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A treatment evaluator tool to monitor the real-world effectiveness of inhaled aztreonam lysine in cystic fibrosis
Authors:Barry J Plant  Damian G Downey  Joe A Eustace  Cedric Gunaratnam  Charles S Haworth  Andrew M Jones  Edward F McKone  Daniel G Peckham  R Ian Ketchell  Diana Bilton
Institution:1. Cork Adult Cystic Fibrosis Centre, University College Cork, Cork University Hospital, Cork, Ireland;2. Belfast Adult Cystic Fibrosis Centre, Belfast City Hospital, Belfast, UK;3. Cystic Fibrosis Unit, Beaumont Hospital, Dublin, Ireland;4. Cambridge Centre for Lung Infection, Papworth Hospital, Cambridge, UK;5. Manchester Adult Cystic Fibrosis Centre, University Hospital of South Manchester, Manchester, UK;6. Department of Respiratory Medicine, St Vincent''s University Hospital, Dublin, Ireland;7. Regional Adult Cystic Fibrosis Unit, St James''s University Hospital, Leeds, UK;8. All Wales Adult Cystic Fibrosis Centre, University Hospital Llandough, Cardiff, UK;9. Department of Respiratory Medicine, Royal Brompton Hospital, London, UK
Abstract:

Background

Studies are required that evaluate real-world outcomes of inhaled aztreonam lysine in patients with cystic fibrosis (CF).

Methods

Our treatment-evaluator tool assessed the effectiveness of inhaled aztreonam in routine practice in 117 CF patients across four time periods (6–12 (P2) and 0–6 months (P1) pre-initiation, and 0–6 (T1) and 6–12 months (T2) post-initiation). Outcomes were: changes in %-predicted forced expiratory volume in 1 s (FEV1), body-mass index (BMI), hospitalisation days and intravenous antibiotic usage.

Results

Median FEV1% predicted for each 6-month period was 38.9%, 34.6%, 37.1% and 36.5%; median change was ? 2.0% between P2 and P1, increasing to + 0.6% (p < 0.001) between P1 and T1. Annualised hospital bed-days was reduced (p = 0.05) post-initiation, as was intravenous antibiotics days (p = 0.001). BMI increased over 6 months post-initiation (p ≤ 0.001).

Conclusions

In patients with CF in routine practice, inhaled aztreonam lysine is associated with improved lung function and weight, and reduced hospitalisation and intravenous antibiotic use.
Keywords:BMI  body mass index  CF  cystic fibrosis  1  IV  intravenous  Aztreonam  Cystic fibrosis  Forced expiratory volume  Evaluation tool  Intravenous antibiotics
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