TY - JOUR T1 - Targeting Antibiotics to Pseudomonas aeruginosa in Small airways (TAPAS) in patients with Cystic Fibrosis JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2021.PA3372 VL - 58 IS - suppl 65 SP - PA3372 AU - Beatrice Guidetti AU - Aukje C. Bos AU - Els Van Der Wiel AU - Ilaria Meneghelli AU - Menno Van Der Eerden AU - Harm A. W. M. Tiddens AU - Sonia Volpi AU - Hettie M. Janssens Y1 - 2021/09/05 UR - http://erj.ersjournals.com/content/58/suppl_65/PA3372.abstract N2 - Introduction: Chronic colonization with Pseudomonas aeruginosa worsens prognosis in Cystic Fibrosis (CF), and is shown to be effectively treated with inhaled tobramycin solution (TIS). Small airways obstruction is a major component in the pathogenesis of CF lung disease. However, small airways are difficult to reach with standard inhaled therapy. Advanced nebulizer technology may be of advantage to treat small airways.Methods: Study design; Open label, multi-center, randomized controlled cross-over study. Inclusion criteria; CF patients aged > 12 yrs with chronic Pseudomonas aeruginosa, using TIS. Study arms: 1. Intervention; Once daily double recommended dose TIS with AKITA®-jet nebulizer (Vectura, Chippenham, UK); 2. Control; Standard treatment of TIS twice daily with own nebulizer. Patients were randomized to start with either study arm 1 or 2 for one month, and after one month of wash out switched to the other arm.Results: Primary endpoint was change in forced expiratory flow at 75% of forced vital capacity (ΔFEF75%) and was compared using paired sample t-test. Secondary outcomes were change in FEF25-75%, FEV1%, and FVC%. 17 of the 21 included patients completed the trial. Mean±SD ΔFEF75% was -1.96±8.0 SD % for the AKITA and 1.07±9.9 SD % for standard treatment (p= 0.646). Secondary outcomes also did not differ between both treatments.Discussion: There was no statistically significant difference in change of small airways obstruction (ΔFEF75%) using double recommended dose of inhaled tobramycin once daily with the smart AKITA nebulizer compared to standard of treatment.Funding: unrestricted research grant by Chiesi, nebulizers provided by Vectura.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3372.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -