New trial results will reduce hospital admissions for patients with cystic fibrosis
A major clinical trial in cystic fibrosis (CF), TORPEDO-CF, led by experts from University Hospitals Bristol and Weston NHS Foundation Trust (UHBW), University of Nottingham and the University of Liverpool compared oral antibiotics with intravenous antibiotics in killing a common germ that causes dangerous complications in CF patients.
The 10 year trial was sponsored by UHBW and funded with £1.5 million from the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme. In total 286 patients took part in the study at 70 CF centres and clinics around the UK and two in Italy.
The study, published in the Lancet Respiratory Medicine, compared the two types of treatment in tackling Pseudomonas aeruginosa, which causes a chronic destructive lung infection in CF patients.
Pseudomonas aeruginosa is a bacterium that lives in the environment, lurking in places such as sink drains. Most CF patients have chronic lung infection with the germ by their late teens. Oral and nebulised (inhaled) antibiotics have mainly been used to eradicate Pseudomonas aeruginosa, but are only effective if the infection is caught in time.
The trial found that compared with oral therapy, intravenous antibiotics did not achieve sustained eradication of P. aeruginosa in a greater proportion of patients with cystic fibrosis and was more expensive.
TORPEDO study results “means that CF patients who have a new Pseudomonas aeruginosa can be treated at home and saved the inconvenience of having to be admitted to hospital for treatment.
Dr Simon Langton Hewer, a consultant respiratory paediatrician at University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) and co-chief investigator of the study, said: “I’m very excited to be able to share the results of this very important study which has implications for adults and children with CF who have a new infection of Pseudomonas aeruginosa. “
“The results of the study provide evidence to guide practice in CF centres and will help to reduce unnecessary hospital admissions.”
The results of the study have been welcomed by the families of patients and the Cystic Fibrosis Trust.
We would like to thank all the participants and their families who took part in this trial.
Acknowledgement and disclaimer: This project was funded by the UK NIHR HTA programme, project number 07/51/01. The views expressed in this Article are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
You can read the full open access paper in full in the Lancet Respiratory Medicine.
A Plain English Summary can be found on the LCTC trial page.