5. Conclusions
This document is the result of an Italian multicenter work aimed at optimizing the use of dornase alfa in CF clinical practice starting from the analysis of factors that influence the current varied scenario regarding its use in CF centers.
In agreement with international guidelines on CF management, we suggest treating CF patients with mucoative agents at the first evidence of pulmonary involvement in order to prevent or slow the decline in lung function and decrease the number of pulmonary exacerbations.
In the pediatric setting, we stress the importance of making a concerted effort to establish early lung abnormalities by imaging and sensitive pulmonary function tests in children and to start timely treatment with mucoactive agents.
When selecting mucoactive agents it is important to consider the age, the clinical conditions of the patient and the mechanism of action of mucoactive agents. Due to its unique features, dornase alfa should be more taken into consideration, dornase alfa has significant therapeutic benefits regardless of the CF patient’s disease severity and enables long-term stabilization/improvement of lung function. In addition, dornase alfa therapy has important advantages in terms of handling and tolerability, with a potential positive impact on therapeutic adherence. Careful assessment and monitoring of individuals with cystic fibrosis will help choose the most appropriate mucoactive medication or combination of mucoactive medications.
When possible, the care of CF patients should be carried out by a multidisciplinary group of specialists including a physiotherapist of respiratory rehabilitation in order to define the most appropriate therapeutic strategy for the individual patient. The CF care team should also discuss with patient and develop an appropriate treatment plan for him.
DECLARATIONS