阿瑞匹坦治疗免疫检查点抑制剂相关性皮疹的疗效观察  

Efficacy of Aprepitan in Treating Rash Associated with Immune Checkpoint Inhibitors

作　　者：刘朝敏[1] 张志[2] 刘薇[1] 罗兴 Liu Chaomin;Zhang Zhi;Liu Wei;Luo Xing(Department of Oncology,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China;Radiology Department,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院肿瘤科,成都610500 [2]成都医学院第一附属医院放射科,成都610500

出　　处：《成都医学院学报》2023年第1期54-57,63,共5页Journal of Chengdu Medical College

基　　金：四川省卫生健康委员会科研课题(普及应用项目)(No:20PJ155);四川省临床重点专科(肿瘤科)建设项目。

摘　　要：目的 探讨阿瑞匹坦治疗免疫检查点抑制剂(ICI)相关性皮疹的临床疗效。方法 选取成都医学院第一附属医院2021年2月至2022年5月收治的84例ICI相关性皮疹患者为研究对象,采用随机数字表法分为试验组和对照组,每组42例。对照组采用夫西地酸乳膏局部外用治疗,疗程1周;试验组在对照组基础上联合口服阿瑞匹坦治疗,疗程3d。比较两组治疗总有效率,治疗前后的瘙痒症状(采用瘙痒评分评估)与生活质量[采用皮肤病生活质量指标(DLQI)问卷评估],血清白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)等炎症因子水平及不良反应发生率。结果 试验组总有效率95.24%明显高于对照组的80.95%,差异有统计学意义(P<0.05)。治疗后,两组瘙痒评分与DLQI评分均较治疗前降低,且试验组低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组血清IL-6、IL-1β、TNF-α均较治疗前降低,且试验组低于对照组,差异均有统计学意义(P<0.05)。试验组和对照组不良反应总发生率分别为26.19%和16.67%,差异无统计学意义(P> 0.05)。结论 阿瑞匹坦联合夫西地酸乳膏治疗ICI相关性1~2级皮疹可通过抑制炎症反应提升治疗效果。Objective To investigate the clinical efficacy of aprepitant for immune checkpoint inhibitor(ICI)-associated rash. Methods A total of 84 patients with ICI-associated rash admitted to the First Affiliated Hospital of Chengdu Medical College from February 2021 to May 2022 were selected and divided into experimental group(n=42) and control group(n=42) by random number table method. The control group was treated with local external application of fusidic acid cream for 1 week,while the experimental group was additionally given oral administration of aprepitant on the basis of the treatment in the control group for 3 d. The total effective rate and incidence of adverse reactions were compared between the two groups. Pruritus symptoms(assessed by pruritus score),quality of life [assessed by Dermatology Life Quality Index(DLQI) Questionnaire],and levels of serum interleukin-6(IL-6),interleukin-1β(IL-1β) and tumor necrosis factor α(TNF-α) in both groups before and after treatment were compared. Result The total effective rate in the experimental group was 95.24%,which was significantly higher than 80.95% in the control group,and the difference was statistically significant(P< 0.05). After treatment,the pruritus score and DLQI score in both groups were lower than those before treatment,and those in the experimental group were lower than those in the control group,and the differences were statistically significant(P< 0.05). After treatment,levels of serum IL-6,IL-1β and TNF-α in both groups were all lower than those before treatment,and those in the experimental group were lower than those in the control group,and the differences were statistically significant(P< 0.05). The total incidence of adverse reactions in the experimental group and the control group were 26.19% and 16.67%,respectively,and the difference was not statistically significant(P> 0.05). Conclusion Aprepitan combined with fusidic acid cream in the treatment of ICI-associated grade 1-2 rash can improve the therapeutic effect by inhibiting inflammatory

关 键 词：阿瑞匹坦 免疫检查点抑制剂 相关性皮疹 炎症 不良反应 

分 类 号：R730.51[医药卫生—肿瘤]