卡瑞利珠单抗致免疫性肝损伤的临床特征分析

Clinical analysis of immune liver injury induced by camrelizumab

目的探讨卡瑞利珠单抗致免疫性肝损伤的病例特点,为临床安全用药提供参考。方法根据关键词检索并筛选数据库建库至2023年8月发表的卡瑞利珠单抗致免疫性肝损伤的个案报道,提取数据并进行分析。结果通过筛选得到12篇文献,共12例患者,其中男7例,女5例,年龄43~76岁,平均(62.92±10.19)岁;多在用药1个月内发生免疫性肝损伤。原患疾病均为恶性肿瘤,主要用法用量为200mg,1次/3周,静脉滴注;主要肝损伤级别为3级肝损伤。经停药和对症治疗后,症状好转3例(25.00%),痊愈5例(41.67%),未愈4例(33.33%)。结论卡瑞利珠单抗可致免疫性肝损伤,严重者可致死;因此要加强卡瑞利珠单抗的临床合理使用,提高对免疫相关不良事件的认知,重视其引起的免疫性肝损伤。

Objective To investigate the case characteristics of immune liver injury induced by camrelizumab,and to provide reference for clinical safety of drug use.Methods According to keywords,the case reports of immune liver injury induced by camrelizumab published from the establishment of the database to August 2023 were retrieved and screened,and the data were extracted and analyzed.Results A total of 12 literatures were selected,involving 12 patients,including 7 males and 5 females.Among them,age 43-76 years old,the average age was(62.92±10.19)years old,and most of them developed immune liver injury within 1 month.The primary diseases were all malignant tumors,and the main dosage of camrelizumab was 200mg intravenously,once every 3 weeks;The main immune liver injury was grade 3.After drug withdrawal and corresponding symptomatic treatment,the symptoms improved in 3 cases(25.00%),recovered in 5 cases(41.67%),and did not recover in 4 cases(33.33%).Conclusion Camrelizumab can cause immune liver injury,which can lead to death in severe cases.Therefore,clinical rational use of camrelizumab should be strengthened,the awareness of immune-related adverse events should be improved and pay attention to the immunological liver injury caused by camrelizumab.