Close monitoring and early intervention: management principles for cystic fibrosis in Denmark
Tavs Qvist, Bibi Uhre Nielsen, Hanne Vebert Olesen, Inger Hee Mabuza Mathiesen, Daniel Faurholt‐Jepsen, Terese L. Katzenstein, Jannik Helweg‐Larsen, Frederikke F. Rönsholt, Majbritt Jeppesen, Mette Frahm Olsen, Frederik Buchvald, Kim G. Nielsen, Søren Jensen‐Fangel, T. Pressler, Marianne Skov
Abstract
Cystic fibrosis (CF) care in Denmark has been characterized by close monitoring and pre-emptive treatment of lung disease and other CF-related complications. Continuous evaluation through data collection and commitment to clinical research has incrementally improved outcomes. This approach has been in line with best practices set forth by European Standards of Care but has also gone beyond Society standards particularly pertaining to early treatment with high-dose combination antimicrobial therapy. Despite a high prevalence of severe CF variants, lung function has been among the best in Europe. In this review, the Danish approach to management of CF prior to the introduction of new CF modulator treatment is explained and benchmarked. Downsides to the Danish approach are discussed and include increased burden of treatment, risk of antimicrobial resistance, side-effects and costs.