Newborn screening alone insufficient to improve pulmonary outcomes for cystic fibrosis.

Autor: Barreda CB; Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA. Electronic address: cbarreda@wisc.edu., Farrell PM; Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA. Electronic address: pmfarrell@wisc.edu., Laxova A; Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA. Electronic address: alaxova@pediatrics.wisc.edu., Eickhoff JC; Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA. Electronic address: eickhoff@biostat.wisc.edu., Braun AT; Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA. Electronic address: atbraun@medicine.wisc.edu., Coller RJ; Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA. Electronic address: rcoller@pediatrics.wisc.edu., Rock MJ; Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA. Electronic address: mjrock@wisc.edu.
Jazyk: angličtina
Zdroj: Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society [J Cyst Fibros] 2021 May; Vol. 20 (3), pp. 492-498. Date of Electronic Publication: 2020 Jun 13.
DOI: 10.1016/j.jcf.2020.06.002
Abstrakt: Background: The Wisconsin Cystic Fibrosis Neonatal Screening Project was a randomized clinical trial (RCT) revealing that children receiving an early diagnosis of CF via newborn screening (NBS) had improved nutritional outcomes but similar lung disease severity compared to those who presented clinically. Because the evaluations of these subjects by protocol ended in 2012, our objective was to assess long-term pulmonary and mortality outcomes.
Methods: Retrospective analysis of the RCT cohort utilized longitudinal outcome measures obtained from the Cystic Fibrosis Foundation Patient Registry (CFFPR). Data included screening assignment, clinical characteristics, percent predicted forced expiratory volume in 1 s (ppFEV 1 ) and mortality. A random intercept model was used to compare the ppFEV 1 decline of subjects between the two groups up to age 26 years. Mortality was analyzed using the Kaplan-Meier method.
Results: Of the 145 subjects who consented to the original study, 104 subjects met inclusion criteria and had adequate data in the CFFPR. Of 57 subjects in the screened group and 47 in the control group, the rates of ppFEV 1 decline were 1.76%/year (95% CI 1.62 to 1.91%) and 1.43%/year (95% CI 1.26 to 1.60%), respectively (p<0.0002). Pseudomonas aeruginosa acquired before 2 years was partially responsible. There was no difference in mortality between the two groups.
Conclusions: NBS alone does not improve pulmonary outcomes in CF, particularly when other risk factors supervene. In an era prior to strict infection control and current therapies, NBS for CF may be associated with worse pulmonary outcomes.
Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest relevant to this article to disclose.
(Copyright © 2020. Published by Elsevier B.V.)
Databáze: MEDLINE
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