IL-17A抑制剂司库奇尤单抗和依奇珠单抗致不良反应文献分析

Literature analysis of adverse drug reactions induced by IL-17A inhibitors:secukinumab and ixekizumab

目的:分析白介素-17A(IL-17A)抑制剂司库奇尤单抗(secukinumab)和依奇珠单抗(ixekizumab致不良反应(ADRs)的临床表现、特点、规律及转归,为临床安全用药提供参考。方法:计算机检索自建库至2021年7月PubMed,Embase,Web of Science,CNKI和万方数据库关于IL-17A抑制剂ADR的个案报道,对纳入病例中患者信息、ADR发生时间、累及系统、临床表现和转归等进行统计分析。结果:IL-17A抑制剂致ADR的个案报道共65例;女性39例(60%),男性26例(40%);患者年龄分布以31~70岁年龄段较多(55例,84.6%);多发生在用药2月内(34例,52.3%);IL-17A抑制剂致ADRs主要以皮肤及其附件损害(23例,33.3%)及胃肠系统损害(23例,33.3%)较多;49例经停药和/或对症支持治疗后症状治愈或好转;9例患者未停药或再激发时症状未改善或者加重。结论:临床使用IL-17A抑制剂时应慎重评估ADR相关危险因素,加强用药监测,尤其是皮肤及胃肠系统的ADR。

Objective: To analyze the clinical manifestations,characteristics,regularity and outcomes of the adverse reactions( ADRs) of IL-17A inhibitors( secukinumab and ixekizumab) in order to provide reference for clinicians to use these drugs safely. Methods: PubMed,Embase,Web of Science,CNKI,and Wanfang databases were searched to collect the ADR case reports of secukinumab and ixekizumab. The patients’ information,occurrence time of ADRs,involved systems,clinical manifestations,and outcome were analyzed statistically. Results: Sixtyfive ADR cases were identified and included. Thirty-nine cases( 60%) were females and 26 cases( 40%) were males. Patients of 31 to 70 years old accounted for the highest percentage( n = 55,84. 6%). ADRs of IL-17A inhibitors frequently occurred within 2 months after medication( n = 34,52. 3%). The ADRs of IL-17A inhibitors mainly presented as lesions of skin and its appendages( n = 23,33. 3%) and lesions of digestive system( n = 23,33. 3%). Forty-nine patients recovered or improved after discontinuation of medication and/or symptomatic support.Nine patients without withdrawal or reactivation did not recover or worsened. Conclusion: In clinical application of IL-17A inhibitors,risk factors of ADRs should be carefully evaluated,and attention should be paid to ADR monitoring,especially ADRs of skin and digestive systems.