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Tosco A, Castaldo A, Colombo C, Claut L, Carnovale V, Iacotucci P, Lucarelli M, Cimino G, Fabrizzi B, Caporelli N, Majo F, Ciciriello F, Padoan R, Poli P, Taccetti G, Centrone C, Casciaro R, Castellani C, Salvatore D, Colangelo C, Bonomi P, Castaldo G, Terlizzi V. Clinical outcomes of a large cohort of individuals with the F508del/5T;TG12 CFTR genotype. J Cyst Fibros 2022; 21:850-855. [PMID: 35523714 DOI: 10.1016/j.jcf.2022.04.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/16/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND In recent years, patients with cystic fibrosis (CF) conductance regulator (CFTR) variant poly(T) sequences have been increasingly reported with a wide spectrum of clinical severity. We describe the long-term clinical outcomes and progression to a CF diagnosis over time in a large Italian cohort of patients carrying the CFTR F508del/5T;TG12 genotype. METHODS A retrospective analysis of subjects from 10 CF centres in Italy with the F508del/5T;TG12 genotype was performed. Demographic, clinical, microbiological, and biochemical data, as well as information about the follow-ups and complications of the enroled patients, were collected. RESULTS A total of 129 subjects (54 females; median age: 15.0 years, range: 0-58 years; 59 older than 18 years) were included. In terms of initial diagnoses, 30 were CF (23.3%), 41 were CFTR-related disorder (CFTR-RD) (31.7%), and 58 were CF transmembrane conductance regulator-related metabolic syndrome/cystic fibrosis screen positive, inconclusive diagnosis (CRMS/CFSPID) (45.0%). After a median follow-up of 6.7 years (range 0.2-25 years), 15 patients progressed to CF, bringing the total number of CF diagnoses to 45/129 (34.9%). Most of these patients had mild lung diseases with pancreatic sufficiency and a low prevalence of CF-related complications. CONCLUSIONS At the end of the study, 34.9% of subjects with the CFTR F508del/5T;TG12 genotype were diagnosed with CF. We suggest including patients with the F508del/5T;TG12 genotype in long-term follow-ups.
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Affiliation(s)
- Antonella Tosco
- Paediatric Unit, Department of Translational Medical Sciences, Cystic Fibrosis Regional Reference Center, University of Naples Federico II, Naples, Italy
| | - Alice Castaldo
- Paediatric Unit, Department of Translational Medical Sciences, Cystic Fibrosis Regional Reference Center, University of Naples Federico II, Naples, Italy
| | - Carla Colombo
- Cystic Fibrosis Regional Reference Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Laura Claut
- Cystic Fibrosis Regional Reference Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Vincenzo Carnovale
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | - Paola Iacotucci
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | - Marco Lucarelli
- Dept of Experimental Medicine, Sapienza University of Rome, Rome, Italy; Pasteur Institute, Cenci Bolognetti Foundation, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Cimino
- Cystic Fibrosis Regional Reference Center, A.O.U. Policlinico Umberto I, Rome, Italy
| | - Benedetta Fabrizzi
- Cystic Fibrosis Regional Reference Center, Mother - Child Department, United Hospitals, Ancona, Italy
| | - Nicole Caporelli
- Cystic Fibrosis Regional Reference Center, Mother - Child Department, United Hospitals, Ancona, Italy
| | - Fabio Majo
- Cystic Fibrosis Centre, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Fabiana Ciciriello
- Cystic Fibrosis Centre, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rita Padoan
- Cystic Fibrosis Regional Support Center, Department of Pediatrics, University of Brescia, ASST Spedali Civili Brescia, Brescia, Italy
| | - Piercarlo Poli
- Cystic Fibrosis Regional Support Center, Department of Pediatrics, University of Brescia, ASST Spedali Civili Brescia, Brescia, Italy
| | - Giovanni Taccetti
- Meyer Children's Hospital, Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Viale Gaetano Pieraccini 24, Florence, Italy
| | - Claudia Centrone
- Diagnostic Genetics Unit, Careggi University Hospital, Florence, Italy
| | | | | | | | | | | | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples, Naples, Italy; CEINGE-Advanced Biotechnology, Naples, Italy
| | - Vito Terlizzi
- Meyer Children's Hospital, Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Viale Gaetano Pieraccini 24, Florence, Italy.
