change.

Conclusion: Shortly after initiating ELX/TEZ/IVA therapy, glucose tolerance measured by OGTT improved in people with CF. This pilot study indicates that ELX/TEZ/IVA treatment has beneficial effects on the endocrine pancreatic function and might prevent or at least postpone future CFRD.

Keywords: continuous glucose monitoring; cystic fibrosis; elexacaftor/tezacaftor/ivacaftor therapy; glucose tolerance; oral glucose tolerance test (OGTT).