乌司奴单抗致脓疱型银屑病文献病例分析
Literature Case Analysis of Ustekinumab-Related Pustular Psoriasis
李芸 1朱濛昕 2谢诚 1朱建国 1缪丽燕1
作者信息
- 1. 苏州大学附属第一医院,药学部,江苏苏州 215000
- 2. 苏州大学附属第一医院 消化内科,江苏苏州 215000
- 折叠
摘要
目的 探讨和分析乌司奴单抗(ustekinumab,UST)导致脓疱型银屑病(pustular psoriasis,PP)的发生情况和特点,为临床安全用药提供参考.方法 检索建库至2023年12月收录在PubMed、Embase、中国知网、万方和维普期刊数据库有关UST致PP的病例报道并对其进行整理和分析.结果 共纳入8篇文献共计8例患者,其中男3例(37.50％),女5例(62.50％),年龄(30～58)岁.发生PP的时间为UST首次治疗后2 d～10周,其中4例(50.00％)发生在第1次注射后.病变部位包括躯干(50.00％)、四肢(37.50％)、后背(12.50％)、手掌(50.00％)、脚底(25.00％)、头皮(12.50％).病变表现为散在红斑、脱落斑块或鳞片、散在脓疱,伴或不伴有炎症、疼痛、瘙痒.预后较好,5例(62.50％)患者在停药后采用免疫抑制剂、糖皮质激素等治疗后快速好转,总治疗周期为1～8周.未停用患者亦全部好转,但再次发生脓疱性病变概率较高(66.67％).结论 临床在使用UST的过程中应意识到其可能导致银屑病(psoriasis,PsA),尤其是PP.通过收集药物治疗史,明确时间关系,确定其他可能的触发因素,借助临床症状以及病理组织学检查,准确诊断.必要时及时停药或调整治疗方案,以确保用药安全.
Abstract
OBJECTIVE To explore and analyze the occurrence of pustular psoriasis caused by ustekinumab in order to provide references for clinical safety drug use.METHODS The case report of ustekinumab-induced pustular psoriasis published in PubMed,Embase,CNKI,Wanfang and VIP were searched for statistical analysis from the establishment of each database to December 2023.RESULTS A total of 8 patients were included in 8 literatures,including 3 males(37.50％)and 5 females(62.50％),aged from 30 to 58 years.Pustular psoriasis occurred 2 days to 10 weeks after the first treatment with ustekinumab,of which 4 cases(50.00％)occurred after the first injection.The lesions include trunk(50.00％),limbs(50.00％),back(12.50％),palm(50.00％),sole of foot(25.00％)and scalp(12.50％).The lesions are scattered in red spots,exfoliated plaques or scales,scattered in pustules,with or without inflammation,pain and pruritus.The prognosis was good.Five patients(62.50％)got better quickly after treatment with immunosuppressive agents and glucocorticoids after drug withdrawal.The total treatment cycle was 1-8 weeks.All the patients who did not stop treatment also improved,but the probability of contradictory pustular lesions occurring again was high(66.67％).CONCLU-SION In the process of clinical use of ustekinumab,the potential psoriasis,especially pustular psoriasis should be realized.By col-lecting the drug treatment history,clarifying the time relationship,identifying other possible triggering factors,and making accurate di-agnosis with the help of clinical symptoms and histopathological examination.If necessary,stop the drug or adjust the treatment plan in time to ensure drug safety.
关键词
乌司奴单抗/不良反应/脓疱型银屑病/文献病例分析Key words
ustekinumab/adverse reaction/pustular psoriasis/literature case analysis引用本文复制引用
基金项目
江苏省药学会奥赛康医院药学基金(A202115)
出版年
2024
NETL
NSTL
万方数据