Ivacaftor
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AIMS: Ivacaftor is a revolutionary treatment option for cystic fibrosis (CF) patients with G551D and other gating mutations. The aim of this study was to evaluate the clinical status of patients on ivacaftor who were followed for up to 6 years together with an evaluation of ivacaftor therapy in one patient with an initial FEV1 less than 40% of predicted value. METHODS: Data on development of clinical status and sinopulmonary-related therapies were obtained from patient health records during ivacaftor treatment lasting for up to six years and were compared with an equivalent period before ivacaftor administration. RESULTS: Five CF adults with a median age 28.6 years (range 21.4-35.6 years) with median FEV1 45% pred. (range 16-85% pred.) were included in the study. Four subjects were also participants in the STRIVE and PERSIST studies. Altogether, twenty-four patient-years of ivacaftor treatment were analyzed. The median FEV1 decline per year decreased from -4.5 to -0.9% pred. (P = 0.043). Reduction in number of days on antibiotic treatment and hospital stays was 21% (P < 0.001) and 75% (P = 0.003), respectively. Improvement and stabilization of lung function was observed for up to six years of treatment. In a patient with severe airway obstruction, an increase in the FEV1 value (30.4% from baseline) was documented during the first twelve months of treatment. CONCLUSION: Ivacaftor therapy resulted in improved and stabilized lung function in up to six years of treatment with a reduction in number of days on antibiotic treatment and hospital stays. Its efficiency was also displayed in a patient with severe airway obstruction.
- Klíčová slova
- adults, cystic fibrosis, ivacaftor, lung disease,
- MeSH
- aktivátory chloridových kanálů terapeutické užití MeSH
- aminofenoly terapeutické užití MeSH
- chinolony terapeutické užití MeSH
- cystická fibróza farmakoterapie patofyziologie MeSH
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- následná péče MeSH
- usilovný výdechový objem fyziologie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- aktivátory chloridových kanálů MeSH
- aminofenoly MeSH
- chinolony MeSH
- ivacaftor MeSH Prohlížeč
Background: Ivacaftor is a modern drug used in the treatment of cystic fibrosis. It is highly lipophilic and exhibits a strong positive food effect. These characteristics can be potentially connected to a pronounced lymphatic transport after oral administration. Methods: A series of studies was conducted to describe the basic pharmacokinetic parameters of ivacaftor in jugular vein cannulated rats when dosed in two distinct formulations: an aqueous suspension and an oil solution. Additionally, an anesthetized mesenteric lymph duct cannulated rat model was studied to precisely assess the extent of lymphatic transport. Results: Mean ± SD ivacaftor oral bioavailability was 18.4 ± 3.2% and 16.2 ± 7.8%, respectively, when administered as an aqueous suspension and an oil solution. The relative contribution of the lymphatic transport to the overall bioavailability was 5.91 ± 1.61% and 4.35 ± 1.84%, respectively. Conclusion: Lymphatic transport plays only a minor role in the process of ivacaftor intestinal absorption, and other factors are, therefore, responsible for its pronounced positive food effect.
- Klíčová slova
- bioavailability, intestinal absorption, ivacaftor, lymphatic transport, pharmacokintetics,
- Publikační typ
- časopisecké články MeSH
Superior efficacy of elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) over tezacaftor/ivacaftor (TEZ/IVA) in people with cystic fibrosis (CF) and Phe508del/Phe508del genotype was shown in clinical trials. We utilized intestinal organoid approach to compare in vitro responses to these 2 CFTR modulator drug combinations and to check potential inter-individual variability in therapeutic response to the triple combination. Organoids from 17 subjects with Phe508del/Phe508del were screened with forskolin induced swelling assay. Significantly larger swelling, when exposed to ELX/TEZ/IVA as compared to TEZ/IVA, was observed in 16 of them. However, 1 sample showed no additional effect of ELX. The finding of unique CFTR variants in this sample indicates that genetic traits other than CF-causing CFTR mutation are worth exploring as they may have an impact on the definitive modulator drug response.
