[Mental health after treatment with elexacaftor/tezacaftor/ivacaftor in end-stage cystic fibrosis].

Abstract

Background: Studies showed significant physical improvement after starting elexacaftor/tezacaftor/ivacaftor (ETI). However, some patients reported new mental health symptoms.

Aim: This study explores the impact of ETI on end-stage cystic fibrosis patients, focusing on mental health.

Method: A mixed-method study was conducted at the cystic fibrosis reference center, University Hospital Leuven (Belgium). Patients were eligible for ETI in a compassionate use program. Data collection included clinical records providing demographic, medical, and psychological data, and semi-structured interviews for qualitative insights.

Results: Post ETI-initiation, all 27 patients demonstrated physical improvement, of which 18 reported positive or no mental health changes and 9 negative changes. Clinical records revealed specific mental health issues, including increased depressive symptoms (n=7), anxiety (n=5), suicidal tendencies (n=4), emotion-regulation difficulties (n=4), and manic episodes (n=2). Semi-structured interviews with 15 patients identified three main themes and four subthemes: revitalizing health, emotional adaption (embracing hope, confronting shadows), and personal development (second lease of life, dealing with the unknown).

Conclusion: Despite remarkable improvements from ETI, 9/27 patients experienced new mental health symptoms, ranging from mild anxiety to suicide attempts. Our study underscores the importance of proactive psychological support and integrated psychiatric care during ETI-initiation.