特瑞普利单抗致不良反应文献分析

Literature analysis of adverse reactions caused by toripalimab

目的:分析特瑞普利单抗致不良反应的发生规律及临床表现特点,进而为临床安全合理用药提供参考。方法:检索中国知网、万方数据库、Pubmed数据库、Web of Science数据库等,检索时限为建库起至2021年12月1日,收集特瑞普利单抗致药物不良反应(ADR)的个案报道,对纳入文献的患者基本情况、发生时间、累及器官、临床表现等进行归纳与分析。结果:共纳入文献14篇,涉及患者16例,其中男性8例(50%)、女性8例(50%),平均年龄为57.93岁;ADR主要发生在用药后30 d内(31.25%),所致ADR主要累及内分泌系统(5例,31.25%)、心血管系统(5例,31.25%)、皮肤系统(3例,18.75%)、泌尿系统(1例,6.25%)、肝胆系统(1例,6.25%)、全身性损害(1例,6.25%),6例出现ADR后停用特瑞普利单抗,4例继续使用特瑞普利单抗,部分患者给予对症及支持治疗,15例患者均好转,1例死亡。结论:51~60岁患者使用特瑞普利单抗更易发生ADR,且发生时间多在用药后30 d内。其ADR累及多个器官/系统,以内分泌系统和心血管系统为主,应特别关注此类ADR,早发现、早治疗。

Objective: To analyze the occurrence and clinical characteristics of adverse reactions caused by toripalimab, so as to provide a reference for clinical safe and rational drug use. Methods: Databases such as CNKI, Wanfang database, Pubmed, Web of Science were searched for the references published from the establishment of the database to December 1, 2021. The case reports of ADR caused by toripalimab were collected, and the basic conditions, time of occurrence, organs involved, and clinical manifestations of patients included in the literature were summarized and analyzed. Results: There are totally 14 literatures included, involving 16 patients, 8 males(50%) and 8 females(50%), with the average age of 57.93 years. ADR mainly occurred within 30 days after medication(31.25%). The resulting ADR mainly occurred inendocrine system(5 cases, 31.25%), cardiovascular system(5 cases, 31.25%), skin system(3 cases, 18.75%), urinary system system(1 case, 6.25%), hepatobiliary system(1 case, 6.25%), and systemic damage(1 case, 6.25%). 6 cases of ADR were discontinued with toripalimab, 4 cases continued to use toripalimab, some patients were given symptomatic and supportive treatment, 15 patients got better, 1 case died;Conclusion: Patients aged 51~60 years old are more prone to ADR when using toripalimab, and the occurrence time is usually within 30 days after taking the drug. The drug affects multiple organs/systems, mainly the endocrine system and the cardiovascular system. Special attention should be paid to these types of ADR for early detection and early treatment.