地舒单抗致低钙血症41例病例报告分析  

Analysis of 41 cases of hypocalcemia induced by denosumab

作　　者：赵俊[1] 全香花[1] 张传洲[1] 仓怀芹[1] 李祥鹏[1] 杨雪[1] 韩冰[1] 张小蕾[1] 李静[1] ZHAO Jun;QUAN Xiang-hua;ZHANG Chuan-zhou;CANG Huai-qin;LI Xiang-peng;YANG Xue;HAN Bing;ZHANG Xiao-lei;LI Jing(Department of Pharmacy,Affiliated Hospital,Qingdao University,Shandong Qingdao 266003,China)

机构地区：[1]青岛大学附属医院药学部,山东青岛266003

出　　处：《中国医院药学杂志》2021年第21期2222-2226,2235,共6页Chinese Journal of Hospital Pharmacy

基　　金：青岛市中医药科技项目(编号:2021-zyyq23);青岛大学附属医院青年科研基金项目(编号:QDFY201919)。

摘　　要：目的:分析地舒单抗致低钙血症的发生规律和临床特点,为临床安全用药提供参考。方法:检索2010年1月至2020年12月PubMed、Web of Science、Springer Link、中国知网(CNKI)、万方数据知识服务平台及维普数据库中地舒单抗致低钙血症的文献报道,对纳入文献的有效信息进行提取分析。结果:地舒单抗致低钙血症的文献报道共36篇,涉及41例患者,报道年份为2012-2020年,其中男16例(39%)、女25例(61%),年龄38~91岁,60岁以上患者29例(70.7%)。发生低钙血症最短为用药后4 d,最长为用药后4个月,部分患者为非首次用药发生。用药1个月内发生低钙血症患者34例(82.93%)。41例患者中,有3例恶性肿瘤患者因疾病进展且出现反复低钙血症预后欠佳而最终死亡,余均好转或痊愈。结论:临床使用地舒单抗应严格按照说明书合理用药,重点关注高风险人群,加强肾功能、电解质、心电图等的监护、加强患者教育,警惕低钙血症发生。OBJECTIVE To explore the occurring regularity and clinical characteristics of denosumab induced hypocalcemia and provide references for clinical safe drug use.METHODS From January 2010 to December 2020,literature reports on desosumab-induced hypocalcemia were retrieved from the databases of PubMed,Web of Science,SpringerLink,China National Knowledge Network(CNKI),WanFang and VIP.And the effective information of the included literatures was extracted.RESULTS A total of 36 articles involving 41 patients reported on denosumab-induced hypocalcemia from 2012 to 2020.There were 16 males(39%)and 25 females(61%)with an age range of 38-91 years.And 29 patients(70.7%)were aged over 60 years.Among 41 patients,the shortest time of hypocalcemia was 4 days and the longest 4 months.Some patients did not take denosumab for the first time.Hypocalcemia occurred in 26 patients(63.4%)within 1 month after dosing.Hypocalcemia occurred in 34 patients(82.93%)within 1 month after dosing.Three deaths occurred due to disease progression of malignancy and recurrent hypocalcemia.The remainders improved or recovered.CONCLUSION Clinical use of desumumab should be strictly prescribed in accordance with the instructions for rational drug use.Clinicians should focus upon high-risk groups,strengthen the monitoring of renal function,electrolytes,electrocardiogram,enhance patient education and stay on a high alert for an occurrence of hypocalcemia.

关 键 词：地舒单抗 RANKL抑制剂 低钙血症 

分 类 号：R969.3[医药卫生—药理学]