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Carnovale V, Iacotucci P, Terlizzi V, Colangelo C, Medio P, Ferrillo L, De Gregorio F, Francalanci M, Taccetti G, Buonaurio S, d'Ippolito M, Marsicovetere G, D'Andria M, Ferrara N, Salvatore D. Effectiveness and safety of elexacaftor/tezacaftor/ivacaftor in patients with cystic fibrosis and advanced lung disease with the Phe508del/minimal function genotype. Respir Med 2021; 189:106646. [PMID: 34673344 DOI: 10.1016/j.rmed.2021.106646] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/31/2021] [Accepted: 10/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Elexacaftor/tezacaftor/ivacaftor (E/T/I) is a cystic fibrosis transmembrane conductance regulator (CFTR) triple combination therapy used for the treatment of cystic fibrosis (CF) in patients aged ≥12 years who have at least one copy of the Phe508del mutation (F) in the CFTR gene or another mutation that is responsive to treatment with E/T/I. This study determined the effectiveness and safety of E/T/I treatment in a cohort of CF patients. METHODS This retrospective cohort study collected data from the first 6 months of treatment of patients with CF, compound heterozygotes for the F and a minimal function (MF) mutations, enrolled in an E/T/I compassionate use program only available to patients having ppFEV1<40 or who are considered for lung transplantation. Forty-seven patients were included. Follow-up was performed after 1, 3, and 6 months from the beginning of therapy, assessing lung function, body mass index (BMI), sweat chloride concentration (SCC), quality of life (QoL), and safety. RESULTS After 6 months of treatment, the mean (standard deviation (SD)) SCC decreased from 91.1 (19.3) mmol/L to 46.2 (24.2) mmol/L. The decrease of SCC was accompanied by improvement of lung function (mean (95% Confidence Interval (CI) absolute increase in ppFEV1 was 10.69 (8.05,13.33) after 1 month and 14.16 (11.43, 16.89) after 6 months of treatment), nutrition (mean (SD) BMI increased from 20.7 (3.0) kg/m2 at baseline to 22.6 (3.1) after 6 months), and QoL. No safety concerns were observed. CONCLUSIONS E/T/I was clinically effective and safe in patients with advanced CF lung disease with an F/MF genotype.
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Affiliation(s)
- Vincenzo Carnovale
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy.
| | - Paola Iacotucci
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | - Vito Terlizzi
- Cystic Fibrosis Center, Department of Paediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | | | - Pietro Medio
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | - Lorenza Ferrillo
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | | | - Michela Francalanci
- Cystic Fibrosis Center, Department of Paediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | - Giovanni Taccetti
- Cystic Fibrosis Center, Department of Paediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | - Serena Buonaurio
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | - Marcella d'Ippolito
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | | | | | - Nicola Ferrara
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
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Salvatore D, Colangelo C, D’Andria M, Marsicovetere G, Passarella D. Elexacaftor/tezacaftor/ivacaftor as rescue therapy in a patient with the cystic fibrosis genotype F508DEL/ G1244E. Clin Case Rep 2021; 9:e04713. [PMID: 34466263 PMCID: PMC8385458 DOI: 10.1002/ccr3.4713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/13/2021] [Accepted: 07/30/2021] [Indexed: 12/02/2022] Open
Abstract
Elexacaftor/tezacaftor/ivacaftor (ETI) is a cystic fibrosis (CF) transmembrane regulator (CFTR) modulator. It is known to be efficacious in stable patients with severe pneumopathy, but there are few data concerning its effectiveness during acute exacerbations. We here describe its use in a woman with CF and respiratory failure.
