Kalydeco: Just in from a trusted member!

Imogene

Administrator
Let me start by saying how helpful I’ve found the cysticfibrosis.com website. It has provided a place where I can read how others cope with experiences and situations similar to those I go through. Hopefully some of my comments have also been of some use to them.

The real purpose of this contact is to inform you about my experiences with Kalydeco. My CF doctor recently prescribed it for me “Off Label”. So far Kalydeco is only FDA approved for 9 Class 3 mutations.)

My doctor has another patient doing very well on Kalydeco with similar mutations to mine. (There were some issues getting him the drug.)

When Kalydeco was recently approved for eight additional mutations, my doctor thought it might get approved for me, maybe even as a result of some confusion with the new additions. We were both quite pleasantly surprised when it was approved in less than 24 hours.

Within less than a day after starting Kalydeco I saw significant changes. I started coughing up much more “crap” than I can ever remember. It also seemed thinner than usual. After several days my cough disappeared. It’s hard to remember the last time this happened. The little I was able to cough up after using hypertonic saline was clear. This has happened only once before, about 20 years ago.

It has been several weeks now and in addition to the lack of cough, I’m feeling much better - even though my FEV1 has not significantly improved.

I would have liked to share my experiences with others on the forum. Readers with similar mutations to mine might also be successful in getting Kalydeco “Off Label”.

Perhaps you could inform those with Class 3 and 4 mutations that currently do not have FDA approval, and let them know they might be able to get Kalydeco now. They should contact their doctors and let them know people are getting Kalydeco “Off Label” and are doing very well. They should consider trying to get it too. It might make a tremendous improvement in some or their lives.

My doctor believes that within a year or two, Kalydeco will get FDA approval for all Class 3 and 4 mutations.
 

rtorres25

Member
Great News! I'm hoping and praying it eventually will be approved for all of us. I have a very rare mutation L206W. I don't know what Class that falls into. Enjoy your newfound health!
 

Angelo

New member
I know what both of my mutations are, but this is the first time I have seen them put into Classes. What are Class 3 and 4 mutations?
 

mpax

New member
I to have never heard of this classification of mutations (like Angelo). Please explain. I am glad to hear the Kalydeco off brand is working for you in such a tremendous way. Please keep us updated with your improvement. Thank you
 

MichaelL

New member
That's great news -- I'm glad you're feeling better. I've had cases where my FEV1 will lag the way I feel, so hopefully yours will come up over time. I look forward to Kalydeco being rolled out to more people. My mutations are Class II and V, so I think I'll be waiting for a while longer.
 

kim's mom

New member
Classification of Mutations

I know what both of my mutations are, but this is the first time I have seen them put into Classes. What are Class 3 and 4 mutations?

The following webcast does a great job explaining the classification of mutations: Roadmap to a Cure: Advancing New CF Treatments – Presentation http://www.cff.org/LivingWithCF/Webcasts/ArchivedWebcasts/Research/
 
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stephen

Guest
Classification of Mutations

In addition to the site mentioned above, the following site describes CF mutation classes in a pictorical format. Selecting the "Class" box on the left brings up a brief description and diagram showing were in the cell each mutation class causes the problem.

http://www.cftr.info/about-cf/role-of-ctfr-in-cf/cftr-mutations/the-six-classes-of-cftr-defects/


Also, a Google search on a "mutation" followed by "mutation class" will usually find sites describing the class of that mutation together with other information on that mutation.
 
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Allansarmy

Guest
Classification of Mutations

In addition to the site mentioned above, the following site describes CF mutation classes in a pictorical format. Selecting the "Class" box on the left brings up a brief description and diagram showing were in the cell each mutation class causes the problem.

http://www.cftr.info/about-cf/role-of-ctfr-in-cf/cftr-mutations/the-six-classes-of-cftr-defects/


Also, a Google search on a "mutation" followed by "mutation class" will usually find sites describing the class of that mutation together with other information on that mutation.

Thank you for that link. However, now I am even more confused. I had never heard of classification until now. That site link shows that my son should be in a class VI looks like with him being Delta F508, or actually they put it as F508del I am assuming same thing.

