Effects of new and emerging therapies on gastrointestinal outcomes in cystic fibrosis.

aDepartment of Pediatric Gastroenterology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands bPediatric Gastroenterology, Hadassah University Hospital, Jerusalem, Israel.

Current opinion in pulmonary medicine. 2017;(6):551-555

Abstract

PURPOSE OF REVIEW Several new therapeutic modalities have recently become available to be used in patients with cystic fibrosis such as potentiators, modulators, and probiotics. Although the effects on pulmonary function have been well documented, gastrointestinal outcomes have been addressed only rarely. RECENT FINDINGS Both the potentiator (ivacaftor) and the potentiator/modulator combination (ivacaftor/lumacaftor) that are currently on the market have a positive effect on BMI. Young patients (2-5 years of age) with a gating mutation may show improvement of exocrine pancreatic function on ivacaftor. In this specific patient population this agent also seems to improve intestinal pH and reflux. The effect of these medications on other gastrointestinal outcomes, such as intestinal inflammation and cystic fibrosis liver disease, has not been described so far. Furthermore, the results of several trials suggest that probiotics might reduce intestinal inflammation. Finally, organoids might be used to predict in vitro the clinical effect of potentiators and modulators. SUMMARY The effect of new interventions on the gastrointestinal outcomes studied so far is favourable. Future studies should address the effect on other gastrointestinal parameters.

Methodological quality

Publication Type : Review

Metadata

MeSH terms : Digestive System