New clinical standards for treating patients with cystic fibrosis (CF) have been released.
A disease, CF affects the lungs and other organs. It is characterized by thick, sticky mucus. CF is always fatal, but thanks to advances in therapy over the last 60 years, life expectancy has increased from a few years to 36 years. Lung disease accounts for 85% of the mortality rate among patients with CF.
Aerosolized antibiotics, recombinant human DNase (dornase alfa), hypertonic saline inhalation, anti-inflammatory agents, macrolide antibiotics, bronchodilators, and N-acetylcysteine were evaluated for safety and efficacy. Because of the scarcity of studies performed in children younger than six years of age, the recommendations apply to patients six years of age and older.
The treatments with the most consistent results yielding “A” and “B” grades and positive recommendations included inhaled tobramycin, dornase alfa, hypertonic saline, and beta2-adrenergic receptor agonists.
The guidelines recommend against using systemic corticosteroids in children, inhaled corticosteroids (excluding patients with concomitant asthma), and prophylactic anti-staphylococcal antibiotics. All other treatments lacked sufficient evidence to recommend for or against their use.
The guidelines are scheduled to be updated every five years.
(Source: Am J Respir Crit Care Med, American Thoracic Society, November 15, 2007.)