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Rakotoarisoa L, Weiss L, Lefebvre F, Porzio M, Ravoninjatovo B, Abely M, Boucher ID, Dubois S, Troussier F, Gilles R, Prevotat A, Kessler L. Comparison of Continuous Glucose Monitoring in Cystic Fibrosis Patients With or Without Pancreatic Exocrine Insufficiency. Horm Metab Res 2022; 54:407-412. [PMID: 35272389 DOI: 10.1055/a-1794-5496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This study aimed to compare continuous glucose monitoring (CGM) in cystic fibrosis (CF) according to pancreatic exocrine status.CGM and oral glucose tolerance testing (OGTT) were realized annually over five years in people with CF (pwCF) aged≥10 years without cystic fibrosis-related diabetes (CFRD). CGM parameters in patients with normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and newly diagnosed CFRD were compared according to presence of pancreatic sufficiency (PS) or insufficiency (PI).Overall, 547 OGTTs and 501 CGMs were performed in 147 CF patients, comprising 122 PI and 25 PS. In PS patients, 84% displayed NGT, 12% IGT, and 4% CFRD vs. 58%, 32%, and 10% (p=0.05) in PI. Among participants displaying normal OGTT, time in glucose range (70-140 mg/dl) was significantly increased, 97% (93, 99) vs. 92% (85, 96), p<0.001, and time above glucose range > 140 mg/dl significantly decreased, 1% (0, 2) % vs. 6% (2, 13), in patients with PS compared to those with PI. No significant differences were highlighted in patients with IGT.CGM revealed significant different glucose tolerance abnormalities in PI versus PS, which were undetected by standard 2-hour OGTT glucose.
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Affiliation(s)
- Luc Rakotoarisoa
- Department of Diabetology, University Hospital Strasbourg, Strasbourg, France
- Inserm UMR 1260, Regenerative Nanomedicine, University of Strasbourg, Strasbourg, France
| | - Laurence Weiss
- CRCM, University Hospital Strasbourg, Strasbourg, France
| | | | - Michele Porzio
- CRCM, University Hospital Strasbourg, Strasbourg, France
| | | | - Michel Abely
- CRCM, University Hospital Centre Reims, Reims, France
| | | | - Séverine Dubois
- Diabetology, University Hospital Centre Angers, Angers, France
| | | | | | - Anne Prevotat
- Allergology, Lille University Hospital Center, Lille, France
| | - Laurence Kessler
- Department of Diabetology, University Hospital Strasbourg, Strasbourg, France
- Inserm UMR 1260, Regenerative Nanomedicine, University of Strasbourg, Strasbourg, France
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Hubert D, Dehillotte C, Munck A, David V, Baek J, Mely L, Dominique S, Ramel S, Danner Boucher I, Lefeuvre S, Reynaud Q, Colomb-Jung V, Bakouboula P, Lemonnier L. Retrospective observational study of French patients with cystic fibrosis and a Gly551Asp-CFTR mutation after 1 and 2years of treatment with ivacaftor in a real-world setting. J Cyst Fibros 2017; 17:89-95. [PMID: 28711222 DOI: 10.1016/j.jcf.2017.07.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/03/2017] [Accepted: 07/03/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ivacaftor has been shown to improve lung function and body weight in patients with CF and a gating mutation. Real-world evaluation is warranted to examine its safety and effectiveness over the long term. METHODS A retrospective observational multicentre study collected clinical data in the year before and the 2years after ivacaftor initiation in patients with CF and a Gly551Asp-CFTR mutation. RESULTS Fifty-seven patients were included. Mean absolute change in FEV1% predicted improved from baseline to Year 1 (8.4%; p<0.001) and Year 2 (7.2%; p=0.006). Statistically significant benefits were observed with increased body mass index, fewer Pseudomonas aeruginosa and Staphylococcus aureus positive cultures, and decreased IV antibiotics and maintenance treatment prescriptions (including azithromycin, Dornase alpha and nutritional supplements). No significant adverse events were reported. CONCLUSION The clinical benefits of ivacaftor reported in previous clinical trials were confirmed in a real-world setting two years post-initiation, also reducing treatment burden.
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Affiliation(s)
- Dominique Hubert
- Pulmonary Department, Adult CF Centre, Cochin Hospital, AP-HP, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | | | - Anne Munck
- Pediatric CF Centre, Robert Debré Hospital, AP-HP, Paris, France
| | - Valérie David
- Pediatric CF Centre, Hôpital Mère-Enfant, Nantes, France
| | - Jinmi Baek
- Clinical Research Unit, Cochin Hospital, AP-HP, Paris, France
| | | | - Stéphane Dominique
- Pulmonary Department, Adult CF Centre, Charles Nicolle Hospital, Rouen University Hospital, Rouen, France
| | - Sophie Ramel
- CF Centre, Centre héliomarin de Perharidy, Roscoff, France
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