司库奇尤单抗相关皮肤不良反应文献病例分析

Literature analysis of cutaneous adverse drug reactions induced by secukinumab

目的:分析司库奇尤单抗所致皮肤药物不良反应(cutaneous adverse drug reactions,CADR)的发生发展特点,为临床安全合理用药提供参考。方法:检索中国知网(CNKI)、维普(VIP)、万方、PubMed和Web of Science数据库收载的司库奇尤单抗致CADR的病例报告和病例系列报告并进行分析。结果:收集司库奇尤单抗致CADR的个案报道16篇共18例,其中男性6例(33.33%),女性12例(66.67%),年龄分布以40岁以上居多(12例,66.67%),发生时间主要集中在用药120 d以内(15例,83.33%),CADR类型主要为感染相关(6例,33.33%)和免疫相关(11例,61.11%)2大类。患者经停药或减量和/或对症处理后均好转。结论:对于存在皮肤损伤、慢性感染、特异性皮炎及炎性肠病病史患者,应加强司库奇尤单抗使用后3个月内的药学监护,尤其应重点关注40岁以上人群,避免严重CADR的发生,保证临床用药安全。

OBJECTIVE To analyze the occurrence and development characteristics of cutaneous adverse drug reactions(CADRs)induced by secukinumab and provide reference for clinical drug use.METHODS Case reports and case series reports of CADR induced by secukinumab were collected from the databases of CNKI,VIP,Wanfang,PubMed and Web of Science,and then analyzed.RESULTS A total of 18 cases were reported in 16 articles,including 6 males(33.33%)and 12 females(66.67%).Patients over 40 years old showed the highest incidence(n=12,66.67%).CADRs induced by secukinumab frequently occurred within 120 days after dosing(n=15,83.33%).CADRs were mainly infection-related(n=6,33.33%)and immune-related ones(n=11,61.11%).All the patients got better after drug withdrawal or dose reduction and/or symptomatic treatment.CONCLUSION For patients with a history of skin injury,chronic infection,atopic dermatitis and inflammatory bowel disease,especially over 40 years old,pharmaceutical care should be strengthened within 3 months of secukinumab treatment in order to avoid the occurrence of severe CADRs and ensure the safety of clinical medication.