Effectiveness of elexacaftor/tezacaftor/ivacaftor on oxidative stress in patients with cystic fibrosis

INTRODUCTION: Cystic fibrosis (CF), a prevalent autosomal recessive disorder, is characterized by chronic respiratory disease, pancreatic insufficiency, and increased oxidative stress due to mutations in the CFTR gene. Elexacaftor/tezacaftor/ivacaftor (ETI) therapy, by enhancing CFTR function, offers a new approach that not only improves pulmonary outcomes but also targets oxidative pathways contributing to CF pathophysiology.EVIDENCE ACQUISITION: A comprehensive literature search was conducted using databases such as PubMed and Cochrane Library, focusing on studies published from the early 2000s to October 2024. Keywords included “cystic fibrosis,“ “oxidative stress,“ and “ETI therapy.“ Study selection criteria centered on CF patients undergoing ETI treatment, with outcomes measured in terms of oxidative stress biomarkers, lung function, and quality of life.EVIDENCE SYNTHESIS: Collected data reveal significant reductions in oxidative stress markers like malondialdehyde (MDA) in patients treated with ETI, correlating with improved lung function and fewer exacerbations. The therapy’s effect on the lung microbiome also suggests potential synergies in reducing inflammation and oxidative stress. Longitudinal effects of ETI indicate its capacity to delay disease progression and reduce the incidence of comorbidities linked to CF.CONCLUSIONS: ETI represents a transformative advancement in CF treatment by addressing oxidative stress and improving clinical outcomes. Ongoing research into its long-term effects, personalized treatment strategies, and microbiome interactions could even further enhance its efficacy. This therapy should be widely integrated into clinical practice to optimize patient care and quality of life in CF.