Full project title: A randomised registry-based open-label study to assess change in respiratory function for people with cystic fibrosis (pwCF) with one or two Phe508del variants established on triple CFTR modulator combination therapy after rationalisation of muco active aerosolised therapies (the CF STORM study)
CF STORM is a ground-breaking trial to find out if people with cystic fibrosis (CF) receiving the drug Kaftrio can safely start to reduce the number of treatments they have to manage as part of their daily healthcare routine.
Cystic fibrosis (CF) affects over 10,000 people in the UK, and the median life expectancy for a person in the UK with CF is around 49 years. Feedback from the CF community has indicated that reducing the treatment burden is considered to be their top research priority. People with CF spend many hours every day on multiple treatments, including aerosolised therapies delivered by nebulisers to keep their lungs stable and prevent chest infections.
CF STORM, one of the first trials of its kind, has been designed to address the question of how to safely reduce the treatment burden. The recent introduction in the UK of a highly effective new drug, Kaftrio, which is suitable for most people with CF, provides an ideal opportunity to robustly explore this question.
CF STORM will investigate whether it is safe to stop so-called mucoactive nebulisers (DNase and hypertonic saline) once eligible people with CF are established on Kaftrio. This could save people valuable time each day that is currently spent prepping, carrying out and cleaning nebulisers, which may have a positive impact on quality of life.
Members of the HEP theme will be conducting an analysis of the cost-effectiveness of this strategy alongside the trial.
The primary aim of the clinical trial is to establish whether patients established on Kaftrio can safely stop taking nebulised active drugs without a significant fall in their respiratory function.
The aim of the health economic component of the study is to establish the cost-effectiveness of this strategy.
The project formally started in January 2021. We are in the final stages of start-up, with pilot sites due to start recruiting patients in April 2021. The trial will fully open all participating CF centres for recruitment in July 2021, and it expected that patient follow-up will continue into late 2023.
The potential or actual impact
At the end of the trial, a knowledge transfer activity will place the trial results in context, both nationally and internationally. The trial outcome will be published in an open-access peer-reviewed journal. In addition, the innovative approach taken to assess a 'stopping strategy' in the context of undertaking a pragmatic registry-based study following the introduction of highly effective and costly therapy will also be published.
This approach is likely to be translatable to other conditions where new transformational therapies are becoming available. It is important that the impact of new, high-cost drugs on the patient journey is assessed rigorously.
A patient-centred knowledge transfer exercise will also be undertaken in October 2023 and will immediately inform people with CF of the implications of the results of CF STORM for their individual patient journey. The main 'take-home messages' will be distributed through the CF Trust framework, including their social media platforms.
Finalising the health economic analysis plan.
Developing data management and data management plan, drafting a health economics analysis plan.
Who is involved?
Co-PI: Prof. Kevin Southern
Professor of Child Health, University of Liverpool
Co-PI: Dr Gwyneth Davies
Clinical Lecturer, University College London
Researchers and Institutions
Health economics lead:
Prof Jennifer Whitty, ARC EoE HEP/UEA
Dr Rory Cameron, ARC EoE HEP/UEA
Host organisation: Alder Hey Children’s NHS Foundation Trust
Imperial College London
Liverpool Clinical Trials Centre
Oxford University Hospitals NHS Foundation Trust
Papworth Hospital NHS Foundation Trust
Queen's University of Belfast
Royal Brompton and Harefield NHS Foundation Trust
UK Cystic Fibrosis Trust
University College London
University of East Anglia
University of Manchester
University of Nottingham
Trial Lead: Dr Gwyneth Davies
Health Economics: Dr Rory Cameron, ARC EoE HEP/UEA