在非小细胞肺癌患者的EGFR-TKI相关间歇性肺病中PPI的影响
Haitao Wang1, Keyu Chen1, Sinan Ma1
1Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
质子抑制剂 (PPI) 与表皮生长因子受体氨酸激酶抑制剂 (EGFR-TKI) 结合,增加非小细胞肺癌 (NSCLC) 患者间歇性肺病 (ILD) 的风险. 密切监测ILD对于接受这些联合治疗的NSCLC患者至关重要.
科学领域:
- 在瘤学瘤学.
- 药物监督 药物监督 药物监督
- 肺部病理学 肺部病理学
背景情况:
- 以前的研究表明,表皮生长因子受体氨酸激酶抑制剂 (EGFR-TKI) 和间歇性肺部疾病 (ILD) 之间存在联系.
- 质子抑制剂 (PPI) 可能对EGFR-TKI相关的ILD风险产生差异影响.
- 美国食品和药物管理局的不良事件报告系统 (FAERS) 数据库被用于调查PPI和EGFR-TKI对ILD的联合影响.
研究的目的:
- 探索ILD与PPI和EGFR-TKI同时使用之间的潜在关联.
- 为了比较使用PPI与不使用PPI的非小细胞肺癌 (NSCLC) 患者中EGFR-TKI相关的ILD的发病率.
主要方法:
- 对FAERS数据库报告从2016年第一季度到2023年第四季度的回顾性分析.
- 应用了不成比例分析,通用线性模型和调整的多变量逻辑回归.
- 在接受与EGFR-TKI同时服用PPI的NSCLC患者中ILD发生率的评估.
主要成果:
- 对于PPI和EGFR-TKIs的组合,观察到1.84 (95% CI 1.54-2.19) 的统计学上显著增加的报告几率比率 (ROR).
- 添加和乘法模型,以及调整的多变量分析 (aOR 1.77,95% CI 1.42-2.19),显示ILD风险显著增加 (p < 0.001).
- 特定的PPI (兰索普拉,埃索梅普拉) 和EGFR-TKIs (osimertinib,gefitinib) 在结合时显示ILD风险较高,超过单独治疗的风险.
结论:
- 与EGFR-TKI单独治疗相比,与特定EGFR-TKI一起使用某些PPI会增加NSCLC患者的ILD风险.
- 不同的PPI和EGFR-TKIs在组合使用时对ILD风险产生不同的影响.
- 对于接受这些药物组合治疗的NSCLC患者,建议对ILD进行仔细监测.
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