Multisystem Effects
As is well known, CF effect more than the lungs, thus there were several
notable reports related to ETI use and multisystem alterations. Presence
of Mycobacterium abscessus infection for over 12 years, was no
longer seen in culture in one PwCF after starting
ETI49. Vitamin levels were altered, with vitamin E
levels increasing 12 months after ETI in a review of 76
patients50 and 2 reported cases of papilledema with
elevated Vitamin A levels51. Mental status changes
(mainly mental fogginess) were seen in a case series of 6 patients, all
stopping the medication withing 3 months of initiation, despite attempts
at altered dosing regimens52. Glycemic effects were
examined in 24 patients with and without CF related diabetes
demonstrating a reduction in glucose parameters from continuous glucose
monitoring and no one showed evidence of
hypoglycemia53. Biliary disease was seen in 7 patients
at two adults centers, with 6 patients requiring
cholecystectomy54. Although the additional effects of
ETI are still being determined, some of benefit, but some of concern,
thus additional care/concern should be undertaken when monitoring our
patients on modulators.