Russian registry of patients with cystic fibrosis: lessons and perspectives
https://doi.org/10.18093/0869-0189-2023-33-2-171-181
Abstract
A registry of patients with cystic fibrosis (CF) of the Russian Federation has been compiled annually since 2011. Analysis of the national registry with large amounts of clinical and laboratory data helps understand changes in demographic indicators, plan measures to improve the quality of medical care and evaluate their effectiveness.
Aim. To analyze health status of patients with cystic fibrosis in the Russian Federation and the dynamics of key clinical and laboratory parameters from 2011 to 2021. Methods. The health status of CF patients was assessed using the registry data from 2011 to 2021.
Results. The analysis revealed an increase in the total number of patients from 1,026% in 2011 to 3,969 in 2021, in the number of patients identified by neonatal screening from 28.8% to 53.5%, and in coverage by genetic testing from 91.8 to 93.6%. At the same time, the number of mutations detected dropped from 80 to 90.5% and the number of patients with unidentified mutations decreased from 9.5 to 3.2%. The mean age at diagnosis of cystic fibrosis did not change (3.3 ± 5.5 in 2011 and 3.1 ± 6.2 in 2021) despite an increase in the number of patients diagnosed through neonatal screening. There was a difference in M ± SD age from 2011 to 2021 (11.5 ± 8.9 in 2011 and 14 ± 9.8 in 2021). The proportion of adult patients was 24.95% in 2011 and 27.4% in 2021. The therapy changed over 11 years - the number of courses of intravenous therapy decreased from 70.9 to 36.4%, the number of patients using inhaled antipseudomonal therapy expanded to 45%, the number of patients using hypertonic sodium chloride solution expanded from 8.7 to 70.7%, the use of glucocorticoids decreased. The targeted therapy was introduced in 2018, and the number of patients receiving pathogenetic drugs is growing.
Conclusion. The observed changes are indicative of the health status of Russian patients with cystic fibrosis. Analysis of registries helps improve the organization of medical care, predict and implement sanitary and epidemic measures, plan therapy, and assist the regions in organizing outpatient monitoring and microbiological control. The registry is analyzed to organize health care for adult patients.
Keywords
About the Authors
E. I. KondratyevaRussian Federation
Elena I. Kondratyeva 0 Doctor of Medicine, Professor, Head of the Scientific and Clinical Department of cystic fibrosis, Research Centre for Medical Genetics; Deputy Director for Science, MRSBHI “Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region”.
Ul. Moskvorechye 1, Moscow, 115522; ul. Bolshaya Serpukhovskaya 62, Moscow, 115093; tel.: (495) 111-03-03
Competing Interests:
none
A. Yu. Voronkova
Russian Federation
Anna Yu. Voronkova - Candidate of Medicine, Leading Researcher, Scientific and Clinical Department of Cystic Fibrosis, Research Centre for Medical Genetics; Leading Researcher, Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region/
Ul. Moskvorechye 1, Moscow, 115522; ul. Bolshaya Serpukhovskaya 62, Moscow, 115093; tel.: (495) 111-03-03
Competing Interests:
none
N. Yu. Kashirskaya
Russian Federation
Nataliya Yu. Kashirskaya - Doctor of Medicine, Professor, Chief Researcher, Laboratory of Genetic Epidemiology Research Centre for Medical Genetics; Professor of the Department of Pediatrics, MRRCI named after M.F.Vladimirsky.
Ul. Moskvorechye 1, Moscow, 115522; ul. Shchepkina 61/2, Moscow, 129110; tel.: (499) 320-60-90
Competing Interests:
none
S. A. Krasovsky
Russian Federation
Stanislav А. Krasovsky - Candidate of Medicine, Senior Researcher, Cystic Fibrosis Laboratory, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Leading Researcher, Scientific and Clinical Department, Federal State Budgetary Scientific Institution “Research Centre for Medical Genetics” ; Author ID: 688178.
Ul. Moskvorechye 1, Moscow, 115522; tel.: (495) 111-03-03
Competing Interests:
none
M. A. Starinova
Russian Federation
Marina A. Starinova - Researcher, Scientific and Clinical Department of Cystic Fibrosis Research Centre for Medical Genetics.
Ul. Moskvorechye 1, Moscow, 115522; tel.: (499) 612-86-07
Competing Interests:
none
E. L. Amelina
Russian Federation
Elena L. Amelina - Candidate of Medicine, Head of the Laboratory of Cystic Fibrosis, Federal Pulmonology Research Institute.
Orekhovyy bul’var 28, Moscow, 115682; tel.: (495) 410-67-00
Competing Interests:
none
S. N. Avdeev
Russian Federation
Sergey N. Avdeev - Doctor of Medicine, Professor, Academician of Russian Academy of Sciences, Leading Researcher, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Director, National Medical Research Center for the profile “Pulmonology”, Vice-Rector for Research and Innovation, Head of the Department of Pulmonology, N.V.Sklifosovsky Institute of Clinical Medicine, Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First MStMU of the Ministry of Health of the RF (Sechenov University), Chief Freelance Pulmonologist of the Ministry of Health of the Russian Federation.
Orekhovyy bul’var 28, Moscow, 115682; ul. Trubetskaya 8, build. 2, Moscow, 119991; tel.: (499) 246-75-18; тел.: (499) 246-75-18
Competing Interests:
none
S. I. Kutsev
Russian Federation
Sergey I. Kutsev - Doctor of Medicine, Professor, Academician of the Russian Academy of Sciences, Research Centre for Medical Genetics; Chief Freelance Specialist in Medical Genetics of the Ministry of Health of the Russian Federation.
