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在妊娠期间使用 elexacaftor/tezacaftor/ivacaftor 三联组合药物。

Use of elexacaftor/tezacaftor/ivacaftor combination in pregnancy.

机构信息

Cystic Fibrosis Regional Reference Center, A.O.U. Policlinico Umberto I, Rome, Italy.

Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Via del Policlinico, 155, 00161, Rome, Italy.

出版信息

Arch Gynecol Obstet. 2024 Jan;309(1):9-15. doi: 10.1007/s00404-023-06962-5. Epub 2023 Mar 13.

Abstract

INTRODUCTION

Management of cystic fibrosis has recently stepped forward with the introduction of cystic fibrosis transmembrane conductance regulator (CFTR) modulators, although data on potential adverse effects are lacking for many categories of patients, such as pregnant women.

METHODS

We report one of the first reports on the outcome of pregnancy in a woman treated with Elexacaftor/Tezacaftor/Ivacaftor during the second and third trimester of pregnancy, showing a significant improvement of respiratory status, compared with the first trimester when the medication was discontinued due to unknown and, therefore, potential teratogenic effects. Also, we performed the review of the existing literature on the topic.

RESULTS

The course of pregnancy was uneventful, with reference to major obstetric complications, and the patient delivered a healthy neonate. These results were similar to those coming from other short series of pregnant women affected by cystic fibrosis and treated with CFTR modulators during pregnancy.

CONCLUSIONS

Thus, despite the lack of evidence on the topic, the use of Elexacaftor/Tezacaftor/Ivacaftor in pregnancy seems to be apparently not associated with major adverse events, thus opening optimistic scenarios in terms of management of these patients.

摘要

简介

随着囊性纤维化跨膜电导调节因子(CFTR)调节剂的引入,囊性纤维化的治疗最近取得了进展,尽管对于许多类别的患者(如孕妇)缺乏潜在不良反应的数据。

方法

我们报告了首例在妊娠第二和第三个三个月接受 Elexacaftor/Tezacaftor/Ivacaftor 治疗的女性的妊娠结局,与因未知且因此具有潜在致畸性而停止用药的第一个三个月相比,该女性的呼吸状况显著改善。此外,我们还对该主题的现有文献进行了综述。

结果

妊娠过程中没有出现重大产科并发症,患者分娩了一个健康的新生儿。这些结果与其他来自患有囊性纤维化且在妊娠期间接受 CFTR 调节剂治疗的孕妇的短系列研究相似。

结论

因此,尽管缺乏这方面的证据,但在妊娠期间使用 Elexacaftor/Tezacaftor/Ivacaftor 似乎与重大不良事件无关,从而为这些患者的治疗提供了乐观的前景。

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