Dornase alfa

• dornase alfa is a genetically engineered version of human DNAase
• the sputum of patients with cystic fibrosis (CF) contains large amounts of DNA - the viscoelastic property of sputum in CF patients is due to the inherent viscosity of DNA, and the mucus glycoproteins
• nebulised dornase alfa is a well tolerated and safe treatment option in CF - dornase alfa reduces the viscosity of CF sputum by decreasing DNA strand size
• there is evidence of medium-term improvement in lung function

NICE state that (1):

• a mucoactive agent should be offered to people with cystic fibrosis who have clinical evidence of lung disease
  
  
• rhDNase (dornase alfa; recombinant human deoxyribonuclease) should be offered as the first choice of mucoactive agent
  
  
• if clinical evaluation or lung function testing indicates an inadequate response to rhDNase, consider both rhDNase and hypertonic sodium chloride or hypertonic sodium chloride alone
  
  
• consider mannitol dry powder for inhalation for children and young people who cannot use rhDNase and hypertonic sodium chloride because of ineligibility, intolerance or inadequate response.

Reference:

• NICE (October 2017) Cystic Fibrosis.