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      Profile of tezacaftor/ivacaftor combination and its potential in the treatment of cystic fibrosis

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          Abstract

          Cystic fibrosis (CF) is a life-limiting autosomal recessive disease caused by dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR) ion channel. Management of CF has traditionally relied upon managing complications of CFTR protein dysfunction and this has led to a steady improvement in survival of CF patients. However, the landscape of CF care has changed substantially over the last decade with the discovery of CFTR modulators that aim to increase or potentially restore the function of the disease-causing CFTR protein. This narrative review summarizes the development of CFTR therapies so far with emphasis on tezacaftor/ivacaftor combination therapy. We have also summarized the Phase II results of triple combination therapy which promises an effective CFTR modulator therapy for more than 90% of CF patients.

          Most cited references22

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          Identification of the cystic fibrosis gene: cloning and characterization of complementary DNA.

          Overlapping complementary DNA clones were isolated from epithelial cell libraries with a genomic DNA segment containing a portion of the putative cystic fibrosis (CF) locus, which is on chromosome 7. Transcripts, approximately 6500 nucleotides in size, were detectable in the tissues affected in patients with CF. The predicted protein consists of two similar motifs, each with (i) a domain having properties consistent with membrane association and (ii) a domain believed to be involved in ATP (adenosine triphosphate) binding. A deletion of three base pairs that results in the omission of a phenylalanine residue at the center of the first predicted nucleotide-binding domain was detected in CF patients.
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            Tezacaftor–Ivacaftor in Residual-Function Heterozygotes with Cystic Fibrosis

            Cystic fibrosis is an autosomal recessive disease caused by mutations in the CFTR gene that lead to progressive respiratory decline. Some mutant CFTR proteins show residual function and respond to the CFTR potentiator ivacaftor in vitro, whereas ivacaftor alone does not restore activity to Phe508del mutant CFTR.
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              CFTR function and prospects for therapy.

              Mutations in the gene coding for the cystic fibrosis transmembrane conductance regulator (CFTR) epithelial anion channel cause cystic fibrosis (CF). The multidomain integral membrane glycoprotein, a member of the adenine nucleotide-binding cassette (ABC) transporter family, conserved in metazoan salt-transporting tissues, is required to control ion and fluid homeostasis on epithelial surfaces. This review considers different therapeutic strategies that have arisen from knowledge of CFTR structure and function as well as its biosynthetic processing, intracellular trafficking, and turnover.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                TCRM
                tcriskman
                Therapeutics and Clinical Risk Management
                Dove
                1176-6336
                1178-203X
                22 August 2019
                2019
                : 15
                : 1029-1040
                Affiliations
                [1 ]Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust , Cottingham HU16 5JQ, UK
                Author notes
                Correspondence: Shoaib FaruqiDepartment of Respiratory Medicine, University of Hull and Hull and York Medical School, Hull University Teaching Hospitals NHS Trust , Castle Hill Hospital, Castle Road, CottinghamHU16 5JQ, UKTel +44 148 262 6706 Email Shoaib.Faruqi@hey.nhs.uk
                [*]

                These authors contributed equally to this work

                Article
                165027
                10.2147/TCRM.S165027
                6710479
                36e894a0-9b96-46f7-b18d-4fa9c9bf4596
                © 2019 Shiferaw and Faruqi.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 17 March 2019
                : 16 June 2019
                Page count
                Tables: 5, References: 44, Pages: 12
                Categories
                Review

                Medicine
                cystic fibrosis,cftr modulators,cftr potentiators,ivacaftor,tezacaftor,triple therapy
                Medicine
                cystic fibrosis, cftr modulators, cftr potentiators, ivacaftor, tezacaftor, triple therapy

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