1例应用PCSK9抑制剂治疗洛拉替尼继发性血脂异常患者的药学监护及相关性文献分析

The pharmacological care of a patient with dyslipidaemia secondary to lorlatinib treated with PCSK9 inhibitor and literature analysis of the correlation

医院门诊医生给予1例洛拉替尼继发性血脂异常患者口服瑞舒伐他汀联合依折麦布降脂药物治疗,1个月后出现肝损,临床药师详细评估患者治疗方案、用药前后血液指标变化和血脂控制情况,并查阅相关文献,认为患者肝损与瑞舒伐他汀相关,建议停用瑞舒伐他汀,1个月后改用PCSK9抑制剂,医生接受建议。患者停药1个月后肝酶指标恢复正常,后应用PCSK9抑制剂,临床药师持续监护患者病情变化,随访6个月期间血脂控制达标,耐受性较好。在本案例中,临床药师对PCSK9抑制剂应用于洛拉替尼继发性血脂异常患者进行用药分析和药学监护,并通过相关文献检索分析PCSK9与肺癌的相关性,对药物的疗效和安全性观察总结,为临床制定方案提供参考。

A patient with lorlatinib secondary dyslipidemia was given oral resuvastatin combined with ezetimibe lipid-lowering drug treatment by the hospital outpatient doctor,and developed liver damage one month after the treatment.Clinical pharmacists evaluated in detail the treatment plans,changes in blood indicators before and after medication,and blood lipid control,searched the related literature,and considered that the patient’s liver damage was related to rosuvastatin.Clinical pharmacists suggested to discontinue rosuvastatin and switch to PCSK9 inhibitor one month later,and the doctor accepted the suggestion.After discontinuing medication for one month,the liver enzyme indicators of the patient returned to normal,and PCSK9 inhibitor was applied afterwards.Clinical pharmacists continuously monitored changes of the patient’s condition,and during a 6-month follow-up period,the blood lipid control met the standard with good tolerance.In this case,clinical pharmacists carried out medication analysis and pharmacological care of PCSK9 inhibitors applied to patients with dyslipidaemia secondary to loratini,analysed the correlation between PCSK9 and lung cancer through relevant literature sreening,observed and summarized the efficacy and safety of the drug to provide a reference for the clinical development of the scheme.