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Terlizzi V, Colangelo C, Marsicovetere G, D’Andria M, Francalanci M, Innocenti D, Masi E, Avarello A, Taccetti G, Amato F, Comegna M, Castaldo G, Salvatore D. Effectiveness of Elexacaftor/Tezacaftor/Ivacaftor Therapy in Three Subjects with the Cystic Fibrosis Genotype Phe508del/Unknown and Advanced Lung Disease. Genes (Basel) 2021; 12:genes12081178. [PMID: 34440351 PMCID: PMC8391133 DOI: 10.3390/genes12081178] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 12/15/2022] Open
Abstract
We evaluated the effectiveness and safety of elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) in three subjects carrying the Phe508del/unknown CFTR genotype. An ex vivo analysis on nasal epithelial cells (NEC) indicated a significant improvement of CFTR gating activity after the treatment. Three patients were enrolled in an ELX/TEZ/IVA managed-access program, including subjects with the highest percent predicted Forced Expiratory Volume in the 1st second (ppFEV1) < 40 in the preceding 3 months. Data were collected at baseline and after 8, 12 and 24 weeks of follow-up during treatment. All patients showed a considerable decrease of sweat chloride (i.e., meanly about 60 mmol/L as compared to baseline), relevant improvement of ppFEV1 (i.e., >8) and six-minute walk test, and an increase in body mass index after the first 8 weeks of treatment. No pulmonary exacerbations occurred during the 24 weeks of treatment and all domains of the CF Questionnaire-Revised improved. No safety concerns related to the treatment occurred. This study demonstrates the benefit from the ELX/TEZ/IVA treatment in patients with CF with the Phe508del and one unidentified CFTR variant. The preliminary ex vivo analysis of the drug response on NEC helps to predict the in vivo therapeutic endpoints.
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Affiliation(s)
- Vito Terlizzi
- Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Anna Meyer Children’s University, 50139 Florence, Italy; (M.F.); (D.I.); (E.M.); (G.T.)
- Correspondence: ; Tel.: +39-0555-662474
| | - Carmela Colangelo
- Cystic Fibrosis Center, AOR Ospedale San Carlo, 19104 Potenza, Italy; (C.C.); (G.M.); (M.D.); (D.S.)
| | - Giovanni Marsicovetere
- Cystic Fibrosis Center, AOR Ospedale San Carlo, 19104 Potenza, Italy; (C.C.); (G.M.); (M.D.); (D.S.)
| | - Michele D’Andria
- Cystic Fibrosis Center, AOR Ospedale San Carlo, 19104 Potenza, Italy; (C.C.); (G.M.); (M.D.); (D.S.)
| | - Michela Francalanci
- Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Anna Meyer Children’s University, 50139 Florence, Italy; (M.F.); (D.I.); (E.M.); (G.T.)
| | - Diletta Innocenti
- Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Anna Meyer Children’s University, 50139 Florence, Italy; (M.F.); (D.I.); (E.M.); (G.T.)
| | - Eleonora Masi
- Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Anna Meyer Children’s University, 50139 Florence, Italy; (M.F.); (D.I.); (E.M.); (G.T.)
| | - Angelo Avarello
- Infectious and Tropical Diseases Unit, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy;
| | - Giovanni Taccetti
- Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Anna Meyer Children’s University, 50139 Florence, Italy; (M.F.); (D.I.); (E.M.); (G.T.)
| | - Felice Amato
- Department of Molecular Medicine and Medical Biotechnology, University of Naples, 20122 Naples, Italy; (F.A.); (M.C.); (G.C.)
- CEINGE—Advanced Biotechnology, 20122 Naples, Italy
| | - Marika Comegna
- Department of Molecular Medicine and Medical Biotechnology, University of Naples, 20122 Naples, Italy; (F.A.); (M.C.); (G.C.)
- CEINGE—Advanced Biotechnology, 20122 Naples, Italy
| | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples, 20122 Naples, Italy; (F.A.); (M.C.); (G.C.)
- CEINGE—Advanced Biotechnology, 20122 Naples, Italy
| | - Donatello Salvatore
- Cystic Fibrosis Center, AOR Ospedale San Carlo, 19104 Potenza, Italy; (C.C.); (G.M.); (M.D.); (D.S.)
