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目的 分析免疫检查点抑制剂（ICIs）引发免疫相关皮肤不良反应（ircAEs）的影响因素，为临床ICIs的个体化用药提供依据。方法 纳入2021年12月至2023年12月接受ICIs治疗的病例共379例，其中有79例发生了ircAEs，作为ircAEs组，未发生ircAEs的病例300例，作为无ircAEs组。收集病例的性别、年龄、肿瘤类型、ircAEs临床表现、治疗方案、既往史、个人史和实验室检查结果，分析ircAEs发生的影响因素。结果 ircAEs组中男性46例（占58.2%），女性33例（占41.8%），年龄（60.53±11.18）岁；无ircAEs组中男性228例（占76.0%），女性72例（占24.0%），年龄（58.5±11.57）岁。ircAEs组年龄为61～70岁的病例有28例（占35.4%）。ircAEs最常见临床表现为皮疹（占39.2%），其次为皮疹伴瘙痒（占21.5%）。二元Logistic回归分析显示，性别、治疗方案和肿瘤类型是ircAEs发生的独立危险因素。结论 性别、治疗方案和肿瘤类型是ircAEs发生的影响因素，女性、患有结直肠癌和胆道癌、治疗方案为ICIs联合靶向药物的患者更易发生ircAEs。ircAEs的临床表现以皮疹和皮疹伴瘙痒为主。临床在使用ICIs时应重点关注存在上述影响因素的患者，减少或避免ircAEs的发生。
Abstract：AIM To analyze the impact factors of immune-related cutaneous adverse effects(ircAEs) induced by immune checkpoint inhibitors(ICIs), and to provide a basis for the personalized medication of ICIs in clinical practice. METHODS A total of 379 patients treated with ICIs from December 2021 to December 2023 were included.Among them, 79 patients with ircAEs were assigned to the ircAEs group, and 300 patients without ircAEs were assigned to the non-ircAEs group. The gender, age, tumor type, clinical manifestations of ircAEs, treatment regimen, previous medical history, personal history and laboratory examination results were collected to analyze the influencing factors of ircAEs. RESULTS In the ircAEs group, there were 46 males(58.2%) and 33 females(41.8%), with an average age of(60.53±11.18) years. In the group without ircAEs, there were 228 males(76.0%) and 72 females(24.0%), with an average age of(58.5±11.57) years. There were 28 patients(35.4%) aged 61-70 years in the ircAEs group. The most common clinical manifestation of ircAEs was rash(39.2%), followed by rash with itching(21.5%). Binary Logistic regression analysis revealed that gender, treatment regimen, and tumor type were independent risk factors for the occurrence of ircAEs. CONCLUSION Gender, therapeutic regimen, and tumor type emerge as significant predictors of ircAEs. Female patients and those diagnosed with colorectal or biliary tract cancers, particularly when treated with a combination of ICIs and targeted therapies, exhibit a higher propensity for developing ircAEs. The predominant clinical presentations of ircAEs include rash and rash with itching. Therefore, in the clinical administration of ICIs, it is essential to maintain a heightened level of surveillance in patients with the aforementioned risk factors to prevent or reduce the occurrence of ircAEs.
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基本信息:
DOI：10.19577/j.1007-4406.2024.11.003
中图分类号:R979.1
引用信息:
[1]吴相雷,邹稼宇,王慧,等.免疫检查点抑制剂致免疫相关皮肤不良反应的影响因素分析[J].中国临床药学杂志,2024,33(11):813-818.DOI:10.19577/j.1007-4406.2024.11.003.
2024-11-25
2024-11-25