Ul. Moskvorechye 1, Moscow, 115522; tel.: (499) 612-00-37
Competing Interests:
none
References
1. Kondratyeva E.I., Krasovskiy S.A., Starinova M.A. et al., eds. [Register of patients with cystic fibrosis in the Russian Federation. 2020]. Moscow: Medpraktika-M; 2022. Available at: https://api.med-gen.ru/site/assets/files/51107/site_registre_2020.pdf [Accessed: December 05, 2022] (in Russian).
2. European Cystic Fibrosis Society. ECFS patient registry. Updated: February 13, 2019. Available at: https://www.ecfs.eu/projects/ecfs-patient-registry/project [Accessed: December 12, 2022].
3. Salvatore D., Buzzetti R., Mastella G. An overview of international literature from cystic fibrosis registries. Part 5: Update 2012–2015 on lung disease. Pediatr. Pulmonol. 2016; 51 (11): 1251–1263. DOI: 10.1002/ppul.23473.
4. Vongthilath R., Richaud Thiriez B., Dehillotte C. et al. Clinical and microbiological characteristics of cystic fibrosis adults never colonized by pseudomonas aeruginosa: analysis of the french CF registry. PLoS One. 2019; 14 (1): e0210201. DOI: 10.1371/journal.pone.0210201.
5. McKone E.F., Ariti C., Jackson A. et al. Survival estimates in European cystic fibrosis patients and the impact of socioeconomic factors: a retrospective registry cohort study. Eur. Respir. J. 2021; 58 (3): 2002288. DOI: 10.1183/13993003.02288-2020.
6. European Cystic Fibrosis Society. ECFS patient registry annual data report. 2020. Available at: https://www.ecfs.eu/sites/default/files/ECFSPR_Report_2020_v1.0%20%2807Jun2022%29_website.pdf [Accessed: December 10, 2022].
7. Krasovskiy S.A., Amelina E.L., Chernyak A.V. et al. [A role of Moscow regional register for management of cystic fibrosis patients]. Pul’monologiya. 2013; (2): 27–32. DOI: 10.18093/0869-0189-2013-0-2-27-32 (in Russian).
8. Asherova I.K., Kapranov N.I. [The register as a means of improving the quality of mucoviscidosis patients’ treatment]. Pediatricheskaya farmakologiya. 2012; 9 (3): 96–100. DOI: 10.15690/pf.v9i3.330 (in Russian).
9. Kondratyeva E.I., Voronkova A.Yu., Bobrovnichiy V.I. et al. [Clinical, molecular, and microbiological characteristics of cystic fibrosis patients at Moscow region and Belarus’ Republic]. Pul’monologiya. 2018; 28 (3): 296–306. DOI: 10.18093/0869-0189-2018-28-3-296-306 (in Russian).
10. Krasovskiy S.A., Chernyak A.V., Voronkov A.Yu. et al. (eds.). [Register of patients with cystic fibrosis in the Russian Federation. 2016]. Moscow: Medpraktika-M; 2018. Available at: https://mukoviscidoz.org/doc/registr/Registre_2016%20ctp.pdf [Accessed: December 05, 2022] (in Russian).
11. [Cystic fibrosis (cystic fibrosis)]. Clinical guidelines. 2021. Available at: https://mukoviscidoz.org/doc/%D0%9A%D0%A0372.pdf [Accessed: December 10, 2022] (in Russian).
12. Castellani C., Duff A.J.A., Bell S.C. et al. ECFS best practice guidelines: the 2018 revision. J. Cyst. Fibros. 2018; 17 (2): 153–178. DOI: 10.1016/j.jcf.2018.02.006.
13. European Cystic Fibrosis Society. Patient Registry. 2021. Available at: https://www.cff.org/medical-professionals/patient-registry [Accessed: December 10, 2022].
14. Michon A.L., Jumas-Bilak E., Chiron R. et al. Advances toward the elucidation of hypertonic saline effects on Pseudomonas aeruginosa from cystic fibrosis patients. PLoS One. 2014; 9 (2): e90164. DOI: 10.1371/journal.pone.0090164.
15. Thorarinsdottir H.R., Kander T., Holmberg A. et al. Biofilm formation on three different endotracheal tubes: a prospective clinical trial. Crit. Care. 2020; 24 (1): 382. DOI: 10.1186/s13054-020-03092-1.
16. Mitra S., Schiller D., Anderson C. et al. Hypertonic saline attenuates the cytokine-induced pro-inflammatory signature in primary human lung epithelia. PLoS One. 2017; 12 (12): e0189536. DOI: 10.1371/journal.pone.0189536.
17. Buonpensiero P., De Gregorio F., Sepe A. et al. Hyaluronic acid improves “pleasantness” and tolerability of nebulized hypertonic saline in a cohort of patients with cystic fibrosis. Adv. Ther. 2010; 27 (11): 870–878. DOI: 10.1007/s12325-010-0076-8.
18. Semivelichenko E.D., Ivkin D.Yu., Okovity S.V. et al. Efficiency of a medical product based on hypertonic sodium chloride (7%) and sodium hyaluronate (0.1%) in experimental pulmonary fibrosis model. Farmateka. 2022; 29 (10): 31–36. DOI: 10.18565/pharmateca.2022.10.31-36 (in Russian)
Supplementary files
Review
For citations:
Kondratyeva E.I., Voronkova A.Yu., Kashirskaya N.Yu., Krasovsky S.A., Starinova M.A., Amelina E.L., Avdeev S.N., Kutsev S.I. Russian registry of patients with cystic fibrosis: lessons and perspectives. PULMONOLOGIYA. 2023;33(2):171-181. (In Russ.) https://doi.org/10.18093/0869-0189-2023-33-2-171-181