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Cystic FibrosisAugust 2021

What Researchers Found Adding the Triple CF Pill on Top of Older Modulators

This 271-patient trial tested whether elexacaftor-tezacaftor-ivacaftor (Trikafta) added benefit for people already on older CF modulators. After 8 weeks, lung function and sweat chloride improved on the triple pill compared with the older combo.

What the trial was testing

The trial enrolled 271 patients with cystic fibrosis. The study was sponsored by Vertex Pharmaceuticals and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

3.7 percentage point lung function improvement on the triple pill vs. older modulators.

New England Journal of Medicine · 2021 · NCT04058353

These findings — that higher lung function on the triple modulator pill compared with older CF modulators — were published in the New England Journal of Medicine and represent the headline result of the study.

Researchers tracked outcomes across 271 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with cystic fibrosis, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Elexacaftor-tezacaftor-ivacaftor (Trikafta) is FDA-approved and available now. This study supports switching to Trikafta from older modulators when you have a Phe508del-gating or Phe508del-residual function mutation. Ask your CF team if a switch makes sense for your genotype.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.