TY - JOUR
T1 - Sex differences in treatment patterns in cystic fibrosis pulmonary exacerbations
AU - Montemayor, Kristina
AU - Psoter, Kevin J.
AU - Lechtzin, Noah
AU - Carson, Sara W.
AU - Merlo, Christian A.
AU - Dezube, Rebecca H.
AU - Riekert, Kristin A.
AU - Allgood, Sarah
AU - Toporek, Alexandra
AU - Jennings, Mark T.
AU - West, Natalie E.
N1 - Publisher Copyright:
© 2021 European Cystic Fibrosis Society
PY - 2021/11
Y1 - 2021/11
N2 - Background: Females with cystic fibrosis (CF) have been shown to have worse pulmonary exacerbation (PEx) related outcomes compared to males. However, it is unknown if sex differences in treatment patterns are contributing to these outcomes. Thus, we sought to explore sex differences in treatment patterns in the Standardized Treatment of Pulmonary Exacerbations (STOP) cohort. Methods: Data for 220 participants from the STOP cohort were analyzed. Multivariable regression models were used to assess if female sex was associated with duration of treatment with IV antibiotics and inpatient length of stay. Secondary outcomes included antibiotic selection, adjunctive therapies, mean FEV1pp and CFRSD-CRISS respiratory symptom scores at the four study assessments. Results: In our adjusted model, the average number of IV antibiotic treatment days was 13% higher in females compared to males (IRR 1.13, 95% CI=1.02,1.25; p=0.02). We found no sex differences in inpatient length of stay, number of IV antibiotics, antibiotic selection or initiation of adjunctive therapies. Overall, females had higher CFRSD-CRISS scores at the end of IV therapy indicating worse symptom severity (23.6 for females vs. 18.5 for males, p=0.03). Conclusions: Despite females having a longer treatment duration, our findings demonstrate that males and females are receiving similar treatments which suggest that the outcome disparities in females with CF may not be due to failure to provide the same level of care. Further research dedicated to sex differences in CF is necessary to understand why clinical outcomes differ between males and females.
AB - Background: Females with cystic fibrosis (CF) have been shown to have worse pulmonary exacerbation (PEx) related outcomes compared to males. However, it is unknown if sex differences in treatment patterns are contributing to these outcomes. Thus, we sought to explore sex differences in treatment patterns in the Standardized Treatment of Pulmonary Exacerbations (STOP) cohort. Methods: Data for 220 participants from the STOP cohort were analyzed. Multivariable regression models were used to assess if female sex was associated with duration of treatment with IV antibiotics and inpatient length of stay. Secondary outcomes included antibiotic selection, adjunctive therapies, mean FEV1pp and CFRSD-CRISS respiratory symptom scores at the four study assessments. Results: In our adjusted model, the average number of IV antibiotic treatment days was 13% higher in females compared to males (IRR 1.13, 95% CI=1.02,1.25; p=0.02). We found no sex differences in inpatient length of stay, number of IV antibiotics, antibiotic selection or initiation of adjunctive therapies. Overall, females had higher CFRSD-CRISS scores at the end of IV therapy indicating worse symptom severity (23.6 for females vs. 18.5 for males, p=0.03). Conclusions: Despite females having a longer treatment duration, our findings demonstrate that males and females are receiving similar treatments which suggest that the outcome disparities in females with CF may not be due to failure to provide the same level of care. Further research dedicated to sex differences in CF is necessary to understand why clinical outcomes differ between males and females.
KW - Cystic fibrosis
KW - Pulmonary exacerbations
KW - Sex differences
KW - Treatment patterns
UR - http://www.scopus.com/inward/record.url?scp=85109821617&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85109821617&partnerID=8YFLogxK
U2 - 10.1016/j.jcf.2021.05.012
DO - 10.1016/j.jcf.2021.05.012
M3 - Article
C2 - 34090802
AN - SCOPUS:85109821617
SN - 1569-1993
VL - 20
SP - 920
EP - 925
JO - Journal of Cystic Fibrosis
JF - Journal of Cystic Fibrosis
IS - 6
ER -