PD-L1抑制剂致1例免疫性肝炎病例分析及药学监护

doi:10.19803/j.1672-8629.2021.07.21

中国药物警戒 ›› 2021, Vol. 18 ›› Issue (7): 693-696.
DOI: 10.19803/j.1672-8629.2021.07.21

PD-L1抑制剂致1例免疫性肝炎病例分析及药学监护

汪潇潇, 陈万一^*

重庆大学附属肿瘤医院,重庆市肿瘤研究所,重庆市肿瘤医院,肿瘤转移与个体化诊治转化研究重庆市重点实验室,重庆 400030

收稿日期:2020-04-14 出版日期:2021-07-15 发布日期:2021-07-23
通讯作者: ^*陈万一,女,副主任药师,临床药学。E-mail：32003371@qq.com
作者简介:汪潇潇,女,主管药师,临床药学。
基金资助:
重庆市科研机构绩效激励引导专项（cstc2019jxl130018）

Pharmaceutical Monitoring of Immunohepatitis Caused by PD-L1 Inhibitor: a Case Study

WANG Xiaoxiao, CHEN Wanyi^*

Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing Cancer Institute, Chongqing Cancer Hospital, Chongqing 400030, China

Received:2020-04-14 Online:2021-07-15 Published:2021-07-23

摘要/Abstract

摘要： 目的分析1例PD-L1抑制剂致免疫性肝炎不良反应,探讨临床药师在临床药学监护中的作用。方法临床药师对患者治疗方案提出药学建议,并开展药学监护。结合文献及相关指南等,进行病例分析。结果临床药师为患者提供有效的免疫相关性不良反应治疗管理方案。患者经激素和免疫抑制剂治疗后病情趋于好转。结论临床药师应关注PD-L1抑制剂使用中的免疫相关不良反应,协助医生保障患者临床用药安全。

关键词: PD-L1抑制剂, 免疫性肝炎, 病例分析

Abstract: Objective To explore the role of clinical pharmacists in the treatment of adverse drug reactions induced by PD-L1 inhibitors. Methods Related literature and guidelines were reviewed, while pharmaceutical recommendations and care were given by clinical pharmacists in response to adverse reactions induced after treatment of immune hepatitis with PD-L1 inhibitors (durvalumab). Results Adverse reactions were assessed by clinical pharmacists, who offered an effective and feasible treatment program so that the patient got better after treatment with hormones and immunosuppressive agents. Conclusion Clinical pharmacists should be alert to immune-related adverse reactions of PD-L1 inhibitors and help physicians to ensure the safety of clinical medication.

Key words: PD-L1 inhibitors, immune hepatitis, case study

中图分类号:

R975.5

汪潇潇, 陈万一. PD-L1抑制剂致1例免疫性肝炎病例分析及药学监护[J]. 中国药物警戒, 2021, 18(7): 693-696.

WANG Xiaoxiao, CHEN Wanyi. Pharmaceutical Monitoring of Immunohepatitis Caused by PD-L1 Inhibitor: a Case Study[J]. Chinese Journal of Pharmacovigilance, 2021, 18(7): 693-696.

参考文献

[1] Suzman DL, Pelosof L, Rosenberg A, et al.Hepatotoxicity of immune checkpoint inhibitors: an evolving picture of risk associated with a vital class of immunotherapy agents[J]. Liver, 2018, 38(6):976-987.
[2] Wang XX, Chen WY.PD-1/PD-L1 inhibitors associated with myocarditis-signal mining based on the three international spontaneous reporting systems in real world[J]. Chinese Journal of New Drugs(中国新药杂志), 2019, 28(11): 1404-1408.
[3] Chae YK, Arya A, Iams W, et al.Current landscape and future of dual anti-CTLA4 and PD-1/PD-L1 blockade immunotherapy in cancer; lessons learned from clinical trials with melanoma and non-small cell lung cancer (NSCLC)[J]. Journal for Immunotherapy of Cancer, 2018, 6(1): 39.
[4] Naidoo J, Page DB, Li BT, et al.Toxicities of the anti-PD-1 and anti-PD-L1 immune checkpoint antibodies[J]. Annals of Oncology: Official Journal of the European Society for Medical Oncology, 2016, 27(7): 1362.
[5] Yang JQ, He XJ, Lv Q, et al.Management of adverse events in cancer patients treated with PD-1/PD-L1 blockade: focus on Asian populations[J]. Frontiers in Pharmacology, 2019, 10(726): 1-16.
[6] Mcguire HM, Shklovskaya E, Edwards J, et al.Anti-PD-1-induced high-grade hepatitis associated with corticosteroid-resistant T cells: a case report[J]. Cancer Immunology, Immunotherapy, CII, 2018, 67(4): 563-573.
[7] Kothapalli A, Khattak MA.Safety and efficacy of anti-PD-1 therapy for metastatic melanoma and non-small-cell lung cancer in patients with viral hepatitis: a case series[J]. Melanoma Research, 2018, 28(2): 155-158.
[8] Li HY, Yang CP. Jin HT.Recent research progress in mechanism of liver injury induced by common drugs[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2019, 16(12): 750-756.
[9] Shi XM, Hu YL, Liang YL, et al.Clinical pharmacy service mode and its effect on patients with liver dysfunction[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2018, 15(5): 286-290.
[10] Shao J, Wang C, Ren P, et al.Treatment and immune-related adverse events of immune checkpoint inhibitors in advanced lung cancer[J]. Bioscience Reports, 2020, 40(5): 1-11.
[11] Darnell EP, Mooradian MJ, Baruch EN, et al.Immune-related adverse events (iraes): diagnosis, management, and clinical pearls[J]. Current Oncology Reports, 2020, 22(4): 39.
[12] Inamori O, Miyagawa-Hayashino A, Ueno A, et al.Fulminant hepatitis as an immune-related adverse event after nivolumab treatment[J]. Pathology International, 2019, 69(7): 434-436.
[13] Ricciuti B, Genova C, De Giglio A, et al.Impact of immune-related adverse events on survival in patients with advanced non-small cell lung cancer treated with nivolumab: Long-term outcomes from a multi-institutional analysis[J]. J Cancer Res Clin Oncol, 2019, 145(2): 479-485.
[14] Yang H, Yin DH.Pharmaceutical practice of one case of severe hypokalemia induced by glucocorticoid in patient with minimal change nephropathy[J]. Chinese Journal of Pharmacovigilance(中国药物警戒),2019,16(7):425-429.
[15] Wen K, Tong YL, Cai Y, et al.Bibliometric analysis of immune-related adverse events caused by PD-1/PD-L1 inhibitors[J]. Chinese Journal of New Drugs(中国新药杂志), 2019, 28(15): 1907-1912.

PD-L1抑制剂致1例免疫性肝炎病例分析及药学监护

Pharmaceutical Monitoring of Immunohepatitis Caused by PD-L1 Inhibitor: a Case Study

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