利妥昔单抗治疗Graves眼病致不良反应分析及药学监护

doi:10.19803/j.1672-8629.2021.12.19

中国药物警戒 ›› 2021, Vol. 18 ›› Issue (12): 1186-1188.
DOI: 10.19803/j.1672-8629.2021.12.19

利妥昔单抗治疗Graves眼病致不良反应分析及药学监护

和心依, 王少科, 薛小荣^*, 胡斌

西安市第四医院药剂科,陕西西安 710004

收稿日期:2020-02-17 出版日期:2021-12-15 发布日期:2021-12-16
通讯作者: ^*薛小荣,女,硕士,副主任药师,临床药学。E-mail：xuexiaorong2006@163.com
作者简介:和心依,女,硕士,主管药师,临床药学。
基金资助:
陕西省重点研发计划（2020SF-203）

Pharmaceutical Care of Adverse Reactions Caused by Rituximab in the Treatment of Graves Orbitopathy

HE Xinyi, WANG Shaoke, XUE Xiaorong^*, HU Bin

Department of Pharmacy, Xi'an Fourth Hospital, Xi'an Shaanxi 710004, China

Received:2020-02-17 Online:2021-12-15 Published:2021-12-16

摘要/Abstract

摘要： 目的分析利妥昔单抗治疗Graves眼病导致不良反应的特点及其防治,为临床安全用药提供参考,为药学监护提供思路。方法对我院眼科2018年6月1日至2019年12月31日期间使用利妥昔单抗的48例患者,共计99次用药进行回顾性分析。结果 48例患者中有10例发生不良反应,女性8例（80.00%）,男性2例（20.00%）,年龄25~54岁。累及系统-器官主要为呼吸系统,心血管系统,皮肤和皮下组织。不良反应多发于首次用药时,症状较轻微。结论对于临床使用经验及安全性研究较少新的药物治疗方案,临床药师应加强药学监护,关注患者相关生理指标及心理状态,明确药学监护重点,及时排除用药禁忌,确保用药安全,充分体现临床药师的价值。

关键词: Graves 眼病, 利妥昔单抗, 药品不良反应, 药学监护

Abstract: Objective To analyze the characteristics of adverse reactions caused by rituximab in the treatment of Graves orbitopathy and recommend ways of prevention and treatment so as to provide reference for clinical safe drug use and for pharmaceutical care.Methods The clinical data on a total of 48 patients who used rituximab 99 times between June 1, 2018 and December 31, 2019 was analyzed retrospectively. Results ADRoccurred in 10 of the 48 cases, including 8 females (80.00%) and 2 males (20.00%) aged 25 to 54. The organs/systems involved were the respiratory system, cardiovascular system, the skin and subcutaneous tissues. ADR mostly occurred the first time rituximab was administered, but the symptoms were mild.Conclusion Clinical pharmacists should strengthen pharmaceutical care when adopting treatment schemes involving new drugs that are not often used and lack safety study. Related physiological indicators and mental state of patients deserve more attention and priorities of pharmaceutical care should be specified. Contraindications should be eliminated in time to ensure medication safety and prove the worth of clinical pharmacists.

Key words: Graves orbitopathy, rituximab, adverse drug reaction, pharmaceutical care

中图分类号:

R994.11

和心依, 王少科, 薛小荣, 胡斌. 利妥昔单抗治疗Graves眼病致不良反应分析及药学监护[J]. 中国药物警戒, 2021, 18(12): 1186-1188.

HE Xinyi, WANG Shaoke, XUE Xiaorong, HU Bin. Pharmaceutical Care of Adverse Reactions Caused by Rituximab in the Treatment of Graves Orbitopathy[J]. Chinese Journal of Pharmacovigilance, 2021, 18(12): 1186-1188.

