奈玛特韦/利托那韦相关不良反应文献分析

Literature analysis of adverse drug reactions related to nirmatrelvir /ritonavir

目的:分析奈玛特韦/利托那韦相关药物不良反应(adverse drug reaction, ADR)的特点,为临床合理用药提供参考。方法:检索建库起至2023年1月中国知网、万方数据库、维普网、PubMed、Web of Science数据库,收集奈玛特韦/利托那韦相关ADR个案报道,提取文献资料进行统计分析。结果:共纳入文献17篇,共计18例患者。其中男性6例,女性12例,患者年龄为14~80岁,其中71~80岁年龄段比例最高。2例怀疑为奈玛特韦/利托那韦导致的ADR,累及神经系统和心脏器官;16例为与其他药物相互作用导致的ADR,相互作用药物为免疫抑制剂11例,钙通道阻滞剂2例,抗肿瘤药物、抗精神病药、血脂调节剂各1例。经停药或对症支持治疗均治愈。结论:奈玛特韦/利托那韦的安全性仍需要进一步监测与研究,临床使用中需重点关注可能的药物相互作用,减少ADR的发生。

Objective:To analyze the characteristics of adverse drug reactions(ADRs)related to nirmatrelvir/ritonavir in order to provide references for rational clinical drug use.Methods:The databases of CNKI,Wanfang,VIP,PubMed and Web of Science were searched to collect case reports of ADR related to nirmatrelvir/ritonavir from the establishment of the database up to January 2023.The literature was extracted for statistical analysis.Results:A total of 17 articles were included,involving 18 patients,6 males and 12 females.The age of the patients ranged 14 to 80 years,with the highest proportion in the age group of 71~80 years.ADRs occurring in neural and cardiac systems from 2 cases were suspected caused by nirmatrelvir/ritonavir.ADRs in sixteen cases were induced by the drug-drug interaction of nirmatrelvir/ritonavir.Drugs that are involved in the drug interactions were immunosuppressants in 11 cases,calcium channel blockers in 2 cases,antineoplastic agents,antipsychotics,and lipid modifying agent in 1 case each.All patients were cured after drug withdrawal or receiving symptomatic and supportive treatment.Conclusion:The safety of nirmatrelvir/ritonavir still requires further monitoring and study.Attention should be paid to possible drug interactions in clinical use to reduce the occurrence of adverse reactions.