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Comegna M, Terlizzi V, Salvatore D, Colangelo C, Di Lullo AM, Zollo I, Taccetti G, Castaldo G, Amato F. Elexacaftor-Tezacaftor-Ivacaftor Therapy for Cystic Fibrosis Patients with The F508del/Unknown Genotype. Antibiotics (Basel) 2021; 10:antibiotics10070828. [PMID: 34356748 PMCID: PMC8300667 DOI: 10.3390/antibiotics10070828] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 01/07/2023] Open
Abstract
The new CFTR modulator combination, elexacaftor/tezacaftor/ivacaftor (Trikafta) was approved by the FDA in October 2019 for treatment of Cystic Fibrosis in patients 6 years of age or older who have at least one F508del mutation in one allele and a minimal-function or another F508del mutation in the other allele. However, there is a group of patients, in addition to those with rare mutations, in which despite the presence of a F508del in one allele, it was not possible to identify any mutation in the other allele. To date, these patients are excluded from treatment with Trikafta in Italy, where the CF patients carrying F508del/unknown represent about 1.3% (71 patients) of the overall Italian CF patients. In this paper we show that the Trikafta treatment of nasal epithelial cells, derived from F508del/Unknown patients, results in a significant rescue of CFTR activity. Based on our findings, we think that the F508del/Unknown patients considered in this study could obtain clinical benefits from Trikafta treatment, and we strongly suggest their eligibility for this type of treatment. This study, adding further evidence in the literature, once again confirms the validity of functional studies on nasal cells in the cystic fibrosis theratyping and personalized medicine.
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Affiliation(s)
- Marika Comegna
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy; (M.C.); (I.Z.); (G.C.)
- CEINGE–Advanced Biotechnologies, Via G. Salvatore, 486, 80145 Naples, Italy
| | - Vito Terlizzi
- Cystic Fibrosis Regional Reference Center, Department of Pediatric Medicine, Anna Meyer Children’s University, Viale Pieraccini, 24, 50139 Florence, Italy; (V.T.); (G.T.)
| | - Donatello Salvatore
- Cystic Fibrosis Center, Hospital San Carlo, Via P. Petrone, 85100 Potenza, Italy; (D.S.); (C.C.)
| | - Carmela Colangelo
- Cystic Fibrosis Center, Hospital San Carlo, Via P. Petrone, 85100 Potenza, Italy; (D.S.); (C.C.)
| | - Antonella Miriam Di Lullo
- Department Reproductive Sciences and Dentistry, University of Naples Federico II of Neuroscience, Via Pansini, 5, 80131 Naples, Italy;
| | - Immacolata Zollo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy; (M.C.); (I.Z.); (G.C.)
- CEINGE–Advanced Biotechnologies, Via G. Salvatore, 486, 80145 Naples, Italy
| | - Giovanni Taccetti
- Cystic Fibrosis Regional Reference Center, Department of Pediatric Medicine, Anna Meyer Children’s University, Viale Pieraccini, 24, 50139 Florence, Italy; (V.T.); (G.T.)
| | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy; (M.C.); (I.Z.); (G.C.)
- CEINGE–Advanced Biotechnologies, Via G. Salvatore, 486, 80145 Naples, Italy
| | - Felice Amato
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy; (M.C.); (I.Z.); (G.C.)
