TNF-α抑制剂注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白/注射用依那西普致葡萄膜炎2例分析  

Two cases of uveitis caused by TNF-αinhibitor recombinant human tumor necrosis factor-αreceptor II:IgG Fc fusion protein for injection/etanercept for injection

作　　者：孙武 陈水龄 周婉瑜[1] 史航 刘璐 贺严 付文涛 褚利群 SUN Wu;CHEN Shuiling;ZHOU Wanyu;SHI Hang;LIU Lu;HE Yan;FU Wentao;CHU Liqun(Ophthalmic Department,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院眼科,北京100091

出　　处：《中国药物警戒》2024年第4期457-460,共4页Chinese Journal of Pharmacovigilance

基　　金：中国中医科学院科技创新工程针灸临床学科重大攻关项目(C12021A03513);北京市自然科学基金资助项目(7244501);北京市中医药科技发展资金项目(BJZYYB-2023-77)。

摘　　要：目的探讨TNF-α抑制剂与葡萄膜炎发病的关系并分析TNF-α抑制剂诱发性葡萄膜炎的临床特点。方法回顾性分析2021年7月至2023年2月某院收治的2例使用TNF-α抑制剂注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白注射用依那西普后出现葡萄膜炎患者的临床特征并复习相关文献。结果2例患者葡萄膜炎发生时间分别在用药后2周和6周,其中前葡萄膜炎1例,前、中间葡萄膜炎1例,经对症治疗后均有好转。在持续生物制剂治疗过程中2例患者均有反复发作倾向。查阅文献发现目前引起葡萄膜炎的TNF-α抑制剂主要包括英夫利昔单抗、阿达木单抗等,多用于治疗类风湿性关节炎、肿瘤、强直性脊柱炎、眼内葡萄膜炎患者等。患者年龄区间在5~77岁,发病时间为用药后1周~4年。经系统治疗,停止免疫抑制剂后,绝大多数诱发性葡萄膜炎患者视力可恢复。结论TNF-α抑制剂可以诱发葡萄膜炎的发生,发病类型以前葡萄膜炎为主,且有复发倾向。及时诊疗后患者的视力预后较好。Objective To investigate the correlations between TNF-αinhibitor and uveitis and to analyze the clinical features of TNF-αinhibitor-induced uveitis.Methods The clinical data of 2 patients with uveitis treated with the recombinant human tumor necrosis factor-alpha receptor II:IgG Fc fusion protein/ETANERCEPT for injection in our hospital between July 2021 and February 2023 was retrospectively analyzed,and the related literature was reviewed.Results Two female patients were collected.The onset of uveitis occurred at 2 and 6 weeks after medication,respectively,with one case of anterior uveitis and one case of anterior and intermediate uveitis.The conditions of both patients improved after symptomatic treatment.Literature review revealed that TNF-αinhibitors that caused uveitis included infliximab,adalimumab,and ETANERCEPT,which were mostly used for the treatment of rheumatoid arthritis,tumor,ankylosing spondylitis,and uveitis.The patients ranged from 5 to 77 in age,and the duration of onset ranged from 1 week to 4 years after medication.The vast majority of patients with TNF-αinhibitors-induced uveitis could recover their vision after systematic treatment and cessation of immunosuppressive agents.Conclusion The occurrence of uveitis is closely related to the use of TNF-αinhibitors,and the type of uveitis is predominantly anterior uveitis with a high chance of recurrence.Most patients have a favorable visual prognosis after prompt diagnosis and treatment.

关 键 词：TNF-Α抑制剂 注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白/注射用依那西普 葡萄膜炎 副作用 英夫利昔单抗 阿达木单抗 视力 

分 类 号：R988.1[医药卫生—药品]