尼沃卢马布诱导的胆管炎的临床特征,治疗和结果
Yang He1,2, Zhiqiang Fan1, Wei Sun3
1Department of pharmacy, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China.
Immunopharmacology and immunotoxicology
|September 8, 2024
概括
尼沃卢马布诱导的胆管炎表现为腹部疼痛和发烧,通常与肝酶升高有关. 类固醇与ursodeoxycholic acid (UDCA) 结合治疗这种严重的免疫相关不良事件,显示出有前途.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 胆管炎是一种罕见但严重的不良反应,与nivolumab治疗有关.
- 尼沃卢马布诱导的胆管炎的临床特征尚未得到很好的定义.
- 这项研究旨在澄清这种疾病的临床病理学,成像和治疗特征.
研究的目的:
- 为了研究尼沃卢马布诱导的胆管炎的临床病理特征.
- 分析尼沃卢马布诱导的胆管炎患者的成像发现.
- 评估尼沃卢马布诱导的胆管炎的治疗策略和结果.
主要方法:
- 病例报告,病例系列和临床研究的回顾性分析.
- 在2017年1月1日至2023年12月31日期间,以中英两种数据库进行文献搜索.
- 包括38名被诊断患有尼沃卢马布诱导的胆管炎的患者.
主要成果:
- 胆管炎发作发生在尼沃卢马布服药后平均7个周期 (11天) 后.
- 常见的初始症状包括腹痛 (42.1%) 和发烧 (18.4%);15.8%无症状,肝酶升高.
- 观察到性酸酶和-氨基转移酶水平升高;活检显示CD8+炎症细胞透. 使用了全身类固醇和UDCA,其中63.2%的患者对单独使用类固醇反应不佳到中度.
- 总体而言,81.6%的患者在接受治疗后有所改善.
结论:
- 临床医生应保持对接受尼沃卢马布治疗的患者胆固醇形成的警,进行适当的评估和成像.
- 使用类固醇和ursodeoxycholic acid (UDCA) 的联合治疗可能对尼沃卢马布诱导的胆结炎有效,特别是当类固醇不足时.
- 早期识别和管理对于nivolumab诱导的胆管炎的良好结果至关重要.
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