目的:探讨恩沃单抗(enfortumab vedotin,EV)皮肤药物不良反应(cutaneous adverse drug reac-tions,CADR)的发生规律和临床表现特点,为临床安全合理用药提供参考.方法:检索中国知网、万方、维普、Pubmed和Web of Science等数据库收载的EV相关CADR个案进行分析.结果:收集EV相关CADR个案报道15篇,共30例患者,其中男性28例,女性2例,年龄分布在59～78岁,CADR发生于用药后1～44 d.对于11例确诊中毒性表皮坏死综合征(Stevens-Johnson syndrome,SJS)或中毒性表皮坏死(toxic epidermal necrolysis,TEN)患者,主要病理特点是大量角化细胞坏死或凋亡,临床表现为全身大面积红斑及大疱,并累及口腔、眼睛、鼻子、生殖器等黏膜.而对于其他19例CADR患者,其临床表现和病理特点差异较大且不典型,严重者与SJS/TEN相似,而对于某些CADR较轻的患者仅表现为全身瘙痒伴皮疹.糖皮质激素是目前用于治疗EV引起CADR的主要药物,但是总体效果不佳,经治疗后仍有13例患者(43.3％)发生死亡.结论:临床应加强对EV引起CADR的认识和监测,及时诊断与治疗,确保用药安全.
Literature analysis of cutaneous adverse drug reactions induced by enfortumab vedotin
Objective:To investigate the regularity of cutaneous adverse drug reactions(CADR)and clinical features of enfortumab vedotin(EV)in order to provide reference for safe and rational drug use.Methods:Case reports of the CADR induced by EV were retrieved from the databases of CNKI,Wanfang,VIP,Pubmed,and Web of Science.Results:A total of 30 cases were reported in 15 studies,including 28 males and 2 females,aged from 59 to 78 years.The CADR occurred between days 1 and 44.In 11 patients diagnosed with toxic epidermal necrosis syndrome(SJS)or toxic epidermal necrosis(TEN),the main pathological feature was a large number of keratinocyte necrosis or apoptosis,and the clinical manifestations were large erythema and bullosa throughout the body,involving the mucous membranes of the mouth,eyes,nose and genitals.For the other 19 patients with CADR,the clinical manifestations and pathological characteristics were different and atypical,and the severe cases were similar to SJS/TEN,while some mild patients only showed systemic pruritus with rash.Glucocorticoids are currently the main drugs used to treat EV-induced CADR,but the overall effect is poor,and 13 patients(43.3％)died after treatment.Conclusion:It is necessary to strengthen the understanding and monitoring CADR induced by EV and timely perform diagnosis and treatment to ensure medication safety.
enfortumab vedotincutaneous adverse drug reactionsliterature analysis
NETL
NSTL
万方数据