- Klíčová slova
- CFTR sequence, Cystic fibrosis, Elexacaftor, Intestinal organoids, Ivacaftor, Tezacaftor,
- MeSH
- aktivátory chloridových kanálů farmakologie terapeutické užití MeSH
- aminofenoly farmakologie terapeutické užití MeSH
- benzodioxoly farmakologie terapeutické užití MeSH
- chinolony MeSH
- cystická fibróza * farmakoterapie genetika MeSH
- fixní kombinace léků MeSH
- indoly MeSH
- lidé MeSH
- mutace MeSH
- organoidy * MeSH
- protein CFTR genetika MeSH
- pyrazoly MeSH
- pyridiny MeSH
- pyrrolidiny MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- aktivátory chloridových kanálů MeSH
- aminofenoly MeSH
- benzodioxoly MeSH
- chinolony MeSH
- elexacaftor MeSH Prohlížeč
- fixní kombinace léků MeSH
- indoly MeSH
- ivacaftor MeSH Prohlížeč
- protein CFTR MeSH
- pyrazoly MeSH
- pyridiny MeSH
- pyrrolidiny MeSH
- tezacaftor MeSH Prohlížeč
The forskolin-induced swelling assay (FIS) in patient-derived intestinal organoids (PDIOs), used to determine in vitro responsiveness to elexacaftor/tezacaftor/ivacaftor (ETI), showed variability in swelling among PDIOs obtained from people with CF (pwCF) carrying the same F508del/F508del CFTR genotype. We aimed to characterise the effect of ETI on the transcriptional activity of PDIOs-derived cells to understand the intracellular processes triggered by ETI and the differences in treatment response. Six high- and six low-responding PDIOs to ETI, derived from F508del/F508del pwCF, were incubated with or without ETI for 2 to 6 h. Gene expression was assessed using 3'-mRNA sequencing and modelled using negative binomial models. Incubation with ETI resulted in a significant upregulation of several biological processes: mostly related to chemokines and signalling, chemotaxis, and tissue development processes. No changes were observed in abundance of the CFTR transcripts or in CFTR-related gene sets and pathways. The genes and pathways associated with ETI did not overlap with those whose expression changed with time only. PDIOs with a high FIS response did not significantly differ in any interpretable gene from the FIS-low organoids. The changes in the PDIOs gene expression upon the exposure to ETI cannot explain differences in the magnitude of PDIOs FIS-measured response to ETI. In conclusion, on incubation with ETI, genes of the CFTR-related pathways do not change their transcriptional activity; instead, overexpression was observed in genes of inflammatory-like cytokine response and receptor activation pathways.
- Klíčová slova
- Cystic fibrosis, Differential expression, Elexacaftor, Intestinal organoid, Ivacaftor, Tezacaftor,
- MeSH
- aktivátory chloridových kanálů farmakologie MeSH
- aminofenoly * farmakologie MeSH
- benzodioxoly * farmakologie MeSH
- chinoliny MeSH
- chinolony * farmakologie MeSH
- cystická fibróza * genetika farmakoterapie MeSH
- fixní kombinace léků MeSH
- indoly * farmakologie MeSH
- lidé MeSH
- organoidy * účinky léků metabolismus MeSH
- protein CFTR genetika MeSH
- pyrazoly MeSH
- pyridiny * farmakologie MeSH
- pyrrolidiny MeSH
- pyrroly * farmakologie MeSH
- stanovení celkové genové exprese MeSH
- thiofeny farmakologie MeSH
- transkriptom MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- aktivátory chloridových kanálů MeSH
- aminofenoly * MeSH
- benzodioxoly * MeSH
- chinoliny MeSH
- chinolony * MeSH
- elexacaftor, ivacaftor, tezacaftor drug combination MeSH Prohlížeč
- elexacaftor MeSH Prohlížeč
- fixní kombinace léků MeSH
- indoly * MeSH
- ivacaftor MeSH Prohlížeč
- protein CFTR MeSH
- pyrazoly MeSH
- pyridiny * MeSH
- pyrrolidiny MeSH
- pyrroly * MeSH
- tezacaftor MeSH Prohlížeč
- thiofeny MeSH
BACKGROUND: Cystic fibrosis is caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein, and nearly 90% of patients have at least one copy of the Phe508del CFTR mutation. In a phase 2 trial involving patients who were heterozygous for the Phe508del CFTR mutation and a minimal-function mutation (Phe508del-minimal function genotype), the next-generation CFTR corrector elexacaftor, in combination with tezacaftor and ivacaftor, improved Phe508del CFTR function and clinical outcomes. METHODS: We conducted a phase 3, randomized, double-blind, placebo-controlled trial to confirm the efficacy and safety of elexacaftor-tezacaftor-ivacaftor in patients 12 years of age or older with cystic fibrosis with Phe508del-minimal function genotypes. Patients were randomly assigned to receive elexacaftor-tezacaftor-ivacaftor or placebo for 24 weeks. The primary end point was absolute change from baseline in