度普利尤单抗致眼部相关不良反应文献分析
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篇名: 度普利尤单抗致眼部相关不良反应文献分析
TITLE: Literature analysis of ocular adverse drug reactions related to dupilumab
摘要: 目的 分析度普利尤单抗致眼部相关不良反应(ADR)的临床表现和特点,为临床安全用药提供参考。方法检索中国知网、万方数据、维普网、PubMed,收集度普利尤单抗致眼部相关ADR的案例报道,对报告涉及的患者性别、年龄、原患疾病、用药情况、ADR发生时间、主要临床表现、治疗及转归等进行统计分析。结果共纳入文献20篇,涉及患者46例,其中男性29例,女性17例,年龄以60岁以下为主。关联性评价结果为“很可能”13例、“可能”33例。所有患者均为使用度普利尤单抗治疗特应性皮炎(AD),无超适应证用药情况。ADR发生时间为用药后2周~2年,以用药后6个月内为主;除3例合并高血压、1例合并慢性阻塞性肺疾病及人类免疫缺陷病毒感染患者同时使用了其他药物外,其余患者均为单用度普利尤单抗。有28例患者有过敏性疾病史,11例有眼部疾病史;眼部相关ADR以结膜炎、葡萄膜炎为主,临床表现主要为结膜充血、肿胀、眼部分泌物等;10例患者发生严重的ADR,包括葡萄膜炎、严重程度的结膜炎及泪点狭窄。45例患者经对症治疗后好转。AD、AD初始症状较重、有过敏性疾病史及眼部基础疾病史可能是度普利尤单抗致眼部相关ADR的高危因素。结论临床使用度普利尤单抗前应详细询问患者的过敏性疾病史和眼部基础疾病史,使用时应注意监测患者是否有发生眼内炎症的风险,同时警惕新的、严重的ADR发生,一旦发生ADR应及时给予对症治疗,以保障患者用药安全。
ABSTRACT: OBJECTIVE To analyze the clinical manifestation and characteristics of ocular adverse drug reaction (ADR) related to dupilumab, so as to provide reference for clinically safe drug use. METHODS Retrieved from CNKI, Wanfang data, VIP and PubMed databases, the case reports about ocular ADR caused by dupilumab were collected, and then analyzed statistically in terms of gender, age, primary disease, drug use, occurrence time of ADR, main clinical manifestations, treatment or outcome, etc. RESULTS A total of 20 pieces of literature were selected, involving 46 patients, among which there were 29 males and 17 females. Mainly patients were under 60 years old. The results of the association evaluation was given as follows: 13 were “very likely” and 33 were “likely”. All patients were treated with dupilumab for atopic dermatitis (AD) without off-label medication. The occurrence time of ADR was 2 weeks to 2 years after administration, mainly within 6 months after medication. All patients received dupilumab monotherapy except that 3 patients with hypertension and 1 patient with chronic obstructive pulmonary disease and human immunodeficiency virus received other drugs simultaneously. Twenty-eight patients had a history of allergic disease, and 11 patients had a history of eye disease. Ocular ADRs were mainly conjunctivitis and uveitis, and the clinical manifestations mainly included conjunctival congestion, swelling, eye secretions, etc. Ten patients developed severe ADR, including uveitis, severe conjunctivitis, and tear point stenosis; 45 patients were improved after symptomatic treatment. AD, serious initial symptoms of AD, allergic disease and underlying ocular diseases might be the high-risk factors of ocular ADR caused by dupilumab. CONCLUSIONS Whether the patient has the history of allergic diseases and basic eye diseases should be asked in detail before clinical use of dupilumab. When using the drug, attention should be paid to monitoring whether the patient has intraocular inflammation, be alert to the occurrence of new or serious ADR, and give timely symptomatic treatment to ensure the safety of drug use.
期刊: 2023年第34卷第14期
作者: 付子仪;谢婷婷;郭代红
AUTHORS: FU Ziyi,XIE Tingting,GUO Daihong
关键字: 度普利尤单抗;视网膜炎;葡萄膜炎;眼部不良反应;文献分析
KEYWORDS: dupilumab; retinitis; uveitis; ocular adverse drug reaction; literature analysis
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