The Impact of Highly Effective Cystic Fibrosis Transmembrane Conductance Regulator Modulators on the Health of Female Subjects With Cystic Fibrosis

• Published in: Clinical therapeutics Vol. 45; no. 3; pp. 278 - 289
• Main Authors: Taylor-Cousar, Jennifer L., Shteinberg, Michal, Cohen-Cymberknoh, Malena, Jain, Raksha
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2023; Elsevier Limited
• Subjects: Aminophenols - pharmacology; Aminophenols - therapeutic use; Antibiotics; Birth control; Birth weight; Breastfeeding & lactation; Cancer screening; Cell surface; CFTR modulators; Conductance; Congenital diseases; Cystic fibrosis; Cystic Fibrosis - drug therapy; Cystic Fibrosis - genetics; Cystic fibrosis transmembrane conductance regulator; Cystic Fibrosis Transmembrane Conductance Regulator - genetics; Cystic Fibrosis Transmembrane Conductance Regulator - metabolism; Cystic Fibrosis Transmembrane Conductance Regulator - therapeutic use; Cytochrome; Drug dosages; Estrogens; Female; Fertility; Genetic disorders; Humans; Infertility; Internal Medicine; Malabsorption; Medical screening; Mutation; Obstetrics; Ovaries; Ovulation; Pharmacokinetics; Pregnancy; Pregnancy complications; Premature birth; Proteins; Quality of life; Quinolones - therapeutic use; Reproductive health; Reproductive technologies; Respiratory diseases; United States > US; cancer screening; CFTR modulators; cystic fibrosis; fertility; pregnancy
• ISSN: 0149-2918; 1879-114X; 1879-114X
• DOI: 10.1016/j.clinthera.2023.01.016

Cystic fibrosis (CF) is a genetic disorder that occurs in people of all genetic ancestries. CF is caused by variants in the CF transmembrane conductance regulator (CFTR) gene that result in decreased, absent, or nonfunctional CFTR protein at the cell surface of the mucous membranes. Clinical manifestations include chronic respiratory disease, malabsorption, and decreased fertility. Historically, therapies for CF were focused on the signs and symptoms of the disease. However, more recently, CFTR modulators, therapies directed at the basic defect, are improving the quality and duration of the lives of people with CF. The predicted survival of people with CF in the United States is now 53 years of age. With the hope of longer, healthier lives, female individuals with CF (fwCF) are expressing the desire to discuss fertility, pregnancy, and parenthood. Furthermore, pregnancy rates are increasing substantially. Understanding the impact of use or discontinuation of highly effective modulator therapy on the reproductive health of fwCF is critical. Finally, fwCF and their providers must consider preventative cancer screening.