Jéssica Matarín sports a prominent pregnant belly. On April 30, she will be due. She is absolutely excited about Bruno's arrival in the world. Until recently, this would have been a high-risk pregnancy, with a high possibility of complications for both mother and child, because the 31-year-old woman has cystic fibrosis.
His case, treated by a multidisciplinary team in the Cystic Fibrosis unit of the Parc Taulí hospital (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 quality and hope of life of the patients (4,000 in Spain), but it does not interfere with pregnancies and seems to have fixed the fertility problems of those affected.
You had to be very willing and take many risks to face a pregnancy with cystic fibrosis. And Matarín had them. “I want to be a mother. I don't know, it's something innate. Since I was little I have liked children, I have a fairly large family and we have always been very close, ”she argues. Her desire was such that, although in 2016 she managed to enter a trial of the new drugs, which showed effectiveness and her life experienced a significant improvement in a year, she decided that she wanted to be a mother even if she had to stop taking the medication and get worse.
"She again had many respiratory problems, many infections, and despite all her efforts, she could not get pregnant," recalls Òscar Asensio, head of the Parc Taulí (reference) unit and president of the Spanish Cystic Fibrosis Society.
Jessica underwent three IVF treatments. Nothing. “I tried everything artificially and we decided to leave it be and return to the Kaftrio clinical trial (this is the name of the effective drug). That was when they told me that there were good pregnancy prognoses (due to the cases registered in the US), and a year or so later I became pregnant naturally”.
It is one of the first pregnancies in Spain of a patient while taking medication for cystic fibrosis and without interrupting treatment. "Jessica gave us the news very excited, very grateful. The pregnancy has gone well, she has been stable at all times 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 than in Spain. There, the first pregnancy of a woman with fibrosis was documented in 1960, in 1990 11 were registered and in 2019, 309.
The leap (greater fertility) occurred with the arrival of Kaftrio on the scene: 618 pregnancies in 2020. "In a year it began to be seen that women became pregnant much more easily than without treatment," Asensio points out. "With the drug already on the market, unlike in the trial phase, if the person accepts the risk, they can continue taking it during pregnancy, and records of no significant repercussions on women or fetuses appear."
The paradigm shift is extraordinary. “Until now, pregnancy caused a more rapid worsening of the disease, and in cases of higher involvement it was not recommended. Only in cases of very slight affectation was it carried out. Pregnancy was a very high risk situation ”, indicates the pulmonologist.
The pathology, which is chronic, hereditary and degenerative, mainly affects the lungs and the digestive system, and causes infections and inflammations that destroy areas of the lung, liver, pancreas and the reproductive system. The life of patients like Jéssica implied more than three hours a day of treatments: nebulizers, daily physiotherapy sessions, spirometry to check the function of the lungs, long hospital stays... Since December 1, 2021 (approval of Kaftrio) in Spain, the prognosis has completely changed.
There is no cure, but the life of the patients "has changed overnight," says Asensio: "'It's as if I had come back to life,' they tell you with these words."
