Stalvey, et al. Growth in Prepubertal Children With Cystic Fibrosis Treated With Ivacaftor. Pediatrics. 2017 Feb

 

Growth in Prepubertal Children With Cystic Fibrosis Treated With Ivacaftor

Stalvey MS, Pace J, Niknian M, Higgins MN, Tarn V, Davis J, Heltshe SL, Rowe SM.

Pediatrics. 2017 Feb;139(2). pii: e20162522. doi: 10.1542/peds.2016-2522.

PMID:28143919

 

Abstract

BACKGROUND AND OBJECTIVES:

Cystic fibrosis (CF) is known for its impact on the lung and pancreas of individuals; however, impaired growth is also a common complication. We hypothesized that targeting the biological defect in the CF transmembrane conductance regulator (CFTR) protein may affect growth outcomes.

METHODS:

In this post hoc analysis, we assessed linear growth and weight in 83 children (aged 6-11 years) enrolled in 2 clinical trials, the longitudinal-observation GOAL study and the placebo-controlled ENVISION study, to evaluate the effects of ivacaftor, a CFTR potentiator. We calculated height and weight z scores and height and weight growth velocities (GVs).

RESULTS:

In ivacaftor-treated children in GOAL, height and weight z scores increased significantly from baseline to 6 months (increases of 0.1 [P < .05] and 0.26 [P < .0001], respectively); height GV increased significantly from 3 to 6 months (2.10-cm/year increase; P < .01). In ivacaftor-treated children in ENVISION, height and weight z scores increased significantly from baseline to 48 weeks (increases of 0.17 [P < .001] and 0.35 [P < .001], respectively). Height and weight GVs from baseline to 48 weeks were also significantly higher with ivacaftor than with placebo (differences of 1.08 cm/year [P < .05] and 3.11 kg/year [P < .001], respectively).

CONCLUSIONS:

Ivacaftor treatment in prepubescent children may help to address short stature and altered GV in children with CF; results from these analyses support the existence of an intrinsic defect in the growth of children with CF that may be ameliorated by CFTR modulation.