Elexacaftor–Tezacaftor–Ivacaftor Reduces Revision Sinus Surgery in People With Cystic Fibrosis

ABSTRACT Objectives To assess whether elexacaftor–tezacaftor–ivacaftor (ETI) reduces the frequency of endoscopic sinus surgeries (ESS) in patients with cystic fibrosis (pwCF). Methods We conducted a retrospective chart review of pwCF aged 6 years and older who received ETI between January 1, 2018 and December 31, 2023. Inclusion criteria required a history of ESS and a follow‐up time of at least 2 years before and after ETI initiation. Records were reviewed from up to 8 years prior to ETI through the most recent visit. The total number and frequency of ESS were evaluated using univariable linear models, estimating mean difference with 95% confidence intervals (CI) and p ‐values. Results Fifty‐six patients met inclusion criteria, with a median follow‐up time of 8 years (IQR: 8, 8) before ETI initiation and 4.13 years (IQR: 3.47, 4.78) after initiation of ETI. Median age at ETI initiation was 13 years (IQR: 10, 23). Among these patients, 98% ( n = 55) required ESS prior to ETI, compared to 21% ( n = 12) after ETI. The average number of sinus surgeries decreased from 2.88 ± 1.68 before ETI to 0.30 ± 0.63 after ETI (mean difference: 2.6; 95% CI: [2.1, 3.1]; p < 0.001). The frequency of surgeries per year dropped from 0.37 ± 0.22 to 0.07 ± 0.15 after beginning ETI (mean difference: 0.30; 95% CI: [0.23, 0.37]; p < 0.001). Conclusion ETI was associated with a significant decrease in the frequency and rate of ESS in pwCF. These findings suggest an improvement in CF‐related chronic rhinosinusitis outcomes following ETI and may influence future CF treatment decisions. Level of Evidence 4.