Triglyceride-related lipid changes in adults with cystic fibrosis treated with elexacaftor/tezacaftor/ivacaftor: A real-world cross-sectional study.

BACKGROUND AND AIMS: Elexacaftor/tezacaftor/ivacaftor (ETI) has transformed clinical outcomes in cystic fibrosis (CF), yet its systemic metabolic effects remain insufficiently characterized. Our aim was to study whether ETI therapy influence lipid metabolism and cardiometabolic markers in adults with CF under real-world conditions.

METHODS

We conducted a retrospective cross-sectional study including 77 adults with CF (58 receiving ETI and 19 untreated). Clinical, nutritional, respiratory, and cardiometabolic variables were collected. Lipid parameters included triglycerides (TG), HDL, LDL, non-HDL, TG/HDL ratio, and lipid-interplay surrogates. Group comparisons were adjusted using ANCOVA controlling for confounders.

RESULTS

ETI-treated patients showed significantly lower TG levels and reduced TG/HDL ratios compared with untreated individuals, independent of clinical covariates. Other lipid fractions (total cholesterol, LDL, non-HDL, HDL) showed no significant between-group differences. ETI therapy was associated with improved respiratory function and nutritional status. No associations were found between ETI and insulin-related markers.

CONCLUSIONS

ETI treatment was independently associated with lower triglyceride levels and a reduced TG/HDL ratio in adults with CF. These findings suggest a potentially more favorable cardiometabolic profile among treated patients. Prospective longitudinal studies are warranted to clarify the long-term cardiovascular implications of ETI therapy.