NEW YORK (Reuters Health) – Improvements in the treatment of cystic fibrosis (CF) during early childhood have led to fewer infections with Pseudomonas aeruginosa and stable lung function between ages 6 and 12 years, according to a longitudinal study conducted at Cincinnati Children’s Hospital in Ohio.

“There have been major advances in CF care in recent decades, with improved nutrition, inhaled antibiotics, inhaled mucolytics, and oral anti-inflammatory therapies,” the research team reports in an online issue of the Journal of Pediatrics posted September 11.

To see if these advances have translated into clinical benefits, Dr. Gary L. McPhail and his associates studied the medical records of two groups of children with CF treated at their center before 5 years of age: 74 patients in birth cohort 1, born between 1985 and 1992; and 70 in birth cohort 2, born between 1993 and 2000.

Between 6 and 12 years of age, more subjects in birth cohort 2 than in cohort 1 were on chronic therapy with the mucolytic dornase alfa (70% vs 39%, p < 0.001), had more clinical visits per year (mean 4.7 vs 3.6, p = 0.0009), and a lower prevalence of chronic P. aeruginosa infection (38% vs 65%, p = 0.002).

Compared with cohort 1, cohort 2 had significantly higher mean peak BMI percentile, peak weight for age percentile, and peak height for age percentile than cohort 1 at age 3, 6, and 12 years, the report indicates.

The authors note that cohort 2 had an improved rate of decline in peak FEV1 percent predicted from age 6 to12.

Contributing to the “negligible” rate of decline in lung function at their center is improved infection control, with a focus on early eradication of P. aeruginosa colonization of the respiratory tract, Dr. McPhail’s team says, as well as initiation of dornase alfa in all CF patients at age 6 years and older.

Reference:
J Pediatr 2008.