P199 Non-invasive monitoring of cystic fibrosis lung disease in a new era: the TERRIFIC-MILE study

Cystic Fibrosis (CF) lung disease is characterized by respiratory infections and chronic inflammation. Monitoring of these parameters and timely interventions are important to prevent structural lung damage. Elexacaftor/tezacaftor/ivacaftor (ETI) markedly improves lung function and decreases pulmonary exacerbations. However, inflammation does not seem to resolve totally. Also, detecting infections has become more difficult, due to lack of sputum production. There is a need for new tools to monitor CF lung disease in the era of ETI. We set up the TERRIFIC-MILE study to investigate novel non-invasive monitoring tools to assess infection and inflammation in CF treated with ETI, or without ETI Subjects: CF, aged >12 years, with ETI or without ETI. Exhaled breath is collected to measure volatile organic compounds (VOCs) with gas chromatography-mass spectrometry (GC-MS) and electronic nose (eNose). Subsequently induced sputum (IS), blood and urine were collected. Samples were taken during at least 3 consecutive hospital visits. Lung function data, CFQ-Rand symptoms (CFRSD/CRISS) were recorded. Principal components in VOCs will be identified to detect bacteria. 74 patients were enrolled (57 with ETI, 17 without ETI) 42 baseline eNose samples before start of ETI were collected. In 174 visits GC-MS, eNose samples were collected in 98%, but sputum in only 52%. If no sputum was available cough swaps were taken for microbiology. The number of successful IS procedures declined during the study period due to no sputum production when treated with ETI. Collection of samples is still ongoing. Results of infection and inflammatory markers and correlation with VOC’s will be analyzed in the coming months. The TERRIFIC-MILE study will correlate different non-invasive tools to monitor infection and inflammation in CF, with a main focus on VOCs in exhaled breath. Results will be presented at the conference. Funded by TAAI Foundation.