percentage of predicted forced expiratory volume in 1 second (FEV1) at week 4. RESULTS: A total of 403 patients underwent randomization and received at least one dose of active treatment or placebo. Elexacaftor-tezacaftor-ivacaftor, relative to placebo, resulted in a percentage of predicted FEV1 that was 13.8 points higher at 4 weeks and 14.3 points higher through 24 weeks, a rate of pulmonary exacerbations that was 63% lower, a respiratory domain score on the Cystic Fibrosis Questionnaire-Revised (range, 0 to 100, with higher scores indicating a higher patient-reported quality of life with regard to respiratory symptoms; minimum clinically important difference, 4 points) that was 20.2 points higher, and a sweat chloride concentration that was 41.8 mmol per liter lower (P<0.001 for all comparisons). Elexacaftor-tezacaftor-ivacaftor was generally safe and had an acceptable side-effect profile. Most patients had adverse events that were mild or moderate. Adverse events leading to discontinuation of the trial regimen occurred in 1% of the patients in the elexacaftor-tezacaftor-ivacaftor group. CONCLUSIONS: Elexacaftor-tezacaftor-ivacaftor was efficacious in patients with cystic fibrosis with Phe508del-minimal function genotypes, in whom previous CFTR modulator regimens were ineffective. (Funded by Vertex Pharmaceuticals; VX17-445-102 ClinicalTrials.gov number, NCT03525444.).
- MeSH
- aktivátory chloridových kanálů aplikace a dávkování škodlivé účinky MeSH
- aminofenoly aplikace a dávkování škodlivé účinky MeSH
- benzodioxoly aplikace a dávkování škodlivé účinky MeSH
- chinolony aplikace a dávkování škodlivé účinky MeSH
- chloridy analýza MeSH
- cystická fibróza farmakoterapie genetika patofyziologie MeSH
- dítě MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- fixní kombinace léků MeSH
- genotyp MeSH
- indoly aplikace a dávkování škodlivé účinky MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mutace * MeSH
- pot chemie MeSH
- protein CFTR genetika MeSH
- pyrazoly aplikace a dávkování škodlivé účinky MeSH
- pyridiny aplikace a dávkování škodlivé účinky MeSH
- pyrrolidiny aplikace a dávkování škodlivé účinky MeSH
- usilovný výdechový objem MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze III MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- Research Support, N.I.H., Extramural MeSH
- Názvy látek
- aktivátory chloridových kanálů MeSH
- aminofenoly MeSH
- benzodioxoly MeSH
- CFTR protein, human MeSH Prohlížeč
- chinolony MeSH
- chloridy MeSH
- elexacaftor MeSH Prohlížeč
- fixní kombinace léků MeSH
- indoly MeSH
- ivacaftor MeSH Prohlížeč
- protein CFTR MeSH
- pyrazoly MeSH
- pyridiny MeSH
- pyrrolidiny MeSH
- tezacaftor MeSH Prohlížeč
INTRODUCTION: Cystic fibrosis transmembrane conductance regulator modulator therapy improves nutritional status and quality of life. Clinical trials have shown pancreatic insufficiency conversion, mostly in pediatric patients treated with ivacaftor. Studies with elexacaftor/tezacaftor/ivacaftor (ETI) in older patients have not suggested restoration of exocrine pancreas function, but quality data in adults are lacking. Our aim was to show the effect of ETI in adults with cystic fibrosis (CF) on nutritional status and digestive function. We hypothesized improvement of nutritional parameters and gastrointestinal symptoms, reduction of pancreatic enzyme replacement therapy, but uncertain improvement in exocrine pancreatic function. METHODS: We prospectively enrolled adults with CF treated with ETI from August 2021 to June 2022. We measured anthropometric parameters, laboratory nutritional markers, change of fecal elastase, pancreatic enzymes replacement therapy needs, and gastrointestinal symptoms. RESULTS: In the cohort of 29 patients (mean age 29.1 years), 82.8% suffered exocrine pancreatic insufficiency. After ETI, mean BMI increased by 1.20 kg/m2 (p < 0.001), mean body weight by 3.51 kg (p < 0.001), albumin by 2.81 g/L, and prealbumin by 0.06 (both p < 0.001). Only 1 patient, initially pancreatic insufficient (4.5%, p < 0.001), developed pancreatic sufficiency, indicated by increased fecal elastase from 45 μg/g to 442.1 μg/g. Mean change in lipase substitution decreased by 1,969 units/kg/day (p < 0.001) and stools frequency by 1.18 per day (p < 0.001). CONCLUSION: Our data suggest increased nutritional parameters, lower pancreatic substitution requirements, and improved defecation in adult CF patients on ETI. Improvement in exocrine pancreatic function might be mutation-specific and needs further study.
