中国药业2023，Vol.32Issue(24)：145-149,5.DOI:10.3969/j.issn.1006-4931.2023.24.034
特瑞普利单抗致肝损伤伴甲状腺功能减退的处理及监护
Pharmaceutical Care of Hepatic Injury Complicated with Hypothyroidism Induced by Toripalimab
摘要
Abstract
Objective To promote the safe use of programmed death-1(PD-1)inhibitors in clinical practice.Methods Clinical pharmacists participated in the medication monitoring of the nasopharyngeal carcinoma patient who diagnosed with hypothyroidism and immune-mediated hepatitis simultaneously after receiving toripalimab.Based on the patient's medication history and past history,the association of toripalimab with hypothyroidism and hepatic injury was determined by the Naranjo's adverse drug reaction(ADR)evaluation scale after pharmaceutical consultation.Based on the outcome of ADRs,clinical pharmacists suggested that physicians adjust the dosage of levothyroxine sodium to improve thyroid function,continue to use drugs for hepatitis B virus,add methylprednisolone,and adjust the hepatoprotective medication regimen.Results It was determined that the patient's hypothyroidism and hepatic injury were ″likely″ related to toripalimab(the Naranjo's ADR evaluation scale score was six points).The physicians adopted some suggestions of the clinical pharmacists,and then the patient's hypothyroidism symptoms were controlled,and the hepatic enzyme level returned to normal.Conclusion Currently,multi-organ immune ADRs induced by toripalimab were rare and serious in China.Clinical pharmacists should provide full monitoring for patients using new anti-tumor drugs such as PD-1 inhibitors,timely evaluate ADRs and provide pharmaceutical suggestions,assist physicians in perfecting treatment regimens to improve the safety and effectiveness of clinical application of new anti-tumor drugs.关键词
特瑞普利单抗/程序性死亡受体-1抑制剂/免疫相关不良事件/甲状腺功能减退/免疫性肝炎Key words
toripalimab/programmed death-1 inhibitor/immune-related adverse event/hypothyroidism/immune-mediated hepatitis分类
医药卫生引用本文复制引用
张冠英,黄立峰,徐银丽,陶霞,王志鹏,汪路遥,伊佳..特瑞普利单抗致肝损伤伴甲状腺功能减退的处理及监护[J].中国药业,2023,32(24):145-149,5.基金项目
上海市临床药学重点专科建设项目[2016-40044-002] （）
上海市卫生健康委员会科研项目[20214Y0319] （）
长征医院人才建设三年行动计划——金字塔人才工程. （）
