替妥木单抗在甲状腺相关眼病治疗中的不良反应及预防策略

Adverse reactions and precautions of teprotumumab in the treatment of thyroid-associated ophthalmopathy

甲状腺相关眼病(TAO)是一种与甲状腺功能异常相关的自身免疫性疾病,会显著影响患者的生活质量,可导致视力障碍和容貌损毁。传统的治疗方法往往不尽如人意。研究发现,替妥木单抗(teprotumumab)是一种可抑制胰岛素样生长因子1受体(IGF-1R)的人源单克隆抗体,目前已成为TAO的新兴靶向治疗药物。尽管此药已证明在TAO治疗中有效且相对安全,但随着临床应用的不断推广,关于此药引发的不良反应值得引起广大眼科医师的重视,包括听力损害、高血糖、腹泻、肌肉痉挛、输液反应、认知功能减退、甲状腺功能抑制、脱发、恶心和疲劳等。此药总体耐受性良好,大多数不良事件的严重程度为轻度或中度。本文对当前替妥木单抗在TAO治疗中的不良反应及预防策略进行了综述。

Thyroid-associated ophthalmopathy(TAO)is an autoimmune disease associated with thyroid dysfunction that can significantly impact quality of life,result in visual impairment and facial disfigurement.Traditional treatments are often unsatisfactory.Studies have shown that teprotumumab,a human monoclonal antibody that can inhibit insulin-like growth factor 1 receptor(IGF-1R),has become an emerging targeted drug for TAO.Although the drug has proven to be effective and relatively safe in the treatment of TAO,adverse reactions are worthy of attention of ophthalmologists with the continuous promotion of clinical application,including hearing impairment,hyperglycemia,diarrhea,muscle spasms,infusion reactions,cognitive decline,thyroid suppression,alopecia,nausea and fatigue.Teprotumumab was generally well tolerated,with most adverse events being mild or moderate in severity.This paper aims to review the adverse reactions and precautions of teprotumumab in the treatment of TAO.