- CEINGE–Advanced Biotechnologies, Via G. Salvatore, 486, 80145 Naples, Italy
- Correspondence:
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Carnovale V, Iacotucci P, Terlizzi V, Colangelo C, Medio P, Ferrillo L, De Gregorio F, Francalanci M, Taccetti G, Buonaurio S, d'Ippolito M, Marsicovetere G, D'Andria M, Ferrara N, Salvatore D. WS12.3 Effectiveness and safety of elexacaftor/tezacaftor/ivacaftor in cystic fibrosis severe patients with the F508del/minimal function genotype. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)00983-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Carnovale V, Iacotucci P, Terlizzi V, Colangelo C, Medio P, Ferrillo L, De Gregorio F, Francalanci M, Taccetti G, Buonaurio S, d'Ippolito M, Marsicovetere G, D'Andria M, Ferrara N, Salvatore D. P037 Elexacaftor/tezacaftor/ivacaftor improve lung disease in patients with advanced cystic fibrosis homozygous for the F508del mutation. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01064-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Salvatore D, Giordani B, Padoan R, Amato A, Ferrari G, Majo F, Colangelo C, De Gregorio F. WS13.6 Epidemiology and factors influencing lung disease in cystic fibrosis with residual function mutations (RFm). J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30238-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Salvatore D, Carnovale V, Iacotucci P, Braggion C, Castellani C, Cimino G, Colangelo C, Francalanci M, Leonetti G, Lucidi V, Manca A, Vitullo P, Ferrara N. Effectivenesss of ivacaftor in severe cystic fibrosis patients and non-G551D gating mutations. Pediatr Pulmonol 2019; 54:1398-1403. [PMID: 31237430 DOI: 10.1002/ppul.24424] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/07/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Ivacaftor is a significant innovation in the treatment of cystic fibrosis (CF) with gating mutations. A substantial percentage of patients with CF have severe lung involvement, but these patients are usually excluded from phase III clinical trials. Thus, the effectiveness of ivacaftor in this population has not been fully determined. METHODS Data were collected from Italian CF centers with patients enrolled in an ivacaftor compassionate use programme (percent predicted [pp] forced expiratory volume in 1 second [FEV1 ] < 40%, or on lung transplant waiting list, or with a fast worsening trend of lung function). Data were collected for 1 year before and 1 year after ivacaftor commencement. RESULTS Thirteen patients received ivacaftor for a median of 320 days. Mean (SD) ppFEV1 increased from 35.1% (14.3%) before treatment to 46.6% (18.8%) after 12 months of treatment (absolute increase 11.5%, relative increase 32.8%). Mean distance of the 6-minute walking test improved significantly, from 535.1 m before to 611.6 m after 12 months of treatment (P = .002). The number of pulmonary exacerbations decreased significantly, from 57 during the year before ivacaftor to 28 in the year following ivacaftor (P = .0048). Five of the 13 patients (38.5%) had no exacerbations during the 12 months after starting ivacaftor. Median weight increased significantly, from 52.7 kg to 55.6 kg (P = .0031). Mean (SD) sweat chloride concentration decreased significantly, from 99.5 (22.8) mmol/L to 39.3 (15.8) mmol/L (P < .0001). No safety concerns were registered. CONCLUSIONS Ivacaftor was safe and effective in patients with CF with severe lung disease and non-G551D gating mutations.
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Affiliation(s)
| | - Vincenzo Carnovale
- Adult Cystic Fibrosis Center, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Paola Iacotucci
- Adult Cystic Fibrosis Center, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | | | - Carlo Castellani
- Cystic Fibrosis Centre, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | | | | | | | - Vincenzina Lucidi
- Cystic Fibrosis Center, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Antonio Manca
- Cystic Fibrosis Center, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Pamela Vitullo
- Cystic Fibrosis Unit, Hospital G. Tatarella, Foggia, Italy
| | - Nicola Ferrara
- Cystic Fibrosis Center, Hospital San Carlo, Potenza, Italy