- Klíčová slova
- Cystic fibrosis, Elexacaftor/tezacaftor/ivacaftor, Exocrine pancreas function, Nutrition, Pancreatic enzyme replacement therapy,
- MeSH
- aminofenoly terapeutické užití MeSH
- benzodioxoly terapeutické užití MeSH
- chinoliny MeSH
- chinolony terapeutické užití MeSH
- cystická fibróza * farmakoterapie komplikace MeSH
- dospělí MeSH
- exokrinní pankreatická insuficience * farmakoterapie etiologie komplikace MeSH
- fixní kombinace léků * MeSH
- gastrointestinální nemoci farmakoterapie MeSH
- indoly * terapeutické užití MeSH
- lidé MeSH
- mladý dospělý MeSH
- nutriční stav * MeSH
- pankreatická elastasa metabolismus MeSH
- prospektivní studie MeSH
- pyrazoly terapeutické užití MeSH
- pyridiny terapeutické užití MeSH
- pyrrolidiny terapeutické užití MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- aminofenoly MeSH
- benzodioxoly MeSH
- chinoliny MeSH
- chinolony MeSH
- elexacaftor, ivacaftor, tezacaftor drug combination MeSH Prohlížeč
- elexacaftor MeSH Prohlížeč
- fixní kombinace léků * MeSH
- indoly * MeSH
- pankreatická elastasa MeSH
- pyrazoly MeSH
- pyridiny MeSH
- pyrrolidiny MeSH
BACKGROUND: Several treatment approaches in cystic fibrosis (CF) aim to correct CF transmembrane conductance regulator (CFTR) function; the efficacy of each approach is dependent on the mutation(s) present. A need remains for more effective treatments to correct functional deficits caused by the F508del mutation. METHODS: Two placebo-controlled, phase 2a studies evaluated GLPG2222, given orally once daily for 29 days, in subjects homozygous for F508del (FLAMINGO) or heterozygous for F508del and a gating mutation, receiving ivacaftor (ALBATROSS). The primary objective of both studies was to assess safety and tolerability. Secondary objectives included assessment of pharmacokinetics, and of the effect of GLPG2222 on sweat chloride concentrations, pulmonary function and respiratory symptoms. RESULTS: Fifty-nine and 37 subjects were enrolled into FLAMINGO and ALBATROSS, respectively. Treatment-related treatment-emergent adverse events (TEAEs) were reported by 29.2% (14/48) of subjects in FLAMINGO and 40.0% (12/30) in ALBATROSS; most were mild to moderate in severity and comprised primarily respiratory, gastrointestinal, and infection events. There were no deaths or discontinuations due to TEAEs. Dose-dependent decreases in sweat chloride concentrations were seen in GLPG2222-treated subjects (maximum decrease in FLAMINGO: -17.6 mmol/L [GLPG2222 200 mg], p < 0.0001; ALBATROSS: -7.4 mmol/L [GLPG2222 300 mg], p < 0.05). No significant effects on pulmonary function or respiratory symptoms were reported. Plasma GLPG2222 concentrations in CF subjects were consistent with previous studies in healthy volunteers and CF subjects. CONCLUSIONS: GLPG2222 was well tolerated. Sweat chloride reductions support on-target enhancement of CFTR activity in subjects with F508del mutation(s). Significant improvements in clinical endpoints were not demonstrated. Observed safety results support further evaluation of GLPG2222, including in combination with other CFTR modulators. FUNDING: Galapagos NV. Clinical trial registration numbers FLAMINGO, NCT03119649; ALBATROSS, NCT03045523.
