某院卡瑞利珠单抗应用的合理性与安全性分析

Rationality and safety application of camrelizumab in a hospital

目的探讨卡瑞利珠单抗的应用合理性与安全性,为临床合理应用提供参考。方法收集某院2020年2月至2023年2月应用卡瑞利珠单抗的患者资料,依据药品说明书及诊疗指南,对卡瑞利珠单抗应用的合理性与安全性进行分析。结果共收集到102例患者应用卡瑞利珠单抗672次,符合说明书或指南推荐的75例(73.53%),存在给药顺序不适宜(41.18%)、用法不适宜(60.78%)、无故中断治疗(42.16%)、预处理不适宜(9.80%)等问题;不良反应发生率为60.78%,主要表现为血液毒性(34.31%)、皮肤毒性(31.37%)、内分泌毒性(27.45%),观察到罕见的不良反应是毛细血管扩张症与银屑病(各1例)。结论我院卡瑞利珠单抗多符合药品说明书或指南推荐,但仍存在超说明书用药问题。此外不良反应发生率较高(60.78%),医院及临床药师应加强免疫检查点抑制剂合理应用管理,特别是毒性监测。

Objective To determine the rationality and evaluation the safety of camrelizumab,and provide reference for rational use of camrelizumab.Methods Data of patients receiving camrelizumab in a hospital from February 2020 to February 2023 were collected.According to drug instructions and guidelines,the rationality and safety of camrelizumab were evaluated.Results Totally 102 patients with 672 times of camrelizumab treatment were collected,75(73.53%)met the indications in the drug intructions or guideline.Problems included irrational order of administration(41.18%),inappropriate usage(60.78%),interruption of treatment without any reason(42.16%)and pretreatment(9.80%).The incidence of adverse drug reactions was 60.78%,mainly manifested as blood toxicity(34.31%),skin toxicity(31.37%),and endocrine toxicity(27.45%).The rare adverse reactions included capillary dilation and psoriasis,one case each.Conclusion Most uses of camrelizumab in the hospital followed the drug instructions or guideline,but there are still cases of off-label indications,with high incidence of adverse reactions(60.78%).Clinical pharmacists should strengthen the management of application of immune checkpoint inhibitors,especially toxicity monitoring.