- •We hypothesised that lower adherence was associated with higher FEV1 variability.
- •Objective adherence data from data-logging nebulisers were used.
- •We found a statistically significant association between lower adherence and higher FEV1 variability.
- •The clinical implications of this result need to be further investigated.
At the same level of lung function, some patients with cystic fibrosis have large variations in their FEV1 percent predicted (FEV1pp) values while others have stable values. We hypothesised that lower adherence to nebuliser therapies was associated with higher FEV1pp variability. We conducted a post hoc analysis of the ACtiF trial data. Adherence was calculated using data from data-logging nebulisers, and FEV1pp variability using the coefficient of variation equation. Amongst the 543 patients included in the analysis, those poorly adherent (adherence < 50%) had a higher FEV1pp variability than patients moderately (50 to < 80%) and highly adherent (≥ 80%), with median values (IQR1–3) of 8.1% (4.9–13.7), 6.3% (3.9–9.8), and 6.3% (3.9–9.3) respectively (p < 0.01). This result was confirmed by a multiple linear regression including adherence as a continuous variable (p < 0.01). Further studies are needed to determine the implications of these differences in FEV1pp variability on the prognosis of patients.
Abbreviations:BMI (body mass index), CF (cystic fibrosis), CFTR (cystic fibrosis transmembrane regulator), DAG (directed acyclic graph), FEV1 (forced expiratory volume in one second), UK (United Kingdom)
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Published online: March 14, 2023
Accepted: March 6, 2023
Received in revised form: February 14, 2023
Received: November 30, 2022
Publication stageIn Press Corrected Proof
© 2023 Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society.