- Klíčová slova
- CFTR modulator, Cystic fibrosis, F508del, GLPG2222, Gating mutation, Ivacaftor,
- MeSH
- aktivátory chloridových kanálů aplikace a dávkování škodlivé účinky farmakokinetika MeSH
- aminofenoly * aplikace a dávkování škodlivé účinky MeSH
- aplikace orální MeSH
- benzoáty * aplikace a dávkování škodlivé účinky farmakokinetika MeSH
- benzopyrany * aplikace a dávkování škodlivé účinky farmakokinetika MeSH
- biologická dostupnost MeSH
- chinolony * aplikace a dávkování škodlivé účinky MeSH
- cystická fibróza * diagnóza farmakoterapie genetika MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- kombinovaná farmakoterapie metody MeSH
- lidé MeSH
- monitorování léčiv MeSH
- mutace MeSH
- pot * chemie účinky léků MeSH
- protein CFTR genetika MeSH
- respirační funkční testy metody MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze II MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- Názvy látek
- aktivátory chloridových kanálů MeSH
- aminofenoly * MeSH
- benzoáty * MeSH
- benzopyrany * MeSH
- chinolony * MeSH
- GLPG2222 MeSH Prohlížeč
- ivacaftor MeSH Prohlížeč
- protein CFTR MeSH
Introduction: Seminal clinical trials with the triple combination of elexacaftor-tezacaftor-ivacaftor (ETI) demonstrated clinical efficacy in people with cystic fibrosis (pwCF) who carry at least one F508del mutation. However, due to exclusion criteria of these clinical trials, the effect of ETI was not studied in a substantial number of pwCF. Thus, we ran a single center trial to evaluate a clinical efficacy of ETI treatment in adult pwCF who were ineligible for enrollment in registration studies. Methods: PwCF on ETI with prior lumacaftor-ivacaftor therapy, severe airway obstruction, well-preserved lung function, or with airway infection with pathogens at risk of more rapid decline in lung function formed the study group, while all the others on ETI formed the control group. Lung function, nutritional status and sweat chloride concentration were assessed before and after initialization of ETI therapy over a 6-month period. Results: Approximately a half of the ETI-treated pwCF at the adult Prague CF center (49 of 96) were assigned to the study group. Their mean changes in body mass index ( + 1.04 kg/m2) and in sweat chloride concentration (-48.4 mmol/L) were similar to the control group ( + 1.02 kg/m2; -49.7 mmol/L), while the mean change in percent predicted forced expiratory volume in 1 s (ppFEV1; + 10.3 points) was significantly lower than in the control group ( + 15.8 points) (p = 0.0015). In the subgroup analysis, pwCF with severe airway obstruction (ppFEV1 <40) and pwCF with well-preserved lung function (ppFEV1 >90) showed a less potential for improvement in lung function during the ETI treatment than controls (median change in ppFEV1 + 4.9 points and + 9.5 points, respectively). Conclusion: PwCF not eligible for inclusion in clinical trials demonstrated improvement in lung function and nutritional status following the initiation of treatment with the ETI combination. Moderate increase in ppFEV1 was observed in those with severe airway obstruction or well-preserved lung function.
