信迪利单抗相关皮肤不良反应文献分析  

Literature analysis of cutaneous adverse drug reactions induced by sintilimab

作　　者：彭伟东 戢太阳 冉凤英 余飞[2] PENG Wei-dong;JI Tai-yang;RAN Feng-ying;YU fei(Department of Pharmacy,Sinopharm Dongfeng General Hospital,Hubei University of Medicine,Shiyan 442008,China;Medical Experimental Center,Sinopharm Dongfeng General Hospital,Hubei University of Medicine,Shiyan 442008,China)

机构地区：[1]湖北医药学院附属国药东风总医院药学部,湖北十堰442008 [2]湖北医药学院附属国药东风总医院实验中心,湖北十堰442008

出　　处：《现代药物与临床》2022年第11期2616-2620,共5页Drugs & Clinic

基　　金：十堰市科学技术研究与开发项目(18Y84,21Y77,21Y78);湖北医药学院附属国药东风总医院青年人才项目(2021Q10,2022Q27)。

摘　　要：目的分析信迪利单抗引起的皮肤药物不良反应(CADR)的发生特点与治疗转归,为临床合理使用信迪利单抗提供参考。方法检索中国知网(CNKI)、万方、维普(VIP)、PubMed等数据库收载的信迪利单抗致CADR的文献报道并进行数据分析。结果收集信迪利单抗导致CADR的个案报道15篇,涉及患者15例,其中男性9例(60.00%),女性6例(40.00%),年龄分布以50岁以上居多(11例,73.33%),发生时间主要集中在用药84 d以内(14例,93.33%),CADR类型以中毒性表皮坏死松解症和大疱性类天疱疮最常见,分别有6例(40.00%)和2例(13.33%)。13例患者经停药和/或对症处理后均好转,1例患者因Stevens-Johnson综合征死亡,1例患者因中毒性表皮坏死松解症死亡。结论信迪利单抗可诱发CADR,应注意红斑、黏膜损伤、皮疹、水疱等可能为CADR发生的信号,除了全身性糖皮质激素治疗以外,静脉注射用人免疫球蛋白和肿瘤坏死因子-α(TNF-α)抑制剂也可作为CADR的补充治疗。Objective To analyze the occurrence characteristics and treatment outcome of cutaneous adverse drug reactions(CADRs)caused by sintilimab and provide reference for clinical drug use. Methods The literature reports of CADR induced by sintilimab were collected from the databases of CNKI, Wanfang, VIP, and PubMed databases and data analyzed. Results A total of 15 cases were reported in 15 articles, including 9 males(60.00%) and 6 females(40.00%), most of them were over 50 years old(11 cases, 73.33%),the occurrence time was mainly within 84 days(14 cases, 93.33%). Toxic epidermal necrolysis and bullous pemphigoid were the most common types of CADR, with 6 cases(40.00%) and 2 cases(13.33%) respectively. All 13 patients improved after drug withdrawal and/or symptomatic treatment. One patient died of Stevens-Johnson syndrome and one patient died of toxic epidermal necrolysis.Conclusion Sintilimab can induce CADR, it should be noted that erythema, mucosal damage, rash and blister may be the signals of CADR, in addition to systemic glucocorticoid therapy, intravenous administration of human immunoglobulin and tumor necrosis factor(TNF)-α inhibitors can also be used as a complementary treatment for CADR.

关 键 词：信迪利单抗 皮肤药物不良反应 文献分析 中毒性表皮坏死松解症 大疱性类天疱疮 STEVENS-JOHNSON综合征 

分 类 号：R986[医药卫生—药品]