Low-Dose Ketone Monoester Administration in Adults with Cystic Fibrosis: A Pilot and Feasibility Study

This pilot study randomized 14 adults with cystic fibrosis receiving modulator therapy to a ketone monoester (n = 9) or placebo control (n = 5) for 5 to 7 days, during hospitalization for acute pulmonary exacerbation or as outpatients. The monoester was well tolerated, with only mild gastrointestinal distress reported. D-beta-hydroxybutyrate rose from 0.2 to 1.6 mM in the monoester group versus 0.2 to 0.3 mM in the placebo group (p = 0.011). Pulmonary function was unchanged, the monoester group self-reported higher subjective respiratory scores (p = 0.031), and plasma inflammatory markers did not differ between groups (p > 0.05).