Efficacy of dornase alfa as part of background therapy in children with cystic fibrosis during the COVID-19 pandemic

Abstract

In the article, the authors provided the overview of the results of international clinical studies and recent papers, as well as their own experience with the use of an enzyme mucolytic – dornase alpha in the treatment of cystic fibrosis and other chronic bronchitis affected by mucostasis. The dornase alfa has been shown to have two more non-mucolytic effects, the most important of them is anti-inflammatory one. It is the anti-inflammatory effect that plays an important role in patients with cystic fibrosis, when chronic bacterial inflammation and destruction of lung tissue take place in the pathogenesis of the disease. Dornase alpha counteracts neutrophil elastase, reducing its concentration in sputum. The authors emphasize on the fact that the same inflammatory reactions occur in covid infection and that it is dornase alfa that acts with an anti-inflammatory effect in ordinary patients, as well as in cystic fibrosis. The authors share their own experience and bring three clinical examples that demonstrate not only good tolerability and safety, but also the clinical efficacy of dornase alfa (Tigerase): in a young child when a diagnosis was established, in a teenager with a successful transition to a biosimilar after a long-term administration, and in a teenager with mucoviscidosis, who successfully managed a covid infection during therapy with this drug. The authors emphasize that dornaza alfa is now the main component of the background therapy of patients with mucoviscidosis, and its representative Tigerase may be successfully used in variously-aged children.