参考文献

[1] Hu ZR, Xu HY, Xu DD, et al.The immunotherapy of thyroid associated ophthalmopathy[J]. Medical Journal of Peking Union Medical College Hospital(协和医学杂志), 2015, 6(6): 462-466.
[2] Bartalena L, Baldeschi L, Boboridis K, et al.The 2016 european thyroid association/European group on Graves’orbitopathy guidelines for the management of Graves’orbitopathy[J]. Eur Thyroid J, 2016, 5(1): 9-26.
[3] Salvi M, Vannucchi G, Campi I, et al.Efficacy of rituximab treatment for thyroid-associated ophthalmopathy as a result of intraorbital B-cell depletion in one patient unresponsive to steroid immunosuppression[J]. Eur J Endocrinol, 2006, 154(4): 511-517.
[4] Zhu HG, Liao L, Dong JJ.Research progress of rituximab in treatment of thyroid associated ophthalmology[J]. Chinese Journal of Clinicians(Electronic Edition)(中华临床医师杂志电子版), 2016, 10(19): 2913-2916.
[5] Ye XZ, Wang J.Two cases of rituximab for treatment of Graves ophthalmopathy[J]. Jiangsu Medical Journal(江苏医药), 2010, 36(7): 863-864.
[6] Liu H, Zhang GM, Zhang YH.Clinical observation and analysis of 29 cases of adverse reactions of rituximab injection[J]. Chinese Journal of Hospital Pharmacy(中国医院药学杂志), 2011, 31(5): 429-431.
[7] Zhu H, Zhou F, Jin J.Literature anaIysis of 56 cases of adverse reactions induced by rituximab[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2018, 15(1): 52-56.
[8] Chen Y, Gao YY, Li Y, et al.Literature analysis of 325 cases of adverse drug reaction of rituximab[J]. Journal of Guangdong Pharmaceutical College(广东药学院学报), 2010, 26(2): 179-181.
[9] Descotes J.Immunotoxicity of monoclonal antibodies[J]. MAbs, 2009, 1(2): 104-111.
[10] Salvi M, Vannucchi G, Curro N, et al.Efficacy of B-cell targeted therapy with rituximab in patients with active moderate to severe Graves’orbitopathy: a randomized controlled study[J]. J Clin Endocrinol Metab, 2015, 100(2): 422-431.
[11] Salvi M, Vannucchi G, Beck-Peccoz P.Potential utility of rituximab for Graves’ orbitopathy[J]. J Clin Endocrinol Metab, 2013, 98(11): 4291-4299.
[12] van Vollenhoven RF, Emery P, Bingham CO, et al.Long-term safety of rituximab in rheumatoid arthritis: 9.5-year follow-up of the global clinical trial programme with a focus on adverse events of interest in RA patients[J]. Ann Rheum Dis, 2013, 72(9): 1496-1502.
[13] Salvi M, Vannucchi G, Curro N, et al.Small dose of rituximab for graves orbitopathy: new insights into the mechanism of action[J]. Arch Ophthalmol, 2012, 130(1): 122-124.
[14] Savino G, Balia L, Colucci D, et al.Intraorbital injection of rituximab: a new approach for active thyroid-associated orbitopathy, a prospe-ctive case series[J]. Minerva Endocrinol, 2013, 38(2): 173-179.
[15] Mitchell AL, Gan EH, Morris M, et al.The effect of B cell depletion therapy on anti-TSH receptor antibodies and clinical outcome in glucocorticoid-refractory Graves’orbitopathy[J]. Clin Endocrinol(Oxf), 2013, 79(3): 437-442.
[16] Xie Y, Zhu J, Zheng W, et al.Clinical observation on rituximab combined with chemotherapy in the treatment of diffused large B cell lymphonla[J]. Tumor(肿瘤), 2009, 29(1): 53-57.
[17] Tian H, Wang RF.The importance of rational control of infusion speed in clinical[J]. Lishizhen Medicine and Materia Medica Research(时珍国医国药), 2008(10): 2544-2545.
[18] Song XK.Influential factor of transfusion speed in administration and medication security[J]. Chinese Pharmaceutical Affairs(中国药事), 2007(7): 514-518.

利妥昔单抗治疗Graves眼病致不良反应分析及药学监护

Pharmaceutical Care of Adverse Reactions Caused by Rituximab in the Treatment of Graves Orbitopathy

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	贾晋生, 刘红亮, 王青, 侯永芳, 李馨龄. 基于知识图谱联合ERNIE-DPCNN模型的药品不良反应自动关联性评价方法研究[J]. 中国药物警戒, 2024, 21(2): 163-166.
[2]	李应芬, 韩雷. 319例注射用脑蛋白水解物药品不良反应报告分析[J]. 中国药物警戒, 2024, 21(2): 195-198.
[3]	徐伟佳, 彭崎, 黄海渝, 张磊姣, 肖华, 吴雪. 285例新型抗肿瘤药物不良反应分析[J]. 中国药物警戒, 2024, 21(2): 199-203.
[4]	郭清华, 彭笑笑, 朱萍, 刘西霖, 杨颖华, 陈志海. 氨氯地平过量致多器官功能障碍综合征1例分析[J]. 中国药物警戒, 2024, 21(2): 204-207.
[5]	方美琳, 郑慧敏, 王存泽, 王凌, 阮君山. 注射用奥沙利铂致全身肌肉疼痛1例分析[J]. 中国药物警戒, 2024, 21(2): 208-210.
[6]	陈玉艳, 张明霞, 张涛, 张晋. 斯鲁利单抗注射液致间质性肺炎不良反应1例分析[J]. 中国药物警戒, 2024, 21(2): 213-215.
[7]	曹桂萍, 邓琳琳, 朱干红, 陆颖, 马爽, 陈玲玲, 刘丽丽. 天麻首乌片致严重肝损伤1例分析[J]. 中国药物警戒, 2024, 21(2): 216-218.
[8]	高云娟, 赵旭, 白天凯, 柏兆方, 王伽伯, 宋海波, 肖小河. 基于不良反应监测大数据的药品安全风险发现与识别策略[J]. 中国药物警戒, 2024, 21(1): 1-5.
[9]	郭龙鑫, 高云娟, 吴承钊, 龙敏娟, 祝胜凯, 宋海波, 赵旭, 肖小河. 基于不良反应监测大数据的中药药源性肝损伤风险信号新发现及易感因素初探[J]. 中国药物警戒, 2024, 21(1): 15-19.
[10]	蒋文硕, 杨莉. 694例癫痫医师药师联合门诊患者药品不良反应分析[J]. 中国药物警戒, 2024, 21(1): 102-106.
[11]	陈华炎, 江东波, 郭春连, 杨家琪, 黎雨欣, 蔡伟明. 326例奈玛特韦片/利托那韦片治疗新型冠状病毒感染安全性分析[J]. 中国药物警戒, 2024, 21(1): 107-110.
[12]	刘赛月, 吕小琴, 周耘. 疑似药品不良反应死亡病例调查及报告实施要点[J]. 中国药物警戒, 2023, 20(9): 971-974.
[13]	里筱竹, 王蔷, 逄瑜, 张轶菁. 个例药品不良反应报告管理浅析与思考[J]. 中国药物警戒, 2023, 20(9): 975-977.
[14]	逄瑜, 刘博, 吕少俐, 王涛, 邢颖, 秦星宇, 田月洁, 吴文宇. 基于国际药物警戒经验探讨收集患者报告的意义[J]. 中国药物警戒, 2023, 20(9): 978-981.
[15]	刘文东, 崔欢欢, 王晓晗, 苏娴, 王海学. 我国儿童用药临床试验期间药物警戒监管体系现状及思考[J]. 中国药物警戒, 2023, 20(9): 1002-1006.