贝伐珠单抗致骨坏死的不良反应分析及药学监护  

Analysis of adverse reactions of bevacizumab-induced osteonecrosis and pharmaceutical care

作　　者：王雷 付中华[1] 史祖宣[2] 赵成龙[1] WANG Lei;FU Zhonghua;SHI Zuxuan;ZHAO Chenglong(Dept.of Pharmacy,Henan Provincial People’s Hospital,Zhengzhou 450003,China;Cancer Center,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院药学部,郑州450003 [2]河南省人民医院肿瘤中心,郑州450003

出　　处：《中国药房》2024年第22期2828-2831,共4页China Pharmacy

基　　金：中华国际医学交流基金会项目(No.Z-2021-46-2101)。

摘　　要：目的为准确识别和治疗贝伐珠单抗致骨坏死的不良反应提供参考。方法临床药师参与1例成人脑胶质瘤患者使用贝伐珠单抗后出现股骨头坏死的治疗过程,通过检索美国FDA不良事件报告系统(FAERS)及查询相关文献和药品说明书,评估股骨头坏死与贝伐珠单抗的关联性,并为医师提供用药建议,对患者进行用药教育。结果患者股骨头坏死与贝伐珠单抗的关联性评估为“可能相关”。医师采纳临床药师的建议,停用贝伐珠单抗,改用安罗替尼继续抗肿瘤治疗。患者也接受临床药师的建议,避免长时间站立,复查时,其疼痛症状已得到控制,股骨头坏死未进展。结论长期使用贝伐珠单抗的患者应加强对骨痛、骨坏死的关注,定期进行影像检查,及早发现并对症治疗,以避免严重骨坏死的发生。OBJECTIVE To provide a reference for accurately identifying and treating adverse reactions of osteonecrosis induced by bevacizumab.METHODS Clinical pharmacists participated in the treatment process of an adult patient with glioma who developed femoral head necrosis after the use of bevacizumab.By searching the FDA Adverse Event Reporting System(FAERS)and consulting relevant literature and drug instructions,the association between femoral head necrosis and bevacizumab was assessed.Medication recommendations were provided to the physician,and medication educations were provided to the patient.RESULTS The association between the patient’s femoral head necrosis and bevacizumab was assessed as“possibly related”.The physicians accepted the clinical pharmacists’advice to discontinue bevacizumab and switched to anlotinib to continue antitumor treatment.The patient also followed the clinical pharmacists’advice to avoid prolonged standing.Upon re-examination,the patient’s pain symptoms were under control,and the femoral head necrosis had not progressed.CONCLUSIONS Patients who receive long-term bevacizumab should attach great importance to bone pain and osteonecrosis,undergo regular imaging examinations,and detect and treat symptoms early to prevent the occurrence of severe osteonecrosis.

关 键 词：股骨头坏死 贝伐珠单抗 FDA不良事件报告系统 不良反应 

分 类 号：R969.3[医药卫生—药理学] R979.1[医药卫生—药学]