Analysis of Depression and Anxiety Scores Following Initiation of Elexacaftor/Tezacaftor/Ivacaftor in Adults With Cystic Fibrosis

Author:

Pudukodu Harish1,Powell Margret Z.2,Ceppe Agathe3,Donaldson Scott H.3,Goralski Jennifer L.3ORCID,Sowa Nathaniel A.4ORCID

Affiliation:

1. Department of Psychiatry Brigham and Women's Hospital Boston Massachusetts USA

2. Department of Psychology and Neuroscience Baylor University Waco Texas USA

3. Department of Medicine, Division of Pulmonary Diseases and Critical Care Medicine University of North Carolina‐Chapel Hill School of Medicine Chapel Hill North Carolina USA

4. Department of Psychiatry University of North Carolina‐Chapel Hill School of Medicine Chapel Hill North Carolina USA

Abstract

ABSTRACTObjectiveElexacaftor/tezacaftor/ivacaftor (E/T/I) has provided life‐changing pharmacotherapy for many people with cystic fibrosis (CF), but conflicting literature exists regarding the effect on mental health. While some reports suggest E/T/I may induce adverse psychiatric symptoms, others report improvements in mental health symptoms. To add to this growing body of knowledge, we retrospectively analyzed depression and anxiety symptoms before and after E/T/I initiation in adults with CF at a single large US CF center.MethodPatient Health Questionnaire‐9 (PHQ‐9) and Generalized Anxiety Disorder‐7 (GAD‐7) scores recorded in a database were studied. Patients with scores collected before and after E/T/I initiation were included. Regression analyses described associations between score changes and age, race, ethnicity, sex, CFTR variant, and prior depression and/or anxiety diagnoses. Secondary analyses examined possible confounding effects of the COVID‐19 pandemic.ResultsThere was no change in mean GAD‐7 (0.5 ± 5.3, p = 0.41) or PHQ‐9 (−0.02 ± 6.0, p = 0.97) scores following initiation of E/T/I (N = 86). A trend between a prior diagnosis of depression and worsening in PHQ‐9 post‐E/T/I was observed (OR 3.58; p = 0.054).ConclusionsTreatment with E/T/I does not lead to changes in depression or anxiety symptoms at the population level in this single center cohort study. A prior diagnosis of depression trended towards an increased odds of worsening PHQ‐9 scores after E/T/I initiation.

Funder

National Institute of Diabetes and Digestive and Kidney Diseases

Publisher

Wiley

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