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免疫检查点抑制剂诱导的胰腺炎:系统性审查和现实世界的药监测分析
Wei Fang1, Huanping Wang1, Xiaoran Zhang2
1Department of Endocrinology, Chengdu Shuangliu Hospital of Traditional Chinese Medicine, Chengdu, China.
免疫检查点抑制剂可以导致胰腺炎,特别是PD-1抑制剂. 虽然经常严重,但这种情况通常是可逆的类固醇治疗,尽管复发是可能的.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗.
- 免疫检查点抑制剂诱导的胰腺炎 (ICIs-P) 是一种罕见但严重的免疫相关不良事件.
- 关于ICI-P的现有文献主要包括案例报告和评论,缺乏全面的全球视角.
研究的目的:
- 调查ICI-P的临床特征和管理.
- 为ICI-P提供基于实践的全球视角.
- 使用药监数据分析与ICI治疗相关的胰腺炎风险.
主要方法:
- 对五个电子数据库进行系统审查.
- 使用OpenVigil 2.1对美国FDA不良事件报告系统 (FAERS) 数据库的不成比例分析.
- 包括来自58项研究的61名患者进行临床特征分析.
主要成果:
- 大多数ICI-P患者是男性 (60.7%) 并接受抗PD-1/PD-L1单疗法 (78.7%).
- 胰腺炎发病的中位时间为108天;64.0%的病例严重 (G3-G4).
- FAERS数据显示,606份炎报告与ICI相关,PD-1抑制剂显示Cemiplimab,Pembrolizumab和Nivolumab的特殊关联和高风险信号.
结论:
- 药监数据表明,ICI治疗,特别是PD-1抑制剂的胰腺炎风险增加.
- 风险因素和ICI-P的诊断仍然具有挑战性,呈现为无症状酶升高或临床胰腺炎.
- 皮质类固醇是主要治疗方法,建议逐渐减少剂量以防止复发;ICI-P在大多数情况下 (83.6%) 是可逆的.
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