P198 - IMPACT OF ELEXACAFTOR-TEZACAFTOR-IVACAFTOR ON BODY MASS INDEX (BMI), BODY COMPOSITION AND LIPID PROFILES IN ADULTS WITH CYSTIC FIBROSIS: A SYSTEMATIC SCOPING REVIEW

P198

IMPACT OF ELEXACAFTOR-TEZACAFTOR-IVACAFTOR ON BODY MASS INDEX (BMI), BODY COMPOSITION AND LIPID PROFILES IN ADULTS WITH CYSTIC FIBROSIS: A SYSTEMATIC SCOPING REVIEW

A. Walsh^1,*, C. Landers^1,2, N. Lucey¹, O. Griffin², S. Carter², C. Corish¹

¹UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, ²National Referral Centre for Adult Cystic Fibrosis, St. Vincent’s University Hospital, Dublin, Ireland

Rationale: Elexacaftor-tezacaftor-ivacaftor (ETI) has substantially improved lung function and life expectancy for people with cystic fibrosis (pwCF). There is emerging evidence to suggest that the prevalence of overweight, obesity and dyslipidaemia is increasing in pwCF on ETI. This presents a need for evaluation of current evidence to inform clinical practice.

Methods: A systematic scoping review was conducted in line with PRISMA guidelines. Peer-reviewed articles and conference abstracts were identified through database searches and conference proceedings. Studies reporting changes in BMI, body composition (fat mass, fat-free mass), and serum lipid profiles (total and LDL cholesterol) in adults with CF following ETI initiation were included. Data were extracted and synthesised descriptively.

Results: One hundred and forty studies met the inclusion criteria. Of the studies reporting BMI, 61% observed statistically significant increases post-ETI, with many individuals achieving guideline-recommended BMI thresholds within 12 months. Several studies also described increases in fat- and fat-free mass, though variation in measurement techniques limited cross-study comparisons. Additionally, 18 studies explored the impact of ETI on lipid profiles, with preliminary evidence indicating statistically significant increases in total and LDL cholesterol, though these changes remained within clinically acceptable ranges. 

Conclusion: ETI is associated with consistent statistically significant increases in BMI and increases in total and LDL cholesterol. However, in most studies, the increases remain within clinically acceptable ranges. Further standardised, longitudinal studies are needed to determine the impact of ETI on cardio-metabolic health and guide the nutritional care of adults with CF.

Disclosure of Interest: None declared