Logistics for sweat test & first newborn CF appointment

Aboveallislove

Super Moderator
Could folks share the logistics for their newborn's first CF appointment? Did it follow the sweat test immediately? Who did you see? Did they give you manual percussion instructions then or at a future one? What meds did they start you on? Immediate blood draw? Did you have monthly appointments the first year?
 
Could folks share the logistics for their newborn's first CF appointment? Did it follow the sweat test immediately? Who did you see? Did they give you manual percussion instructions then or at a future one? What meds did they start you on? Immediate blood draw? Did you have monthly appointments the first year?

We had oue cf apt before the sweat test bc we had 2 mutations show up on the newborn screen. We were so scared before bc all the info at that point we had on cf was from the internet..big mistake!! Once we had the apt and met all the specialists we felt so much better and at ease. We started creon, aquadeks vitamin and salt after 1st apt as well as doing cpt. We have monrhly apts until he is 6 months and then we will space them out...as long as he continues to do well. We are 4 months and no issues yet! Its alot at that first apt but it all becomes so routine so quickly and you just make it part of life. I hope that was helpful!! If you have anymore questions just ask were all in this together:)
 

Aboveallislove

Super Moderator
Thanks so much! Our son is actually 5 1/2 but I'm trying to put together a nice intro for new parents because what you and many others experienced shouldn't be the case! I'm ting to pull man different experiences so I can give some representation of scenarios. Thank you so much for helping and others, please any experiences to share for the summary for parents getting that newborn screen call on what to expect at first appointment.
 

Tnjackson2

New member
Thanks so much! Our son is actually 5 1/2 but I'm trying to put together a nice intro for new parents because what you and many others experienced shouldn't be the case! I'm ting to pull man different experiences so I can give some representation of scenarios. Thank you so much for helping and others, please any experiences to share for the summary for parents getting that newborn screen call on what to expect at first appointment.

This is a great idea to compile this type of info for parents/loved ones to read ab first getting diagnosed. Thanks for posting! The first step in our journey was getting the call from my son's regular pediatrician, which came on a Tuesday, my son was about 2.5 weeks old. The actual doctor didn't make the call, but his nurse did. She said they got results back from blood that was drawn at the hospital after him being born, and that the results indicated a diagnosis of cf. She said they'd already scheduled us an appoint at UAB for Friday morning to have a sweat test to "rule out" cf. Well...I was in panic mode, immediately went to the Web doing research, was horrified at what I learned, and went into cry cry cry mode. So when his peds doctor called, he gave me more info about the actual results from the test. His IVR levels were elevated, which prompted them to do the second prong DNA testing. DNA testing showed he had 2 genetic mutations, which confirms a dx of cf. If he'd had one genetic mutation, he would just have been a carrier.

We had our first cf appointment immediately (well about 3 hours) following my son's sweat test. His levels were intermediate, but the mutations confirmed a cf diagnosis. We'll repeat his sweat test at 6 mos. So the doctor explained cf and our son's specific mutations. He got started on enzymes, salt and vitamins that evening. They also did a throat culture, and they tried to take a stool sample but son (surprisingly had not gone all day). We didn't get an explanation about the cpt until our second cf appointment, which actually is a different cf center because we moved to Georgia. At the second appointment, we met with the same team + addition of respiratory therapist, who was the one to do the throat culture. We actually also don't meet with a doctor at our clinic appointments, it's with a nurse practitioner. Is this atypical ? or not too different from "norm"? Well I know this was a LOT of info :) but if anybody has any questions, please ask!! We're new to this and still learning, but this is a great place for everybody to share different ideas/approaches and what works for some but not others.
 

Aboveallislove

Super Moderator
Thanks mom! Also, are you aware of the current state of drug research re 1717-1G->A? It took me about a year to get up on what's going on so I thought I'd share. That mutation is a "residual mutation" one and Vertex recently announced results from a proof of concept study that shows Kalydeco works on those and it is moving to Phase 3 (which is last before FDA approval is sought) and it specifically included that mutation. AND they have another study of VX661 and Kalydeco which they will be moving forward for mutations which benefit from Kalydeco alone. So there is near-term hope that the drugs will be available soon. In fact, once he's 2, I a CF doctor should be willing to script Kalydeco for him (as they have 2-5 results for gating mutations) and that helps fixes the defect in the mutation, ...not just address the symptoms. Let me know if this doesn't make sense or if you want more info.
 

