Weight gain in people with cystic fibrosis-related diabetes can be a side effect of Trikafta

People with cystic fibrosis-related diabetes who are using Trikafta are more at risk of putting on weight compared to those not taking the medication, new evidence has found.

Otherwise known as elexacaftor, tezacaftor or ivacaftor, Trikafta could change care offered to individuals with cystic fibrosis-related diabetes, according to the researchers.

In addition, the results show that non-insulin therapies can also be beneficial for those living with diabetes and cystic fibrosis.

“Until now, insulin has been the only recommended treatment of cystic fibrosis-related diabetes,” said the authors.

They added: “In our three-year study, physicians were able to use alternate, non-insulin anti-glycaemic therapies without any significant side effects.

“This suggests a paradigm shift in the treatment of cystic fibrosis-related diabetes in people who are also treated with CFTR modulators.”

Around 50% of people living with cystic fibrosis will go on to develop disease-related diabetes, the study has reported.

Cystic fibrosis is a genetic condition caused by a faulty gene that affects the movement of salt and water in and out of cells.

This, along with recurrent infections, can result in a build-up of thick, sticky mucus in the body’s tubes and passageways – particularly the lungs and digestive system.

According to the researchers, individuals living with cystic fibrosis are more likely to suffer from malnutrition as a result of their increased energy expenditure, inadequate calorie intake and impaired absorption.

The underlying biological mechanisms underlying cystic fibrosis-related diabetes are damaged pancreas cells that produce insulin. Traditionally, insulin therapies have been used to treat cystic fibrosis-related diabetes.

Sold as Kaftrio in the European Union, Trikafta contains a variation of three cystic fibrosis-related diabetes.

Prior evidence has proven that Trikafta can improve lung function in people living with cystic fibrosis, but there is not much research around it improving it in those with cystic fibrosis-related diabetes.

To resolve this lack of evidence, researchers from Saint Louis University School of Medicine in Missouri looked at the health records of 27 adults with cystic fibrosis-related diabetes who were taking Trikafta medication.

Each participant had at least one F508del mutation in the CTFR gene. Nine of the participants were on modified diets alone, while the other 18 also used insulins.

The findings have shown that the participants with a low BMI gained around 11 lbs in weight when they were taking Trikafta medication.

“In conclusion, we found that CFTR modulator therapy with Trikafta led to an increase in weight in adult cystic fibrosis-related diabetes people with low BMI, but not in those whose BMI was already at target,” said the authors.

They added: “Therapy for cystic fibrosis-related diabetes may change to be more in line with that of type 2 diabetes and more research will be needed to explore the cardiovascular and renal effects of non-insulin therapies in the management of cystic fibrosis-related diabetes.”

The study has been published in the Journal of Clinical and Transitional Endocrinology.

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