Objectives: This study aims to study the healthcare (HC) costs associated with cystic fibrosis (CF) in children diagnosed prenatally (ANT), through newborn screening (NBS), after birth due to meconium ileus (MI), or later based on symptoms (LS). Additionally, it seeks to clinically characterize children with CF (chCF) with different trajectories of HC costs. Study design: A retrospective observational study was conducted on data from the French CF Registry (FCFR) and the French National Claims Database (SNDS) linked from 2006 to 2021. HC costs related to CF diagnosis circumstances were estimated per year of life among chCF up to age 10. Group-based trajectory modeling was performed to identify subgroups with similar cost trajectories. Results: Between 2006 and 2011, data from 1,065 chCF were recorded in the FCFR. 973 (91.4%) were matched with SNDS, and 779 (73.1%) had at least 10 years of follow-up. NBS resulted in the lowest costs. During the first year, HC costs of chCF diagnosed with MI and ANT were higher than for those diagnosed with NBS or LS. Expenses declined in the second year of life and then gradually increased to approximately €20,000 by the tenth year. Three groups with different cost trajectories were identified. Groups with the highest costs had a lower lung function at 6 and 10 years and the lowest weight and height z-scores at 2 and 10 years (all p<0.05). Conclusion: HC costs were lower in chCF diagnosed by NBS, and high HC costs could occur at the earliest stages of CF.

Background: It is unclear whether sensitization patterns differentiate children with severe recurrent wheeze (SRW) / severe asthma (SA) from those with non-severe recurrent wheeze (NSRW) / non-severe asthma (NSA). Our objective was to compare the sensitization patterns between children with SRW/SA and NSRW/NSA from the French COBRAPed cohort. Methods: IgE to 112 components (c-sIgE) (ImmunoCAP® ISAC) were analyzed in 125 preschool (3-6 years) and 170 school-age children (7-12 years). Supervised analyses and clustering methods were applied to identify patterns of sensitization among children with positive c-sIgE. Results: We observed c-sIgE sensitization in 51% of preschool and 75% of school-age children. Sensitization to house dust mite (HDM) components was more frequent among NSRW than SRW (53% vs 24%, p<0.01). Sensitization to non-specific lipid transfer protein (nsLTP) components was more frequent among SA than NSA (16% vs 4%, p<0.01) and associated with a FEV1/FVC <-1.64 z-score. Among sensitized children, seven clusters with varying patterns were identified. The two broader clusters identified in each age group were characterized by “few sensitizations, mainly to HDM”. One cluster (n=4) with “multiple sensitizations, mainly to grass pollen, HDM, PR-10, and nsLTP” was associated with SA in school-age children. Conclusions: Although children with wheeze/asthma display frequent occurrences and high levels of sensitization, the sensitization patterns did not clearly discriminate children with severe disease from those with milder disease. These results suggest that the severity of wheeze/asthma may depend on both IgE- and non-IgE-mediated mechanisms.

Introduction: The prognosis of cystic fibrosis (CF) has dramatically changed over the past decade in France, mostly due to global improvements in specific care. Currently, the majority of French CF patients are adults, meaning they went through a transition process from a pediatric CF center to an adult CF center. To determine the impact of that transfer on clinical evolution, we report the transition procedure of our CF center in Lyon. Materials and Methods: From January 2006 to December 2016, 117 CF patients went through a standardized transition process from the pediatric to the adult CF center of Lyon. We compared the clinical evolution of the patients over 3 periods starting the year before transfer and ending the next year after transfer. Clinical data taken into account were FEV1%, BMI, pulmonary colonization, number of antibiotic courses, and number of days of hospitalization per year and outpatient visits per year. Results: No significant differences were observed between respiratory and nutritional status, pulmonary colonization, number of antibiotic courses, and numbers of hospitalizations and visits when comparing the 3 periods of observation (the year before, the year after and the next year after transfer) around transition. Conclusion: The standardized procedure of transition in Lyon is associated with the maintenance of a stable clinical status of our CF patients.