• Nutrition · Mar 2024

    Impact of CFTR modulator therapy on body composition as assessed by thoracic computed tomography: A follow-up study.

    • Víctor Navas-Moreno, Fernando Sebastian-Valles, Víctor Rodríguez-Laval, Carolina Knott-Torcal, Mónica Marazuela, Nuria Sánchez de la Blanca, Jose Alfonso Arranz Martín, Rosa María Girón, and Miguel Antonio Sampedro-Núñez.
    • Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Madrid, Spain.
    • Nutrition. 2024 Mar 15; 123: 112425112425.

    ObjectiveTreatment with cystic fibrosis transmembrane conductance regulator (CFTR) modulators in individuals with cystic fibrosis (CF) has brought a significant change in forced expiratory volume in 1 second (FEV1) and clinical parameters. However, it also results in weight gain. The aim of our study is to evaluate the effect of CFTR modulator treatment on body composition, measured by computed tomography (CT).MethodsAdult subjects with CF under follow-up at La Princesa University Hospital were recruited. All of them were on elexacaftor-tezacaftor-ivacaftor (ELX/TEZ/IVA) treatment. Body composition analysis was conducted using CT scans and an open-source software. The results were then compared with bioimpedance estimations, as well as other clinical and spirometry data.ResultsOur sample consisted of 26 adult subjects. The fat mass compartments on CT scans correlated with similar compartments on bioimpedance, and normal-density muscle mass exhibited a strong correlation with phase angle. Higher levels of very low-density muscle prior to treatment were associated with lower final FEV1 and less improvement in FEV1 after therapy. We observed an increase in total body area (P < 0.001), driven by increases in total fat mass (P < 0.001), subcutaneous fat (P < 0.001), visceral fat (P = 0.002), and intermuscular fat (P = 0.022). The only muscle compartment that showed an increase after treatment was very low-density muscle (P = 0.032).ConclusionsCT scans represent an opportunity to assess body composition on CF. Combination treatment with CFTR modulators, leads to an improvement in FEV1 and to an increase in body mass in all compartments primarily at the expense of fat mass.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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