Jéssica Matarín has a prominent pregnant belly. On April 30, he will be out of account. She is absolutely delighted with Bruno’s arrival in the world. Until recently, it would have been a high-risk pregnancy, with a high possibility of complications, both for the mother and the child, because the 31-year-old woman has cystic fibrosis. His case, treated by a multidisciplinary team at the cystic fibrosis unit of the Parc Taulí hospital in Sabadell, is one of the first to prove that the new and revolutionary medication against the pathology has not only led to an extraordinary improvement in the quality and life expectancy of patients (4,000 in Spain), but it also does not interfere with pregnancies and seems to have fixed the fertility problems of those affected.
You had to be very eager and take many risks to face a pregnancy with cystic fibrosis. And Matarín had it. “I want to be a mother. I don’t know, it’s an innate thing. I’ve liked children since I was little, I have a very large family and we’ve always been very close,” she argues. She wanted it so much that, despite the fact that in 2016 she managed to enter a trial of the new drugs, which proved effective and her life experienced a significant improvement within a year, she decided that she wanted to be a mother even if she had to stop the medication and get worse. “She again had many respiratory problems, many infections and, despite all efforts, she could not get pregnant”, recalls Òscar Asensio, head of the cystic fibrosis unit at Parc Taulí and president of the Spanish Cystic Fibrosis Society.
Jéssica underwent three in vitro fertilization treatments. Nothing. “I tried everything artificially and we decided to leave it at that and go back to the clinical trial of Kaftrio [that’s the name of the effective drug]. Then it was when they told me that there were good pregnancy prognoses [for the cases registered in the US], and after a year or so I got pregnant naturally.”
It is one of the first pregnancies in Spain of a patient while taking medication against cystic fibrosis and without interrupting the treatment. “Jéssica gave us the news very excited, very grateful. The pregnancy went well, she has been stable the whole time and apparently the fetus is perfect”, explains Asensio. The doctor, in agreement with Jéssica’s current pulmonologist, Xavier Pomares, decided that the woman could take Kaftrio during pregnancy in view of the results of the drug in the US, where it began to be marketed in 2019, almost three years before that in Spain. The first pregnancy of a woman with fibrosis was documented there in 1960, in 1990 there were 11, and in 2019, 309. The jump [more fertility] came with the entry of Kaftrio: 618 pregnancies in 2020. “Within a year it started to be seen that women became pregnant much more easily than without the treatment”, points out Asensio. “With the drug already on the market, unlike the trial phase, if the person accepts the risk, they can continue taking it during pregnancy, and there are records of no significant repercussions for women and fetuses.”
“Until now, pregnancy caused a faster worsening of the disease and it used to be discouraged. Only in cases of very mild damage was it carried forward. Pregnancy was a very high-risk situation”, says the pulmonologist. The pathology, which is chronic, hereditary and degenerative, mainly affects the lungs and digestive system, and produces infections and inflammations that destroy areas of the lung, liver, pancreas and reproductive system. The life of patients like Jéssica involved more than three hours of treatments every day. Since December 2021 [approval of Kaftrio in Spain], patients’ lives “have changed overnight”, says Asensio.
