A current review of the safety of cystic fibrosis transmembrane conductance regulator modulators

J Clin Pharm Ther. 2021 Apr;46(2):286-294. doi: 10.1111/jcpt.13329. Epub 2020 Dec 7.

Abstract

What is known and objective: Treatment with cystic fibrosis transmembrane conductance regulator (CFTR) modulators has led to improved clinical outcomes and an increase in lifespans of cystic fibrosis (CF) patients. As CF patients continue to live longer, they are at risk for developing adverse drug reactions associated with polypharmacy and CFTR modulators.

Comment: The authors aim to describe safety concerns of the current combination CFTR modulators, based upon a literature review, including notable safety concerns and recommendations for drug-drug interactions.

What is new and conclusion: Cystic fibrosis transmembrane conductance regulator agents are generally well tolerated with low discontinuation rates when compared to placebo. Elevations in liver enzymes and drug-drug interactions are the most notable safety concerns. Additionally, lumacaftor/ivacaftor has shown more respiratory-related adverse events and drug-drug interactions compared to elexacaftor/tezacaftor/ivacaftor and tezacaftor/ivacaftor. Postmarketing studies are needed to determine long-term safety concerns.

Keywords: cystic fibrosis; cystic fibrosis transmembrane conductance regulator; safety; side effects.

Publication types

  • Review

MeSH terms

  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis Transmembrane Conductance Regulator / adverse effects
  • Cystic Fibrosis Transmembrane Conductance Regulator / therapeutic use*
  • Cytochrome P-450 CYP3A Inhibitors / metabolism
  • Drug Interactions
  • Genotype
  • Humans
  • Liver Function Tests

Substances

  • Cytochrome P-450 CYP3A Inhibitors
  • Cystic Fibrosis Transmembrane Conductance Regulator