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Salvatore D, Braggion C, Messore B, Pisi G, Tuccio G, Bena C, Colangelo C. IPD2.05 Effects of ivacaftor in patients with cystic fibrosis and severe lung disease carrying CFTR mutations with residual function. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30289-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Salvatore D, Dell'Edera D, Colangelo C, Smaldore G. Salt depletion syndrome as the initial presentation of cystic fibrosis in a toddler with the rare p.Ala309Gly (A309G) CFTR variant. Clin Genet 2016; 90:186-7. [DOI: 10.1111/cge.12733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 01/06/2016] [Accepted: 01/07/2016] [Indexed: 11/29/2022]
Affiliation(s)
- D. Salvatore
- Cystic Fibrosis Center; Pediatric Center Bambino Gesù Basilicata, AOR Hospital San Carlo; Potenza Italy
| | - D. Dell'Edera
- Unit of Cytogenetics and Molecular Genetics; ‘Madonna delle Grazie Hospital’; Matera Italy
| | - C. Colangelo
- Cystic Fibrosis Center; Pediatric Center Bambino Gesù Basilicata, AOR Hospital San Carlo; Potenza Italy
| | - G. Smaldore
- Laboratory of Biochemistry; AOR Hospital San Carlo; Potenza Italy
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Salvatore D, Dell'Edera D, Colangelo C, Smaldore G. p.Leu636Pro mutation is associated with cystic fibrosis transmembrane conductance regulator-related disorders (congenital bilateral absence of vas deferens). Int J Urol 2015; 22:803-4. [DOI: 10.1111/iju.12801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 02/26/2015] [Accepted: 03/29/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Donatello Salvatore
- Cystic Fibrosis Center; Pediatric Center Bambino Gesù Basilicata, AOR Hospital San Carlo; Potenza Italy
| | - Domenico Dell'Edera
- Unit of Cytogenetics and Molecular Genetics; Madonna delle Grazie Hospital; Matera Italy
| | - Carmela Colangelo
- Cystic Fibrosis Center; Pediatric Center Bambino Gesù Basilicata, AOR Hospital San Carlo; Potenza Italy
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Shen H, Colangelo C, Wu T, Maffei M, Goldstein D. 235 Haptoglobin: A Novel Innate Ligand that Induces Inflammation after Tissue Necrosis. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ciprandi G, Cadario G, Valle C, Ridolo E, Verini M, Di Gioacchino M, Minelli M, Gangemi S, Sillano V, Colangelo C, Pravettoni V, Pellegrino R, Borrelli P, Fiorina A, Carosso A, Gasparini A, Riario-Sforza GG, Incorvaia C, Puccinelli P, Scurati S, Frati F. Sublingual immunotherapy in polysensitized patients: effect on quality of life. J Investig Allergol Clin Immunol 2010; 20:274-279. [PMID: 20815304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Quality of life (QOL) is an important issue in allergic rhinitis and has been evaluated in a number of studies that have shown how it is impaired in untreated patients and improved by effective treatment. However, there are no data concerning QOL after sublingual immunotherapy (SLIT) in polysensitized patients. OBJECTIVE To evaluate the effect, in real-life clinical practice, of SLIT on QOL in a population of polysensitized patients with allergic rhinitis. METHODS We prospectively evaluated 167 consecutively enrolled polysensitized patients with allergic rhinitis. QOL was measured in all cases with the Rhinoconjunctivitis Quality of Life Questionnaire at baseline and after 1 year of SLIT (performed in approximately 70% of cases using single allergen extracts provided by the same manufacturer). RESULTS The most frequent causes of sensitization were grass pollen, Parietaria, and house dust mites. The mean number of sensitizations per patient was 3.65. SLIT was performed with 1 extract in 123 patients (73.6%), with 2 extracts in 31 patients (18.6%), and with more than 2 extracts in 13 patients (7.8%). The mean values of all the QOL items improved significantly (P < .01 in all cases), with the following reductions noted: activities, 3.96 to 2.89; sleep, 2.07 to 1.56; general problems, 2.16 to 1.5; practical problems, 3.69 to 2.58; nasal symptoms, 3.57 to 2.50; eye symptoms, 2.92 to 1.83; and emotional aspects, 2.2 to 1.44. CONCLUSIONS This study provides evidence that QOL can be improved in polysensitized patients treated with SLIT, and that the use of just 1 or 2 allergen extracts seems to be sufficient and effective in terms of improving QOL.
