EPS9.05 Vantobra®, a new formulation of nebulised tobramycin: early real-world experiences at our large regional UK adult cystic fibrosis centre

Vantobra® (170 mg/1.7 ml), nebulised via a drug-specific eFlow handset and eFlow device, has been shown to have comparable efficacy and safety as TOBI® 300 mg/5 ml via an LC Plus handset and conventional nebuliser device (Sands, et al., 2014Sands D et al.Journal of Cystic Fibrosis. 2014; 13: 653-660Abstract Full Text Full Text PDF PubMed Google Scholar). With a reduced treatment time of 4.4 minutes, 19.9 minutes faster than TOBI® Vantobra® is an appealing option for pwCF. There is currently no real-world data available for tolerance oradherence to Vantobra®. Objectives: To evaluate the real-world patient tolerance, experience and use of Vantobra® in pwCF. Methods: A prospective audit of patient’s experience and clinical outcomes completing a drug response assessment (DRA) of Vantobra® prior to 31/10/22. Results: 18 pwCF (61% (11) Female) completed a DRA of Vantobra®; Median age 30 (IQR 24–39), best ppFEV1 in 12 months 63% (IQR 48–75%), all grew PsA. 83% (15) had tried and discontinued (due to adverse events (AEs) or adherence or both) at least 1 other formulation of inhaled tobramycin (TOBI®Podhaler® (14), Bramitob® (6) or TOBI® (6)). All (18) passed the DRA with median constriction ppFEV1 –1% (IQR –6–2%). 11% (2) reported a mild AE during the DRA (cough) but were assessed as safe to continue use. Taste, rated on a scale of 0–10 (10 = worst), was median 5 (IQR 2–6). At time of review 72% (13) continue on Vantobra® 11% (2) discontinued due to an AE (1 cough, 1 tight chest), 6% (1) discontinued due to treatment burden (compared to no treatment), 6% (1) had delivery issues, 6% (1) died (not related to Vantobra®). Of those 2 (11%) who discontinued due to AEs, both discontinued TOBI®Podhaler® due to similar AEs as with Vantobra® and 1 discontinued Bramitob® due to adherence. In the 5 on CFHH, median adherence increased by 6% (IQR –2–9%) on Vantobra®. Conclusion: Our early real-world experiences with Vantobra® have shown that it is well tolerated and has the potential to improve adherence to treatment in pwCF.