免疫检查点抑制剂与消化系统炎症不良反应之间的关联:来自药物监测分析和系统审查的证据
Ya Zou1, Qinchuan Li1, Lu Zhou1
1Department of Clinical Pharmacology, Chengdu Second People's Hospital, Chengdu, China.
Frontiers in pharmacology
|November 12, 2025
概括
像PD-1抑制剂这样的免疫检查点抑制剂 (ICI) 与上肠道和肝脏炎症有关,而CTLA-4抑制剂会增加肠球炎的风险. 对这些ICI特定风险的认识对于患者管理至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 调节癌症治疗的免疫系统.
- 在不同ICI类别中对消化系统炎症不良反应的真实数据有限.
- 与免疫相关的Sjögren综合征/腹肌炎的证据主要来自病例报告.
研究的目的:
- 通过使用现实世界的数据,评估ICI和消化炎性不良反应之间的关联.
- 通过系统性审查,识别ICI相关的Sjögren综合征/腹肌炎的已发表病例.
主要方法:
- 对FDA不良事件报告系统 (FAERS) 数据库 (2015-2023) 的不成比例分析.
- 对于ICI相关的Sjögren综合征/肌炎,系统性文献审查至2025年7月.
主要成果:
- PD-1 抑制剂与免疫媒介食道炎和胃炎有很强的关联.
- 布罗利祖马布与肝胆事件 (胆管炎,肝炎) 有很高的相关性.
- CTLA-4 抑制剂 (ipilimumab) 对免疫媒介肠道炎的信号最强;阿特佐利祖马布和伊皮利穆马布与自发性细菌周周炎有关.
- 确定了93例ICI相关的Sjögren综合征/腹肌炎,主要是在服用PD-1抑制剂的黑色素瘤/肺癌患者中.
结论:
- PD-1 抑制剂与上部肠道和肝胆道反应更为相关;CTLA-4 抑制剂携带更高的肠球炎风险.
- 特定于ICI的监测协议和量身定制的管理 (例如皮质类固醇) 是必不可少的.
- 临床医生应该怀疑罕见的反应,如sianladenitis和个性化ICI治疗的风险和益处评估.
关键词:
ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI IC1 ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI ICI IC1 IC1 IC1 IC1 IC2 IC1 IC1 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 IC2 which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which which数据挖掘是数据挖掘的一个方法.消化系统炎症性不良反应药物监督和药物监督黄体炎是一种黄体炎.更多相关视频
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