Impact of elexacaftor/tezacaftor/ivacaftor on depression and anxiety in cystic fibrosis
Background: Cystic fibrosis (CF) is associated with worsening of depression and anxiety symptoms. Elexacaftor/tezacaftor/ivacaftor (Trikafta®), a cystic fibrosis transmembrane regulator (CFTR) modulator approved in 2019, significantly improves lung function, decreases pulmonary exacerbations, and im...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-12-01
|
| Series: | Therapeutic Advances in Respiratory Disease |
| Online Access: | https://doi.org/10.1177/17534666221144211 |
| _version_ | 1797853327281618944 |
|---|---|
| author | Lijia Zhang Dana Albon Marieke Jones Heather Bruschwein |
| author_facet | Lijia Zhang Dana Albon Marieke Jones Heather Bruschwein |
| author_sort | Lijia Zhang |
| collection | DOAJ |
| description | Background: Cystic fibrosis (CF) is associated with worsening of depression and anxiety symptoms. Elexacaftor/tezacaftor/ivacaftor (Trikafta®), a cystic fibrosis transmembrane regulator (CFTR) modulator approved in 2019, significantly improves lung function, decreases pulmonary exacerbations, and improves quality of life. Studies are needed to evaluate the effects of Trikafta on symptoms of anxiety and depression. Research Question: Do adults with CF report a change in depression and anxiety symptoms after Trikafta initiation? Study Design and Methods: A retrospective chart review was conducted of patients with CF ( n = 127) receiving care from January 2015 through February 2022. Data collected included demographics, annual PHQ-9 and GAD-7 scores, FEV1 percent predicted at each visit, BMI, consistency and timeline of Trikafta use, mental health diagnoses, counseling/psychotherapy use, psychiatric medication use, prescriber of psychiatric medications, number of psychiatric emergency department visits and psychiatric hospital admissions, and sleep disturbances. Results: Of the 127 patients screened for eligibility, 100 patients were included. Data collected yielded 563 PHQ-9, 563 GAD-7, and 560 ppFEV1 data points. No significant changes in average PHQ-9 or GAD-7 scores were found after Trikafta initiation or due to the COVID-19 pandemic. However, 22% of patients initiated or had a change in psychiatric medications, and patients with changes in psychiatric medications had significantly higher PHQ-9 and GAD-7 scores than patients not prescribed psychiatric medications. Trikafta use improved lung function by an average of 5.23% ( p = 8.56e−08). Around a quarter (23%) of all patients reported sleep issues after initiating Trikafta. Interpretation: No significant changes in average PHQ-9 and GAD-7 scores were found after Trikafta initiation. A quarter of patients required a change in psychiatric medications, and significant differences in depression and anxiety scores were found between patients with a change in psychiatric medications and those not prescribed medication. Twenty-three percent of patients reported a prevalence of sleep issues after Trikafta initiation. |
| first_indexed | 2024-04-09T19:47:44Z |
| format | Article |
| id | doaj.art-86d6f031f3f94c7a801e2a37bc52fffc |
| institution | Directory Open Access Journal |
| issn | 1753-4666 |
| language | English |
| last_indexed | 2024-04-09T19:47:44Z |
| publishDate | 2022-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Respiratory Disease |
| spelling | doaj.art-86d6f031f3f94c7a801e2a37bc52fffc2023-04-03T13:34:29ZengSAGE PublishingTherapeutic Advances in Respiratory Disease1753-46662022-12-011610.1177/17534666221144211Impact of elexacaftor/tezacaftor/ivacaftor on depression and anxiety in cystic fibrosisLijia ZhangDana AlbonMarieke JonesHeather BruschweinBackground: Cystic fibrosis (CF) is associated with worsening of depression and anxiety symptoms. Elexacaftor/tezacaftor/ivacaftor (Trikafta®), a cystic fibrosis transmembrane regulator (CFTR) modulator approved in 2019, significantly improves lung function, decreases pulmonary exacerbations, and improves quality of life. Studies are needed to evaluate the effects of Trikafta on symptoms of anxiety and depression. Research Question: Do adults with CF report a change in depression and anxiety symptoms after Trikafta initiation? Study Design and Methods: A retrospective chart review was conducted of patients with CF ( n = 127) receiving care from January 2015 through February 2022. Data collected included demographics, annual PHQ-9 and GAD-7 scores, FEV1 percent predicted at each visit, BMI, consistency and timeline of Trikafta use, mental health diagnoses, counseling/psychotherapy use, psychiatric medication use, prescriber of psychiatric medications, number of psychiatric emergency department visits and psychiatric hospital admissions, and sleep disturbances. Results: Of the 127 patients screened for eligibility, 100 patients were included. Data collected yielded 563 PHQ-9, 563 GAD-7, and 560 ppFEV1 data points. No significant changes in average PHQ-9 or GAD-7 scores were found after Trikafta initiation or due to the COVID-19 pandemic. However, 22% of patients initiated or had a change in psychiatric medications, and patients with changes in psychiatric medications had significantly higher PHQ-9 and GAD-7 scores than patients not prescribed psychiatric medications. Trikafta use improved lung function by an average of 5.23% ( p = 8.56e−08). Around a quarter (23%) of all patients reported sleep issues after initiating Trikafta. Interpretation: No significant changes in average PHQ-9 and GAD-7 scores were found after Trikafta initiation. A quarter of patients required a change in psychiatric medications, and significant differences in depression and anxiety scores were found between patients with a change in psychiatric medications and those not prescribed medication. Twenty-three percent of patients reported a prevalence of sleep issues after Trikafta initiation.https://doi.org/10.1177/17534666221144211 |
| spellingShingle | Lijia Zhang Dana Albon Marieke Jones Heather Bruschwein Impact of elexacaftor/tezacaftor/ivacaftor on depression and anxiety in cystic fibrosis Therapeutic Advances in Respiratory Disease |
| title | Impact of elexacaftor/tezacaftor/ivacaftor on depression and anxiety in cystic fibrosis |
| title_full | Impact of elexacaftor/tezacaftor/ivacaftor on depression and anxiety in cystic fibrosis |
| title_fullStr | Impact of elexacaftor/tezacaftor/ivacaftor on depression and anxiety in cystic fibrosis |
| title_full_unstemmed | Impact of elexacaftor/tezacaftor/ivacaftor on depression and anxiety in cystic fibrosis |
| title_short | Impact of elexacaftor/tezacaftor/ivacaftor on depression and anxiety in cystic fibrosis |
| title_sort | impact of elexacaftor tezacaftor ivacaftor on depression and anxiety in cystic fibrosis |
| url | https://doi.org/10.1177/17534666221144211 |
| work_keys_str_mv | AT lijiazhang impactofelexacaftortezacaftorivacaftorondepressionandanxietyincysticfibrosis AT danaalbon impactofelexacaftortezacaftorivacaftorondepressionandanxietyincysticfibrosis AT mariekejones impactofelexacaftortezacaftorivacaftorondepressionandanxietyincysticfibrosis AT heatherbruschwein impactofelexacaftortezacaftorivacaftorondepressionandanxietyincysticfibrosis |