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Mukoviszidose

Erkrankung auf dem Weg zur personalisierten Therapie

Cystic fibrosis

Disease on the way to personalized therapy

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Zusammenfassung

Durch die Einführung des Neugeborenenscreenings ist es möglich geworden, bei den meisten Patienten die symptomatische Therapie der Mukoviszidose schon in den ersten Lebenswochen zu beginnen. Allein hierdurch werden sich die Lebenserwartung der Patienten sowie ihre Lebensqualität und die ihrer Familien weiter verbessern. Eine Vielzahl von mutationsspezifischen, aber auch mutationsklassenübergreifenden Therapieansätzen befindet sich in der präklinischen und klinischen Entwicklung – zwei sind mittlerweile zugelassen. Da die individuelle Wirksamkeit dieser Therapien gerade im Kindesalter allein durch klinische Parameter oftmals schwierig zu belegen ist, sind Messungen der verbesserten Chloridkanalfunktion in vivo und in vitro zunehmend wichtige Untersuchungsmethoden.

Abstract

By the introduction of newborn screening it has become possible in most patients to implement symptomatic therapy for cystic fibrosis in the first weeks of life. The life expectancy and the quality of life of patients and their families will be improved by this implementation. Many mutation-specific therapies as well as mutation-agnostic treatments are in preclinical and clinical development and two have already been approved. Because of the difficulties in evaluating the individual effectiveness of these therapies by using clinical parameters alone, measurement of improved chloride channel function in vivo and in vitro is becoming more important.

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Literatur

  1. Alton EW et al (2015) Repeated nebulisation of non-viral CFTR gene therapy in patients with cystic fibrosis: a randomised, double-blind, placebo-controlled, phase 2b trial. Lancet Respir Med 3:684–693

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Baltin et al (2010) Drug treatment of cystic fibrosis - cost patterns and savings potential for outpatient treatment. Med Klin 105:887–900

    Article  Google Scholar 

  3. CTN. https://www.ecfs.eu/ctn/clinical-trials. Zugegriffen: 20.06.2017

  4. Dekkers JF et al (2016) Characterizing responses to CFTR-modulating drugs using rectal organoids derived from subjects with cystic fibrosis. Sci Transl Med 8:344ra84

    Article  PubMed  Google Scholar 

  5. Kerem E et al (2014) Ataluren for the treatment of nonsense-mutation cystic fibrosis: a randomised, double-blind, placebo-controlled phase 3 trial. Lancet Respir Med 2:539–547

    Article  CAS  PubMed  Google Scholar 

  6. Konstan M et al (2016) Evidence of reduction in annual rate of FEV1 decline and sustained benefits with Lumacaftor and Ivacaftor (LUM/IVA) in patients (pts) with CF homozygous for F508del CFTR. Pediatr Pulmonol 45(Suppl):260

  7. Nivalis Press Release 23. Februar 2017. http://ir.nivalis.com/press-releases/detail/60

  8. PTC Press Release 2. März 2017. http://files.shareholder.com/downloads/PTCT/4372255087x0x931044/18C4651E-6EF3-45EC-9024-97A2F675C48E/PTCT_News_2017_3_2_General.pdf

  9. Ramsey BW et al (2011) A CFTR potentiator in patients with cystic fibrosis and the G551D mutation. N Engl J Med 365:1663–1672

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Sawicki GS et al (2015) Sustained Benefit from ivacaftor demonstrated by combining clinical trial and cystic fibrosis patient registry data. Am J Respir Crit Care Med 192:836–842

    Article  CAS  PubMed  Google Scholar 

  11. Sly PD et al (2009) Lung disease at diagnosis in infants with cystic fibrosis detected by newborn screening. Am J Respir Crit Care Med 180:146–152

    Article  PubMed  Google Scholar 

  12. Sommerburg O et al (2017) Das Mukoviszidosescreening wird in Deutschland eingeführt. Monatsschr Kinderheilkd 165:49–54

  13. Tümmler B (2016) Therapie der Mukoviszidose mit CFTR-Modulatoren. Pneumologie 70:301–313

    Article  PubMed  Google Scholar 

  14. Vertex Press Release, 28. März 2017. http://investors.vrtx.com/releasedetail.cfm?ReleaseID=1019156

  15. Vertex Press Release 7. Nov. 2016. http://investors.vrtx.com/releasedetail.cfm?ReleaseID=997999

  16. Wainwright CE et al (2015) Lumacaftor–Ivacaftor in patients with cystic fibrosis homozygous for Phe508del CFTR. N Engl J Med 373:220–231

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Wielpütz et al (2014) Magnetic resonance imaging detects changes in structure and perfusion, and response to therapy in early cystic fibrosis lung disease. Am J Respir Crit Care Med 189:956–965

  18. Zolin A et al (2014) ECFS registry annual data report 2010. European Cystic Fibrosis Society, Karup

    Google Scholar 

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Correspondence to S. van Koningsbruggen-Rietschel.

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Interessenkonflikt

E. Rietschel hat Berater-, Autoren- und Vortragshonorare von Vertex Pharmaceuticals und von PTC Pharmaceuticals erhalten. S. van Koningsbruggen-Rietschel gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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J. Dötsch, Köln

M. Weiß, Köln

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van Koningsbruggen-Rietschel, S., Rietschel, E. Mukoviszidose. Monatsschr Kinderheilkd 165, 681–687 (2017). https://doi.org/10.1007/s00112-017-0322-0

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  • DOI: https://doi.org/10.1007/s00112-017-0322-0

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