Sex Disparities May Persist in CF Despite Modulators
Review findings suggested female patients with cystic fibrosis may continue to experience worse pulmonary outcomes despite highly effective modulator therapy
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By
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Andrea Surnit
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May 22, 2026
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Clinical Scorecard: Sex Disparities May Persist in CF Despite Modulators
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Sex disparities in pulmonary morbidity and mortality, influenced by hormonal factors and genetic expression. |
| Target Population | |
| Care Setting | |
Key Highlights
- Female patients experience worse pulmonary morbidity and earlier mortality despite modulator therapy.
- Estrogen may contribute to airway dehydration and impaired mucociliary clearance.
- Pregnancy and menopause are significant hormonal states affecting cystic fibrosis outcomes.
- CFRD prevalence is higher in female patients compared to male patients.
- HEMT has improved outcomes but sex disparities in treatment response persist.
Guideline-Based Recommendations
Diagnosis
- Monitor pulmonary function and exacerbation rates in female patients.
Management
- Consider hormonal influences when managing cystic fibrosis in female patients.
Monitoring & Follow-up
- Evaluate the impact of hormonal fluctuations on pulmonary outcomes.
Risks
- Female patients may have higher rates of pulmonary exacerbations and CFRD.
Patient & Prescribing Data
Elexacaftor/tezacaftor/ivacaftor improves lung function but shows greater benefits in male patients.
Clinical Best Practices
- Assess the role of estrogen in airway biology and immune signaling.
- Evaluate the effects of pregnancy and menopause on cystic fibrosis management.
- Monitor for persistent airway pathogens and inflammation post-treatment.
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