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Pediatric Pulmonology: The Remaining Barriers to Normalcy in Cystic Fibrosis

The Remaining Barriers to Normalcy in Cystic Fibrosis

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Improving outcomes of infections in cystic fibrosis in the era of CFTR modulator therapy

By Lisa Saiman MD, MPH

Currently, available single and dual‐combination cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies have favorably altered the life course of individuals with cystic fibrosis (CF) by decreasing morbidities and increasing survival. However, even with CFTR modulator use, questions and challenges remain to optimize the management of lung infections. This review (a) identifies these ongoing challenges and discusses the current understanding of the potential impact of CFTR modulator therapy on infections; (b) describes ongoing research to optimize detection, diagnosis, and treatment of CF microorganisms; and (c) discusses strategies to develop new anti‐infective therapies. The CF Foundation has launched the Infection Research Initiative to fund research that will improve our understanding of the complex microbial ecology within the CF lung, improve detection of CF pathogens, optimize current treatment, including long‐term chronic therapies, and develop new anti‐infective therapies. Ongoing clinical trials to determine the optimal duration of treatment of pulmonary exacerbations and to diagnose and treat nontuberculous mycobacteria represent clinical research paradigms that could be used to answer other complex treatment questions. The anti‐infective pipeline includes both existing anti‐infective and non‐anti‐infective agents, many of which are proposed to have unique mechanisms of action in CF. Future studies plan to evaluate short‐ and long‐term clinical effectiveness and impact on infections, of the next generation of CFTR modulator therapy, the highly effective triple‐combination therapy, for individuals with CF, homozygous or heterozygous for F508del.

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Journal Issue: The Remaining Barriers to Normalcy in Cystic Fibrosis V

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PP Cover - November 2018

Pediatric Pulmonology

The Remaining Barriers to Normalcy in Cystic Fibrosis I

October 2015 · View Articles

The Remaining Barriers to Normalcy in Cystic Fibrosis II

October 2016 · View Articles

The Remaining Barriers to Normalcy in Cystic Fibrosis III

November 2017 · View Articles

The Remaining Barriers to Normalcy in Cystic Fibrosis IV

November 2018 · View Articles

The Remaining Barriers to Normalcy in Cystic Fibrosis V

November 2019 · View Articles

The Remaining Barriers to Normalcy in Cystic Fibrosis VI

February 2021 · View Articles

The Remaining Barriers to Normalcy in Cystic Fibrosis VII

February 2022 · View Articles

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