依库珠单抗引起感染性不良反应文献分析  

Literature analysis of infectious adverse reactions induced byeculizumab

作　　者：海莉丽[1] 李涛[1] 邢亚兵[1] 吕萌 HAI Li-li;LI Tao;XING Ya-bing;LYU Meng(Department of Pharmacy,Children's Hospital of Zhengzhou University,Henan Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院药学部,河南郑州450000

出　　处：《中国医院药学杂志》2022年第17期1825-1829,共5页Chinese Journal of Hospital Pharmacy

摘　　要：目的:探讨依库珠单抗(eculizumab,Euz)引起的感染性不良反应(infectious adverse reactions,iADRs)及其特点,为临床用药提供参考。方法:检索数据库(万方、中国知网、PubMed、Embase和Cochrane),收集依库珠单抗导致iADRs的文献报道,按指定纳入排除标准提取信息。运用SPSS 20.0进行统计学分析。结果:共纳入20篇文献,131例病例。病例来源于8种原发病,阵发性睡眠性血红蛋白尿和溶血尿毒综合征报道占比95.2%。总体年龄范围为0.67~73岁,男女比为1∶1.6,16岁以上病例占比82%。疫苗预防接种率为94.4%,并有3例预防性使用抗菌药物,但仍未消除脑膜炎奈瑟菌(Neisseria meningitidis,Nm)感染的风险。其中Nm感染组107例,占比81.7%。淋病奈瑟菌(Neisseria gonorrhoeae,Ng)组10例,占比7.7%。其他奈瑟菌属感染7例,占比5.3%。其他感染病原包括隐球菌、黑曲霉、葡萄球菌、铜绿假单胞菌、梭杆菌、水痘-带状疱疹病毒等,共7例,占比5.3%。Euz发生iADRs的时间为(562±618)d,范围为(14~2190)d,65%的病例超过6个月发生,Nm感染组与非Nm感染组相比,发生时间差异无统计学意义。结局良好病例占比59.5%,结局不良病例占比14.6%,病死率11.5%,Nm感染组和非Nm感染组预后相比差异无统计学意义。结论:依库珠单抗的iADRs特点多为迟发型不良反应,病死率较高,病原学多样,但多数为Nm(B、Y、NG和C型为主)感染,Nm感染组与非Nm感染组结局相似。应尽可能提前开展预防措施,延长监测时间,迅速识别并早期给予经验性治疗,以降低不良结局发生及病死率。OBJECTIVE To investigate the infectious adverse reactions(iADRs)caused by eculizumab(Euz)and its characteristics,so as to provide reference for clinical medication.METHODS Wanfang,CNKI,PubMed,Embase and Cochrane databases were searched to collect literature reports on iADRs caused by Euz,and the information was extracted according to the specified inclusion and exclusion criteria.SPSS 20.0 was used for statistical analysis.RESULTS A total of 20 literatures and 131 cases were included.The cases were mainly used for the treatment of 8 primary diseases,and the reports of paroxysmal nocturnal hemoglobinuria and hemolytic uremic syndrome accounted for 95.4%.The overall age range was 0.67-73 years,and 82%of the cases were over 16 years old.The ratio of male to female is 1∶1.6.The vaccination rate was 94.4%,and 3 cases were prophylaxis with antibiotics,but the risk of Nm infection was not eliminated,among which 107 cases(81.7%)were infected with Neisseria meningitidis(Nm).In the group of Neisseria gonorrhoeae(Ng),10 cases were infected,accounting for 7.7%.7 cases were infected by other Neisseria,accounting for 5.3%.Other infectious agents included Cryptococcus,Aspergillus Niger,Staphylococcus,Pseudomonas aeruginosa,Fusobacterium and Varicella zoster virus,accounting for 5.3%.The onset time of iADRs in Euz was(562±618)d,ranging from(14~2190)d.65% of cases appeared after more than 6 m.There was no significant difference in the onset time between the Nm group and the non-Nm group.Good outcome cases accounted for 59.5%,bad outcome cases accounted for 14.6%,the case fatality rate 11.5%.There was no significant difference in prognosis between the Nm group and the non-Nm group.CONCLUSIONS The iADRs of Euz are mostly characterized by delayed adverse reactions with high mortality and diverse etiology,but most of them are Nm(mainly B,Y,NG and C types)infection,and the outcome of Nm infection group is similar to that of non-Nm infection group.Therefore,preventive measures should be carried out as early as possible,the monitorin

关 键 词：依库珠单抗 感染 不良反应 药物 文献分析 

分 类 号：R969[医药卫生—药理学]