纳武利尤单抗致甲状腺功能减退文献分析

Literature analysis of hypothyroidism induced by nivolumab

目的分析纳武利尤单抗导致甲状腺功能减退的临床特点,为其监测和处置提供参考。方法检索中国知网、万方数据、PubMed数据库、Web of Science数据库,收集2014年1月-2021年11月纳武利尤单抗致甲状腺功能减退的文献并进行分析。结果共筛选出个案报道26例,不良反应中位发生时间为(3.82±2.30)个月;26例患者中出现乏力13例,厌食5例,肌肉乏力4例;出现甲状腺功能减退后,14例患者继续使用纳武利尤单抗,7例停用纳武利尤单抗;23例患者给予左旋甲状腺素替代治疗,3例未给予;19例症状消失、甲功恢复正常,1例死亡。结论在使用纳武利尤单抗期间应注意患者临床症状,定期监测甲状腺功能指标,当出现甲状腺功能减退时,应及时给予左旋甲状腺素替代治疗。

Objective To analyze the clinical characteristics of hypothyroidism induced by nivolumab,and to provide reference for its monitoring and management.Methods Literatures on hypothyroidism caused by nivolumab from January 2014 to November 2021 were collected and analyzed by searching CNKI,Wanfang Data,PubMed and Web of Science databases.Results A total of 26 cases were screened out,and the median time of adverse reactions was(3.82±2.30)months.There were 13 cases of fatigue,5 cases of anorexia and 4 cases of muscle weakness in 26 patients.Fourteen patients continued to use nivolumab after hypothyroidism,and seven patients stopped using nivolumab.Levothyroxine replacement therapy was given to 23 patients and not to 3 patients.The symptoms disappeared in 19 cases and the thyroid function returned to normal,and 1 case died.Conclusion Clinical symptoms should be paid attention to during the use of nivolumab,thyroid function indicators should be monitored regularly,and replacement therapy should be given in time when hypothyroidism occurs.