Assessing the impact of elexacaftor/tezacaftor/ivacaftor on anxiety & depression symptom scores in adults with Cystic Fibrosis

•Impact of ETI on GAD-7 and PHQ-9 scores were examined in adults with CF at baseline, 6- and 12-months post-initiation.•In contrast to prior studies, this study had a longer follow-up time and most (75 %) of our cohort was CFTR-modulator naïve.•Median GAD-7 and PHQ-9 scores decreased at 6 months post-ETI, and both remained decreased at 12 months post-ETI.•Using minimally clinically important difference of ±4 points, 20 % of individuals experienced improvements in anxiety and depression scores at 6 and 12 months post-ETI, while 10 % experienced worsening.•Individuals with clinically significant change in GAD-7 and PHQ-9 scores were more likely to have a psychiatric diagnosis and use psychiatric medications pre-ETI. The mental health effects of elexacaftor/tezacaftor/ivacaftor (ETI) on adults with CF are still uncertain with mixed findings from published studies. To systematically investigate the impact of ETI on symptoms of anxiety and depression in adults with CF, Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire (PHQ-9) scores were evaluated at baseline, 6 months, and 12 months post-ETI. Overall, GAD-7 and PHQ-9 scores improved at 6 months post-ETI, with a greater proportion of individuals experiencing a clinically significant improvement (vs. worsening) of their symptoms, which was sustained at 12 months. Factors influencing mental health outcomes included pre-existing psychiatric diagnoses and psychiatric medication use. In conclusion, although there was overall improvement in anxiety and depression symptoms post-ETI, approximately 10 % of individuals experienced clinically significant worsening.