Abstract
This retrospective population-based study investigated the impact of elexacaftor/tezacaftor/ivacaftor (ETI) therapy on inhaled medication adherence in people with cystic fibrosis (pwCF). Prescription refill rate (PRR) for several inhaled medications were compared before and after ETI introduction in three major Italian CF centers. We found a significant decrease in PRR for most inhaled antibiotics and dornase-alpha after ETI implementation.This suggests that patients may be reducing their adherence to inhaled medications, potentially due to improved respiratory symptoms and quality of life. The study highlights the challenges of maintaining adherence to chronic inhaled medications in pwCF, even after the introduction of breakthrough therapies like ETI. Monitoring adherence remains crucial for optimizing patient outcomes, and the PRR emerges as a valuable tool for tracking adherence in real-world settings.