纳武利尤单抗在真实世界中相关甲状腺不良事件的因素分析  

Analysis of Factors Associated with Adverse Thyroid Events in the Real World of Nivolumab

作　　者：王琳[1] 吴伟 刘笑雪 杨晨[3] 杨华兴 陈璿瑛[1] WANG Lin;WU Wei;LIU Xiaoxue;YANG Chen;YANG Huaxing;CHEN Xuanying(The First Affiliated Hospital of Nanchang University,Nanchang Jiangxi 330006,China;Lianxi District People's Hospital of Jiujiang,Jiujiang Jiangxi 332005,China;Nanchang University,Nanchang Jiangxi 330006,China)

机构地区：[1]南昌大学第一附属医院,江西南昌330006 [2]九江市濂溪区人民医院,江西九江332005 [3]南昌大学,江西南昌330006

出　　处：《药品评价》2024年第4期435-439,共5页Drug Evaluation

基　　金：江西省中医药管理局科技计划(2021A335);江西省卫生厅课题(SKJP220212447);江西省教育厅重点课题(170022)。

摘　　要：目的分析真实世界中患者使用纳武利尤单抗治疗后甲状腺功能障碍的发生情况及危险因素。方法回顾性收集南昌大学第一附属医院从2019年10月至2023年3月使用纳武利尤单抗患者的临床信息。结果甲状腺功能障碍的发生率为23.8%,甲状腺功能减退型最高。甲状腺功能减退的发生时间为12周,甲状腺功能亢进发生时间为6周。体质量指数(BMI)小于18.5 kg/m2的患者甲状腺功能障碍发生率更高(P=0.029)。结论BMI小于18.5 kg/m2的患者使用纳武利尤单抗更容易发生甲状腺功能障碍。当患者使用纳武利尤单抗发生体重快速变化时,需要注意患者甲状腺功能变化。Objective This study aims to investigate the prevalence and associated risk factors of thyroid dysfunction among patients receiving nivolumab treatment in real world settings.Methods Retrospective collection of clinical data from patients administered nivolumab at the First Affiliated Hospital of Nanchang University between October 2019 and March 2023 was conducted.Results The incidence of thyroid dysfunction stood at 23.8%,with hypothyroidism emerging as the most prevalent manifestation.Hypothyroidism typically manifested at 12 weeks,whereas hyperthyroidism surfaced at 6 weeks posttreatment initiation.Patients with a BMI below 18.5 kg/m2 had a higher incidence of thyroid dysfunction(P=0.029).Conclusion Individuals with a BMI below 18.5 kg/m2 are more susceptible to developing thyroid dysfunction while undergoing nivolumab therapy.Vigilance regarding alterations in thyroid function is crucial when patients undergoing nivolumab treatment experience rapid weight fluctuations.

关 键 词：免疫检查点抑制剂 纳武利尤单抗 甲状腺功能障碍 体质量指数 

分 类 号：R969[医药卫生—药理学]