Health inequities in the modulator era

John B. Palla, Theresa Annette Laguna*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of reviewTo discuss the existing health inequities in people with cystic fibrosis (CF) and how the recent development of cystic fibrosis transmembrane regulator (CFTR) modulators may impact these inequities.Recent findingsPeople with CF (pwCF) from low socioeconomic status (SES) have more pulmonary exacerbations, worse nutritional status, lower pulmonary function, and an increased mortality rate with less access to lung transplantation. pwCF who identify as racial and ethnic minorities have earlier mortality, lower lung function, are less likely to be detected on newborn screening resulting in a delayed diagnosis, are underrepresented in clinic trials, and less likely to be eligible for a CFTR modulator. Female sex is associated with more pulmonary exacerbations and earlier mortality. Sexual gender minorities are a vulnerable population with worse health outcomes, and more research is needed in CF. CFTR modulators are inaccessible to low to middle-income countries due to significant cost burden.SummaryPeople with CF from low SES, racial and ethnic minorities, female sex, and sexual gender minorities face health inequities. CFTR modulator use will further widen existing health inequities given the unequal access to modulators based on nonqualifying genetics and exorbitant cost restricting use both on an individual and global level.

Original languageEnglish (US)
Pages (from-to)626-633
Number of pages8
JournalCurrent opinion in pulmonary medicine
Volume29
Issue number6
DOIs
StatePublished - Nov 1 2023

Keywords

  • cystic fibrosis
  • cystic fibrosis transmembrane regulator modulators
  • health inequities

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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