安罗替尼致高血压文献病例分析  

Literature case analysis of hypertension induced by anlotinib

作　　者：王春晖[1] 宋承誉 吴薇[1] Wang Chunhui;Song Chengyu;Wu Wei(Department of Pharmacy,Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China;School of Pharmacy,Fudan University,Shanghai 201203,China)

机构地区：[1]复旦大学附属中山医院,上海200032 [2]复旦大学药学院,上海201203

出　　处：《实用药物与临床》2024年第4期285-290,共6页Practical Pharmacy and Clinical Remedies

基　　金：上海市临床重点专科项目(shslczdzk06504);上海市医苑新星青年医学人才培养资助计划(沪卫人事〔2022〕65号);复旦大学附属中山医院管理科学基金(2021ZSGL08)。

摘　　要：目的探讨安罗替尼相关高血压的临床特点。方法检索中国知网、万方、PubMed、Web of Science数据库(截至2023年7月31日),收集安罗替尼相关高血压文献病例报告类文献,提取患者基本情况、安罗替尼用药情况、高血压情况、干预措施和转归等,进行描述性统计分析。结果纳入分析的文献为16篇,患者18例,男性8例,女性10例;年龄27~76岁,平均58岁;非小细胞肺癌13例,结缔组织和软组织恶性肿瘤2例,肝内胆管癌1例,卵巢癌1例,子宫癌1例。联用其他抗肿瘤药物4例;安罗替尼初始剂量均为12 mg/d。发生的高血压分级为1级3例(17%),2级4例(22%),3级9例(50%),4级2例(11%)。除8例患者从服用安罗替尼至发生高血压的时间不详外,其余10例患者从服用安罗替尼至发生高血压的时间在7 d~6个月内,中位时间36(30,42)d,其中7例(39%)发生在服用安罗替尼2个月内。18例患者中出现不同程度乏力6例(33%),头痛6例(33%),头晕5例(28%),呕吐3例(17%),视物模糊2例(11%),恶心1例(6%),抽搐1例(6%)。13例伴其他不良反应,其中手足综合征7例(39%),蛋白尿3例(17%),高脂血症3例(17%),可逆性后部白质脑病综合征2例(11%),癫痫1例(6%),便血1例(6%),皮疹1例(6%)。1~2级患者安罗替尼未调整(6例)或减量治疗(1例)后耐受良好;3~4级患者中,8例停用安罗替尼且接受降压药治疗,2例减量治疗,1例未调整,随访血压控制平稳。结论安罗替尼相关高血压多发生在用药2个月内,往往伴其他不良反应,3级以上高血压常见,但大多数患者经对症处理、停药或减量后转归良好。Objective To explore the clinical characteristics of hypertension related to anlotinib.Methods The relevant databases including CNKI,Wanfang,PubMed and Web of Science were searched(up to 31 July,2023)and case reports on hypertension induced by anlotinib were collected.Patients'information including basic characteristics,drug use of anlotinib,situation of hypertension,interventions and outcomes were collected and analyzed by descriptive statistical method.Results A total of 18 patients with anlotinib-related hypertension reported in 16 literatures were enrolled in this study,including 8 males and 10 females,aged from 27 to 76 years with an average of 58 years.Anlotinib was applied for non-small cell lung cancer in 13 patients,connective tissue and soft tissue malignancy in 2 patients,intrahepatic cholangiocarcinoma in 1 patient,ovarian cancer in 1 patient,and uterine cancer in 1 patient.It was used in combination with other antitumor drugs in 4 patients.The initial dose of anlotinib was 12 mg/d.The hypertension was classified as grade 1 in 3 patients(17%),grade 2 in 4 patients(22%),grade 3 in 9 patients(50%),and grade 4 in 2 patients(11%).Except that the time from application of anlotinib to hypertension occurrence was not known in 8 patients,and the time from taking anlotinib to developing hypertension was within 7 days to 6 months,with the median time from medication to hypertension occurrence being 36(30~42)days in other 10 patients,and 7(39%)of them developed hypertension within 2 months of administration.Among the 18 patients,there were 6 patients(33%)with varying degrees of fatigue,6 patients(33%)with headache,5 patients(28%)with dizziness,3 patients(17%)with vomiting,2 patients(11%)with blurred vision,1 patient(6%)with nausea,and 1 patient(6%)with convulsion.Other adverse events occurred in 13 patients,including hand-foot syndrome(HFS)in 7 patients(39%),proteinuria in 3 patients(17%),hyperlipidemia in 3 patients(17%),reversible posterior leukoencephalopathy syndrome in 2 patients(11%),epilepsy in 1 patient(

关 键 词：抗肿瘤药 安罗替尼 血管生成抑制剂 高血压 不良反应 

分 类 号：R969[医药卫生—药理学]