Vancouver, Canada – One year of treatment with Trikafta (elexacaftor/tezacaftor/ivacaftor) was associated with significant improvements in work productivity and daily activities among people with cystic fibrosis (CF), according to a real-world study conducted in Canada.
The improvements were linked to better lung function, enhanced physical functioning, fewer respiratory symptoms, and a greater ability to manage everyday responsibilities. The findings suggest that Trikafta’s benefits extend beyond clinical measures to improve patients’ participation in work, education, and daily life.
“These findings suggest that the clinical benefits of Trikafta extend beyond traditional physiologic outcomes and translate into meaningful improvements in day-to-day functioning and workforce participation,” the researchers wrote in the study, Assessing the impact of elexacaftor/tezacaftor/ivacaftor on work productivity and activity impairment in people living with cystic fibrosis in Canada, published in the Journal of Cystic Fibrosis.
Study examines real-world effects of Trikafta
CFTR modulator therapies, including Trikafta, have significantly improved outcomes for people with CF. These treatments can enhance lung function, nutritional status, and health-related quality of life while reducing pulmonary exacerbations, or flare-ups of respiratory symptoms, and the need for lung transplants.
These advances have also enabled some people with CF to pursue education, complete academic milestones, and participate more fully in the workforce. However, the effects of CFTR modulators on work productivity and everyday activities have remained insufficiently characterized.
To address this gap, researchers across Canada analyzed data from two studies: CAN-IMPACT-CF, a prospective study conducted at five Canadian CF clinics, and REAL-ETI-CF, a retrospective study involving patients at the St. Paul’s Hospital Adult CF Clinic in Vancouver.
The analysis included 146 participants who completed the Work Productivity and Activity Impairment questionnaire at baseline and after 12 months of Trikafta treatment. Their mean age was 33, and 60% were male.
At the start of the study, 53% of participants were employed, 16% were students, 25% were neither working nor studying, and 6% were both employed and enrolled in school. Participants who were neither working nor studying tended to be older, included a higher proportion of women, and had poorer lung function than those who were working, studying, or both.
Work productivity improves after 12 months
Among employed participants, several measures of work-related impairment declined substantially after one year of treatment.
Absenteeism, which measures the proportion of work missed because of health problems, fell from 13.1% to 3.3%. Presenteeism, which reflects reduced productivity while working because of health-related limitations, decreased from 24.9% to 8.8%.
Overall work productivity loss, which combines absenteeism and presenteeism, dropped from 30% to 10.8%.
Students also experienced reductions in absenteeism, presenteeism, and school productivity loss. However, these changes were not statistically significant, meaning the study could not rule out the possibility that they occurred by chance. The researchers suggested that the smaller number of students may have limited the ability to detect meaningful differences.
Better physical functioning and fewer respiratory symptoms drive gains
Improvements in work productivity were associated with changes in nine of the 12 domains measured by the Cystic Fibrosis Questionnaire-Revised (CFQ-R), an assessment of health-related quality of life.
The strongest associations with improved work or school productivity involved better physical functioning, reduced respiratory symptoms, and improved role functioning, which reflects the ability to fulfill everyday responsibilities.
Participants also reported fewer limitations in regular activities such as housework and shopping. Overall activity impairment decreased from 30.1% to 15.1% after 12 months of treatment.
As with work productivity, reductions in activity impairment were most strongly associated with improvements in physical functioning, respiratory symptoms, and role functioning.
Potential economic benefits of improved productivity
The findings may also have important economic implications. In 2021, the year Trikafta was approved in Canada, the annual indirect costs associated with lost productivity, work and school absenteeism, and time spent on intensive daily treatments were estimated at CA$174 million (approximately US$122 million).
Following the broader availability of Trikafta, these indirect costs were estimated to have fallen to CA$98 million (approximately US$69 million), a reduction of about 45%. The researchers noted that this decline coincided with fewer hospitalizations, less time spent on treatments, and reduced time away from work or school.
Although these estimates reflect broader changes and do not establish that Trikafta alone caused the reduction, they highlight the potential economic benefits associated with improved health and daily functioning among people with CF.
Longer-term research needed
The researchers concluded that starting Trikafta was associated with significant improvements in work productivity and reduced activity impairment after one year of treatment.
They emphasized that larger studies with longer follow-up periods are needed to determine whether these gains are sustained and to better understand how employment, education, and daily functioning evolve over time in the Trikafta era.
Overall, the findings highlight how CFTR modulator therapy may help people with cystic fibrosis not only improve their health but also participate more fully in work, education, and everyday life.
Contact
Bradley S. Quon
Faculty of Medicine, University of British Columbia