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MESH Headings
- Administration, Sublingual
- Adolescent
- Adult
- Animals
- Antigens, Dermatophagoides/therapeutic use
- Antigens, Plant/therapeutic use
- Desensitization, Immunologic
- Female
- Humans
- Immunization
- Male
- Parietaria/immunology
- Poaceae/immunology
- Pollen/adverse effects
- Pyroglyphidae/immunology
- Quality of Life
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/immunology
- Rhinitis, Allergic, Perennial/physiopathology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/immunology
- Rhinitis, Allergic, Seasonal/physiopathology
- Rhinitis, Allergic, Seasonal/therapy
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Affiliation(s)
- G Ciprandi
- Department of Internal Medicine, University of Genoa, Genoa, Italy.
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Abstract
BACKGROUND The presence of anti-FcepsilonRI and anti-IgE autoantibodies in a subset of patients with chronic urticaria suggests their aetiopathogenetic role. In clinical practice, the presence of these antibodies is usually considered when the autologous serum skin test (ASST) is positive. AIMS To evaluate if the positive ASST follows up the activity of chronic urticaria. METHODS Autologous serum skin test and thyroid autoantibody detection were performed in 82 patients with chronic urticaria and repeated 1 year later, when the vast majority of patients were symptom-free. Twenty patients with Hashimoto thyroiditis (HT), who had never suffered from urticaria, represented the control group. RESULTS At the start of the study, the prevalence of positive ASST was 46.6%. The association of HT-urticaria was 29.3%. ASST was positive in 62 and 39% of patients with and without HT, respectively (P > 0.05 ns). One year later, 28 of 34 patients with a positive ASST were symptom-free, but 50% of them were positive for ASST. The ASST was positive in 86.7 and 8% of patients with and without HT, respectively (P < 0.001). In the control group, ASST was always negative. CONCLUSIONS The co-existence of autoimmune thyroiditis with chronic urticaria seems to induce a significant difference in the persistence of a positive ASST. Consistent with previous reports, a positive ASST correlates with disease exacerbation in chronic urticaria patients without thyroiditis. In patients with thyroiditis and urticaria, positive ASST persists even after the urticaria has disappeared, thus questioning whether a positive ASST to be a surrogate marker of the functional role of anti-FcepsilonRI and anti-IgE autoantibodies.
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Affiliation(s)
- A Fusari
- Department of Respiratory and Allergic Diseases, Umberto I(o) Hospital, Torrette, Ancona, Italy
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Della Rossa A, Baldini C, Tavoni A, Tognetti A, Neglia D, Sambuceti G, Puccini R, Colangelo C, Bombardieri S. Churg-Strauss syndrome: clinical and serological features of 19 patients from a single Italian centre. Rheumatology (Oxford) 2002; 41:1286-94. [PMID: 12422002 DOI: 10.1093/rheumatology/41.11.1286] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Churg-Strauss syndrome is a rare multisystem vasculitis of unknown aetiology. Due to the rarity of the disease, few single-centre case series have been described. The aim of this study was to evaluate a small series from a single Italian centre in order to describe the clinical features of the disease, the treatment and long-term follow-up. METHODS Nineteen Churg-Strauss syndrome patients were selected from the medical records of all vasculitis patients attending the Immunology Unit at the Department of Internal Medicine of the University of Pisa in the decade between 1989 and 2000. Data were obtained retrospectively. RESULTS All the patients had asthma and hypereosinophilia. As in other case series, the lungs, skin and peripheral nervous system were the most commonly involved organs. The majority of our patient received i.v. pulses of methylprednisolone followed by i.v. pulses of cyclophosphamide. The outcome and long-term follow-up were good. There were no fatalities observed in this series during the follow-up period. CONCLUSIONS Churg-Strauss syndrome is a systemic vasculitis occurring in patients with a history of asthma and allergic rhinitis. The positive results of the treatment protocol used in this preliminary study deserve to be tested in controlled multicentre studies.
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Affiliation(s)
- A Della Rossa
- Department of Internal Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy
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Rhodes M, Colangelo C. Spondylolysis and its relation to spondylolisthesis. Am J Surg 1946; 72:20-5. [DOI: 10.1016/0002-9610(46)90124-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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