New research uncovered that tobacco smoke can inhibit the therapeutic benefit of the cystic fibrosis transmembrane conductance regulator (CFTR) modulators in children.

Tobacco smoke has been shown reduce CFTR functional expression in vitro and contributes to acquired CFTR dysfunction in animal models. Therefore, researchers sought to determine whether tobacco smoke exposure also inhibits the clinical benefit of CFTR modulators, specifically, tezacaftor/ivacaftor.

They performed a retrospective analysis of the CF Foundation Patient Registry comparing lung function changes, pulmonary exacerbations, and hospitalizations after tezacaftor/ivacaftor initiation in patients who were exposed to smoke vs patients who were not (ages, 12-18 years). Smoke exposure was determined by annual caregiver self-reports and was estimated using fixed-effects modelling, which accounted for sex, race, and parent education.

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