Orkambi* (lumacaftor/ivacaftor) vs Trikafta* (elexacaftor/tezacaftor/ivacaftor; ivacaftor)

Orkambi* (lumacaftor/ivacaftor) vs Trikafta* (elexacaftor/tezacaftor/ivacaftor; ivacaftor)

Orkambi (lumacaftor/ivacaftor) and Trikafta (elexacaftor/tezacaftor/ivacaftor) are both used to treat cystic fibrosis in patients with specific genetic mutations. Orkambi is approved for patients who have two copies of the F508del mutation in the CFTR gene, typically starting from age 2 and above, while Trikafta, which includes an additional active ingredient, elexacaftor, is approved for a broader range of CFTR mutations and can be used in patients 6 years and older. Trikafta has been shown to result in more significant improvements in lung function and other outcomes compared to Orkambi, making it a potentially more effective option for eligible patients.

Difference between Orkambi* and Trikafta*

Metric Orkambi* (lumacaftor/ivacaftor) Trikafta* (elexacaftor/tezacaftor/ivacaftor; ivacaftor)
Generic name Lumacaftor/Ivacaftor Elexacaftor/Tezacaftor/Ivacaftor and Ivacaftor
Indications Cystic fibrosis in patients who are homozygous for the F508del mutation in the CFTR gene Cystic fibrosis in patients aged 6 years and older who have at least one F508del mutation in the CFTR gene or a mutation in the CFTR gene that is responsive to Trikafta treatment
Mechanism of action Lumacaftor improves the conformational stability of F508del-CFTR, allowing it to reach the cell surface, while ivacaftor increases the open probability of the CFTR channel, enhancing chloride transport Elexacaftor and tezacaftor help in correcting the folding and trafficking of the F508del-CFTR protein to the cell surface, while ivacaftor increases the channel's open probability, enhancing chloride transport
Brand names Orkambi Trikafta
Administrative route Oral Oral
Side effects Shortness of breath, chest tightness, nausea, diarrhea, rash, increased liver enzymes, etc. Headache, diarrhea, abdominal pain, rash, increased liver enzymes, common cold symptoms, etc.
Contraindications Patients with severe hepatic impairment, use of certain cytochrome P450 inducers or inhibitors Patients with severe hepatic impairment, use of certain cytochrome P450 inducers or inhibitors
Drug class CFTR modulators CFTR modulators
Manufacturer Vertex Pharmaceuticals Vertex Pharmaceuticals

Efficacy

Orkambi (lumacaftor/ivacaftor) Efficacy in Cystic Fibrosis

Orkambi, a combination medication consisting of lumacaftor and ivacaftor, is designed to treat cystic fibrosis (CF) in patients who have two copies of the F508del mutation in the CFTR gene. The efficacy of Orkambi has been demonstrated through clinical trials where it has shown to improve lung function, as measured by the percent predicted forced expiratory volume in one second (ppFEV1). Patients treated with Orkambi experienced a modest but statistically significant improvement in lung function compared to those receiving placebo. Additionally, Orkambi has been associated with a reduction in pulmonary exacerbations, which are a key concern for individuals with CF as they can lead to a decline in lung function and overall health.

Trikafta (elexacaftor/tezacaftor/ivacaftor; ivacaftor) Efficacy in Cystic Fibrosis

Trikafta, a more recent advancement in CF treatment, combines elexacaftor, tezacaftor, and ivacaftor. This triple combination therapy is approved for individuals with at least one F508del mutation, which encompasses a larger portion of the CF population compared to Orkambi. Trikafta has shown a significant improvement in lung function, with patients experiencing a remarkable increase in ppFEV1 compared to baseline. Clinical trials have demonstrated that Trikafta not only improves lung function but also leads to a reduction in sweat chloride levels, indicating an improvement in the function of the CFTR protein. Furthermore, patients on Trikafta have reported improvements in quality of life and a reduction in the rate of pulmonary exacerbations.

Comparative Efficacy in Cystic Fibrosis Management

When comparing Orkambi and Trikafta, the latter appears to have a more profound impact on lung function and overall health outcomes in CF patients. Trikafta's efficacy is attributed to its ability to address the defective CFTR protein more effectively due to the presence of elexacaftor in the combination. The addition of elexacaftor enhances the processing and trafficking of the CFTR protein to the cell surface, thereby improving its function. This leads to better outcomes in terms of lung function and a more significant decrease in the frequency of pulmonary exacerbations compared to Orkambi.

Conclusion on the Efficacy of CFTR Modulators

In conclusion, both Orkambi and Trikafta have been shown to be effective in the management of cystic fibrosis in individuals with specific genetic mutations. While Orkambi marked a significant step forward in the treatment of CF, Trikafta has set a new standard with its enhanced efficacy. It is important to note that the choice of therapy should be individualized based on the patient's genotype and clinical status, and the decision should be made in consultation with a healthcare provider specialized in cystic fibrosis. As research continues, these treatments may evolve further, offering even greater hope for those affected by this challenging condition.

Regulatory Agency Approvals

Orkambi*
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
  • Therapeutic Goods Administration (TGA), Australia
Trikafta*
  • Food and Drug Administration (FDA), USA

Access Orkambi* or Trikafta* today

If Orkambi* or Trikafta* are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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