Clinical decision support(CDS) systems with automated alerts integrated into electronic medical records demonstrate efficacy for detecting medication errors(ME) and adverse drug events(ADEs). Critically ill patients a...Clinical decision support(CDS) systems with automated alerts integrated into electronic medical records demonstrate efficacy for detecting medication errors(ME) and adverse drug events(ADEs). Critically ill patients are at increased risk for ME, ADEs and serious negative outcomes related to these events. Capitalizing on CDS to detect ME and prevent adverse drug related events has the potential to improve patient outcomes. The key to an effective medication safety surveillance system incorporating CDS is advancing the signals for alerts by using trajectory analyses to predict clinical events, instead of waiting for these events to occur. Additionally, incorporating cutting-edge biomarkers into alert knowledge in an effort to identify the need to adjust medication therapy portending harm will advance the current state of CDS. CDS can be taken a step further to identify drug related physiological events, which are less commonly included in surveillance systems. Predictive models for adverse events that combine patient factors with laboratory values and biomarkers are being established and these models can be the foundation for individualized CDS alerts to prevent impending ADEs.展开更多
目的为临床安全使用替雷利珠单抗提供参考。方法检索中国知网、维普、万方、中国生物医学文献数据库及PubMed,Embase,Web of Science等数据库(检索时限自建库起至2023年4月30日),对替雷利珠单抗安全性的相关临床研究、上市后不良反应的...目的为临床安全使用替雷利珠单抗提供参考。方法检索中国知网、维普、万方、中国生物医学文献数据库及PubMed,Embase,Web of Science等数据库(检索时限自建库起至2023年4月30日),对替雷利珠单抗安全性的相关临床研究、上市后不良反应的个案报道等30多篇文献进行系统整理,总结替雷利珠单抗免疫相关不良事件(irAE)的发生特点。结果不同的临床试验中,替雷利珠单抗irAE总发生率为22.2%~76.7%;其中≥3级irAE的发生率为7.0%~36.7%。替雷利珠单抗相关irAE常发生于皮肤系统、内分泌系统、消化系统、泌尿系统、呼吸系统、心血管系统,临床表现为皮疹,甲状腺功能异常、高血糖,腹泻,肾功能损伤,肺炎,心肌病等。基于目前的临床观察及相关研究,替雷利珠单抗irAE程度大多轻微,未导致治疗中断。结论irAE发生情况显示,替雷利珠单抗用于临床恶性肿瘤的抗肿瘤治疗有一定安全性,但作为新上市的药物,临床应用时间短,经验相对不足,建议临床医师严格把握适应证,做好用药监护,以确保用药安全。展开更多
目的分析阿替利珠单抗发生不良反应(adverse reactions,ADRs)的临床特点与规律,为临床安全用药提供参考。方法搜索中国知网、维普、万方、Web of Science、PubMed数据库,收集关于阿替利珠单抗所致不良反应的报道文献并进行分析,研究时间...目的分析阿替利珠单抗发生不良反应(adverse reactions,ADRs)的临床特点与规律,为临床安全用药提供参考。方法搜索中国知网、维普、万方、Web of Science、PubMed数据库,收集关于阿替利珠单抗所致不良反应的报道文献并进行分析,研究时间为2022年4—8月。结果阿替利珠致不良反应报道共94例;其中男性56例(59.57%),女性38例(40.43%),男性占比较高;年龄(62.8±12.0)岁,中老年人居多;多数发生在用药后的90 d内(71例,71.0%);阿替利珠单抗致ADRs累及多个系统/器官,其中以神经系统损害(22例,22.0%)占比最多;3~4级严重ADRs占比最多(64例,64.0%);94例经治疗和(或)停药后,好转或治愈80例,死亡5例。结论阿替利珠单抗所致ADRs涉及不同性别与年龄段病人,累及多个系统/器官,临床使用应随时监测,警惕ADRs的发生,做到及时识别与治疗。展开更多
基金Supported by The Agency for Healthcare Research and Quality,No.R18HS02420-01
文摘Clinical decision support(CDS) systems with automated alerts integrated into electronic medical records demonstrate efficacy for detecting medication errors(ME) and adverse drug events(ADEs). Critically ill patients are at increased risk for ME, ADEs and serious negative outcomes related to these events. Capitalizing on CDS to detect ME and prevent adverse drug related events has the potential to improve patient outcomes. The key to an effective medication safety surveillance system incorporating CDS is advancing the signals for alerts by using trajectory analyses to predict clinical events, instead of waiting for these events to occur. Additionally, incorporating cutting-edge biomarkers into alert knowledge in an effort to identify the need to adjust medication therapy portending harm will advance the current state of CDS. CDS can be taken a step further to identify drug related physiological events, which are less commonly included in surveillance systems. Predictive models for adverse events that combine patient factors with laboratory values and biomarkers are being established and these models can be the foundation for individualized CDS alerts to prevent impending ADEs.
文摘目的为临床安全使用替雷利珠单抗提供参考。方法检索中国知网、维普、万方、中国生物医学文献数据库及PubMed,Embase,Web of Science等数据库(检索时限自建库起至2023年4月30日),对替雷利珠单抗安全性的相关临床研究、上市后不良反应的个案报道等30多篇文献进行系统整理,总结替雷利珠单抗免疫相关不良事件(irAE)的发生特点。结果不同的临床试验中,替雷利珠单抗irAE总发生率为22.2%~76.7%;其中≥3级irAE的发生率为7.0%~36.7%。替雷利珠单抗相关irAE常发生于皮肤系统、内分泌系统、消化系统、泌尿系统、呼吸系统、心血管系统,临床表现为皮疹,甲状腺功能异常、高血糖,腹泻,肾功能损伤,肺炎,心肌病等。基于目前的临床观察及相关研究,替雷利珠单抗irAE程度大多轻微,未导致治疗中断。结论irAE发生情况显示,替雷利珠单抗用于临床恶性肿瘤的抗肿瘤治疗有一定安全性,但作为新上市的药物,临床应用时间短,经验相对不足,建议临床医师严格把握适应证,做好用药监护,以确保用药安全。
文摘目的分析阿替利珠单抗发生不良反应(adverse reactions,ADRs)的临床特点与规律,为临床安全用药提供参考。方法搜索中国知网、维普、万方、Web of Science、PubMed数据库,收集关于阿替利珠单抗所致不良反应的报道文献并进行分析,研究时间为2022年4—8月。结果阿替利珠致不良反应报道共94例;其中男性56例(59.57%),女性38例(40.43%),男性占比较高;年龄(62.8±12.0)岁,中老年人居多;多数发生在用药后的90 d内(71例,71.0%);阿替利珠单抗致ADRs累及多个系统/器官,其中以神经系统损害(22例,22.0%)占比最多;3~4级严重ADRs占比最多(64例,64.0%);94例经治疗和(或)停药后,好转或治愈80例,死亡5例。结论阿替利珠单抗所致ADRs涉及不同性别与年龄段病人,累及多个系统/器官,临床使用应随时监测,警惕ADRs的发生,做到及时识别与治疗。