- Klíčová slova
- cystic fibrosis, elexacaftor-tezacaftor-ivacaftor, lung function, nutritional status, sweat chloride concentration, variant specific therapy,
- Publikační typ
- časopisecké články MeSH
BACKGROUND: We have recently shown that human epididymis protein 4 (HE4) levels correlate with the severity of cystic fibrosis (CF) lung disease. However, there are no data on how HE4 levels alter in patients receiving CFTR modulating therapy. METHODS: In this retrospective clinical study, 3 independent CF patient cohorts (US-American: 29, Australian: 12 and Irish: 19 cases) were enrolled carrying at least one Class III CFTR CF-causing mutation (p.Gly551Asp) and being treated with CFTR potentiator ivacaftor. Plasma HE4 was measured by immunoassay before treatment (baseline) and 1-6 months after commencement of ivacaftor, and were correlated with FEV1 (% predicted), sweat chloride, C-reactive protein (CRP) and body mass index (BMI). RESULTS: After 1 month of therapy, HE4 levels were significantly lower than at baseline and remained decreased up to 6 months. A significant inverse correlation between absolute and delta values of HE4 and FEV1 (r = -0.5376; P < .001 and r = -0.3285; P < .001), was retrospectively observed in pooled groups, including an independent association of HE4 with FEV1 by multiple regression analysis (β = -0.57, P = .019). Substantial area under the receiver operating characteristic curve (ROC-AUC) value was determined for HE4 when 7% mean change of FEV1 (0.722 [95% CI 0.581-0.863]; P = .029) were used as classifier, especially in the first 2 months of treatment (0.806 [95% CI 0.665-0.947]; P < .001). CONCLUSIONS: This study shows that plasma HE4 levels inversely correlate with lung function improvement in CF patients receiving ivacaftor. Overall, this potential biomarker may be of value for routine clinical and laboratory follow-up of CFTR modulating therapy.
- Klíčová slova
- BMI, Biomarker, Cystic fibrosis, FEV(1), HE4, Ivacaftor, Sweat chloride,
- MeSH
- aktivátory chloridových kanálů terapeutické užití MeSH
- aminofenoly terapeutické užití MeSH
- biologické markery analýza MeSH
- chinolony terapeutické užití MeSH
- cystická fibróza * genetika patofyziologie terapie MeSH
- dítě MeSH
- dospělí MeSH
- index tělesné hmotnosti MeSH
- lidé MeSH
- monitorování léčiv metody MeSH
- mutace MeSH
- pot chemie MeSH
- protein CFTR genetika MeSH
- protein WFDC2 analýza MeSH
- respirační funkční testy metody MeSH
- retrospektivní studie MeSH
- usilovný výdechový objem účinky léků MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinická studie MeSH
- práce podpořená grantem MeSH
- Názvy látek
- aktivátory chloridových kanálů MeSH
- aminofenoly MeSH
- biologické markery MeSH
- chinolony MeSH
- ivacaftor MeSH Prohlížeč
- protein CFTR MeSH
- protein WFDC2 MeSH
- WFDC2 protein, human MeSH Prohlížeč
- Klíčová slova
- Cystic fibrosis, Elexacaftor/tezacaftor/ivacaftor, Exocrine pancreatic insufficiency,
- MeSH
- aktivátory chloridových kanálů terapeutické užití MeSH
- aminofenoly * terapeutické užití MeSH
- benzodioxoly * terapeutické užití MeSH
- chinoliny terapeutické užití MeSH
- chinolony * terapeutické užití MeSH
- cystická fibróza * farmakoterapie genetika MeSH
- dospělí MeSH
- exokrinní pankreatická insuficience farmakoterapie etiologie genetika MeSH
- fixní kombinace léků MeSH
- genotyp MeSH
- indoly * terapeutické užití MeSH
- lidé MeSH
- protein CFTR * genetika MeSH
- pyrazoly * terapeutické užití MeSH
- pyridiny terapeutické užití MeSH
- pyrrolidiny terapeutické užití MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- dopisy MeSH
- kazuistiky MeSH
- Názvy látek
- aktivátory chloridových kanálů MeSH
- aminofenoly * MeSH
- benzodioxoly * MeSH
- chinoliny MeSH
- chinolony * MeSH
- elexacaftor, ivacaftor, tezacaftor drug combination MeSH Prohlížeč
- elexacaftor MeSH Prohlížeč
- fixní kombinace léků MeSH
- indoly * MeSH
- ivacaftor MeSH Prohlížeč
- protein CFTR * MeSH
- pyrazoly * MeSH
- pyridiny MeSH
- pyrrolidiny MeSH
- tezacaftor MeSH Prohlížeč