But this site here: http://www.cff.org/aboutCFFoundatio...ting-Mutations-that-Cause-Cystic-Fibrosis.cfm

Shows my son having "The most common CF mutation, Delta F508, is a Class II mutation"

Can anyone shed some light as to which class my son actually falls under. If I remember right, he is a Double Delta F508 so they wright it like DDF508 does that make since? I am embarrassed to say I am in the health field for 20 years. I did not study mutations much in my field of work. They did not do a DNA Mutation for my son when he was young as they felt that they did not need to, this was almost 18 years ago. Now with the advent of Kalydeco they had him tested about a few years ago to see if he qualified for the drug.

If anyone can help me that would be great.
 
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Allansarmy

Guest
I wasn't aware of the classificaitons, either. I found a very helpful 'table' that laid it out in terms even I could understand :)

Here you go:

http://respiratory-research.com/content/11/1/140/table/T1


Unfortunately, my son's mutations are class 1 and class 2. Sounds like we may be a ways out, too. But - I'm so excited that Kalydeco is providing such great results for those who are using it.

Ahhh thank you for this table. Yes it appears my son is a Class II which directly contradicts http://www.cftr.info/wp-content/uploads/m1_s1_03_03_step7_v02.jpg which shows it as being Class VI the table you showed only goes to Class V. Did they add another class :confused:
 

GenH

New member
Kalydeco has been approved with 9 gating (class 3) mutations. It is thought it will also help many class 4, 5 and 6 mutations (residual function).

I have added info to my blog about the mutation classes and other mutations that may be helped by Kalydeco (including graphs from Vertex):
http://sixtyfiverosesblog.wordpress.com/cf-mutation-classes/
http://sixtyfiverosesblog.wordpress.com/kalydeco-with-other-mutations/

Also, VX809 may help more mutations beyond F508del:
http://sixtyfiverosesblog.wordpress.com/2013/10/18/how-does-vx809-help-f508del-part-2/

rtorres25, L206W is a class 5 mild processing mutation, that appears to improve with Kalydeco alone and VX809 alone (see the links above). In the lab it actually improves more than F508del with VX809, being corrected to 100% of normal.
 

GenH

New member
Ahhh thank you for this table. Yes it appears my son is a Class II which directly contradicts http://www.cftr.info/wp-content/uploads/m1_s1_03_03_step7_v02.jpg which shows it as being Class VI the table you showed only goes to Class V. Did they add another class :confused:

That image is talking about rescued F508del, which means F508del that has made it to the surface with the help of a corrector (such as VX809). The rescued F508del is less stable than normal so that is why it is included in that image. F508del without a corrector is class 2.
 
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stephen

Guest
GenH

There is a lot of great information on the links you posted.

As you mentioned in reference to Kalydeco, "It is thought it will also help many class 4, 5 and 6 mutations ". This is also covered on your links.

People with these mutations should definetely try to get Kalydeco! They may succeed and be very plesantly suprised.
 

GenH

New member
People with these mutations should definetely try to get Kalydeco! They may succeed and be very plesantly suprised.

Yes if you are lucky enough to live in the US, and have a known residual function mutation or clinical signs of residual function (later age of diagnosis, lower sweat test or pancreatic sufficiency), I would definitely suggest trying to access Kalydeco.

Unfortunately it is not the case for those who live in other countries, currently there are many countries right now where Kalydeco is not even available to people with G551D...
 
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Keepercjr

Guest
I tried Kalydeco a few years ago after convincing my doctor and not taking "no" for an answer. I have DF508 and M1101R. Supposedly the M1101R is a class 2 but may belong in class 4. I am pancreatic sufficient. Either way, kalydeco had no effect on me unfortunately. I took it for almost 6 months for good measure and... nothing :( My insurance approved it no problem though!
 

GenH

New member
I tried Kalydeco a few years ago after convincing my doctor and not taking "no" for an answer. I have DF508 and M1101R. Supposedly the M1101R is a class 2 but may belong in class 4. I am pancreatic sufficient. Either way, kalydeco had no effect on me unfortunately. I took it for almost 6 months for good measure and... nothing :( My insurance approved it no problem though!

Interesting post, did your sweat test or FEV1 change at all?
 
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