Tnjackson2

New member
Thanks mom! Also, are you aware of the current state of drug research re 1717-1G->A? It took me about a year to get up on what's going on so I thought I'd share. That mutation is a "residual mutation" one and Vertex recently announced results from a proof of concept study that shows Kalydeco works on those and it is moving to Phase 3 (which is last before FDA approval is sought) and it specifically included that mutation. AND they have another study of VX661 and Kalydeco which they will be moving forward for mutations which benefit from Kalydeco alone. So there is near-term hope that the drugs will be available soon. In fact, once he's 2, I a CF doctor should be willing to script Kalydeco for him (as they have 2-5 results for gating mutations) and that helps fixes the defect in the mutation, ...not just address the symptoms. Let me know if this doesn't make sense or if you want more info.

Thank you, thank you Aboveallislove for that info!! We've had a lot of sickness and yuckiness in the house, and our son's first hospitalization occur, and I haven't had a chance to get on here. I've had your response lingering in my head on the current drug research re: 1717-1G->A, and I've been trying to figure out just which topic string or message it was in. Lord I can't tell if I'm coming or going these days. Anyway I found it thank goodness! I hadn't heard about this news, but again thanks so much for sharing this with me!! It helps to hang on to some hope about the new drugs coming out. I'd love some more information when you get a moment to share it. I'll also do a search of what you were explaining above and see what pops up. Hope things are going well w/ your fam and your little man!
 

Aboveallislove

Super Moderator
Oh mom...I'm so sorry. That first hospitalization is so hard. Hoping Everett is doing much better. I will put together more detail with links for you either tonight or tomorrow.
 

Aboveallislove

Super Moderator
Everett's mom: Here are three links you'll want to read.
https://clinicaltrials.gov/ct2/show/NCT01685801?term=vx770&rank=32
This was the pilot study on residual function mutations and you can see 1717-1G-
>A listed as one included.

http://investors.vrtx.com/releasedetail.cfm?ReleaseID=852372
This is the Vertex press release on that study.

http://investors.vrtx.com/releasedetail.cfm?ReleaseID=890626
This is the Vertex press release detailing plans to study Kalydeco and 661 for those with residual function mutations. Another study showed the Kalydeco + 661 helped those who have 551 (which Kalydeco is already approved for), got even more improvement. So logically, if Kalydeco helps residual function mutations (which the results above say it does), then Kalydeco + 661, would help those with residual function (like Everett), even more!!

Once you've read, let me know if you want me to try to decifer anything.
 

Tnjackson2

New member
Thank you so much!! I'm going to read through these, and see what the news is. I truly appreciate you pulling this up for me and posting. If I have any questions, I'll get in touch with you. My little man is doing better, we were able to go home from the hospital yesterday. Up until now we've just been doing CPT, but now the doctor is starting him on the nebulizer/drugs regime to help clear the infection up. Thank you again.
 

Aboveallislove

Super Moderator
https://clinicaltrials.gov/ct2/show/NCT01705145?term=vx770&rank=15

You'll also see in that first press release this: in Europe, adults with the R117H mutation.
Vertex today announced that its New Drug Application (NDA) for the use of ivacaftor in children ages 2 to 5 who have the G551D or one of the eight additional gating mutations was accepted for filing by the Food and Drug Administration (FDA), and a target review date of March 17, 2015 was set under the Prescription Drug User Fee Act (PDUFA) for the FDA's approval decision.

The above link is the actual study. Now that is a study of Kalydeco for those 2-5 with GATING mutations, not Residual function ones, like Everett's. But once it is approved for 2 - 5 year olds, given the evidence that it does work for residual function mutations, a doctor can prescribe it "off label" meaning for a use other than on the label. AND by the time Everett is 2 years old, the residual function studies will likely have results so even if it hasn't been approved yet for him, Kalydeco would easily be prescribed to keep him healthy until the 661 combo get to the approval for 2 - 5 year olds with residual. function. Hang in there. You must be soooooo exhausted!! big mommy hugs.
 
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