基于循证的伊布替尼不良反应及药学监护

Evidence-based ibrutinib-related adverse reactions and pharmaceutical care

伊布替尼是首个小分子布鲁顿酪氨酸激酶(BTK)抑制剂靶向药,主要用于B细胞恶性肿瘤。随着国内外相关研究不断增加,越来越多伊布替尼的不良反应被发现,如出血、心房颤动、高血压、感染、腹泻、关节痛/肌痛、皮肤毒性、血液学毒性等。在治疗中,伊布替尼所的不良反应常属于1~2级,少见严重不良反应。通过全面检索伊布替尼相关常见和罕见不良反应的文献,归纳总结其不良反应类型及发生率,探讨预防、处理的措施和药学监护方法,以期为临床工作提供循证依据,最大程度地减少不良反应发生。

Ibrutinib,a small molecule BTK inhibitor,is the first targeted drug mainly used for B cell malignant tumors.With the increase of related research at home and abroad,more and more adverse reactions induced by ibrutinib have been discovered,such as bleeding,atrial fibrillation,hypertension,infection,diarrhea,arthralgia/myalgia,skin toxicity,and hematological toxicity.Ibrutinib has been associated with an increased risk of grade 1 ~ 2 toxicities.Serious adverse events are rare.Based on literature,this article summarizes the types,incidence,prevention,management,and pharmaceutical care of common as well as rare but important toxicities of ibrutinib.It is expected to provide evidencebased recommendations and minimize side effects.