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