Literature Analysis of Adverse Drug Reactions Induced by Nivolumab
Objective To provide a reference for timely identification and response of adverse drug reactions(ADRs)induced by nivolumab.Methods The case reports of ADRs induced by nivolumab in the PubMed,CNKI,WanFang and VIP from the inception of these databases to December 2021 were searched.The clinical information on patients with ADRs(including patients′ general data,primary disease,dosage of nivolumab,occurrence time of ADRs,involved systems/organs,clinical manifestations,final outcomes)was summarized and analyzed.Results A total of 600 studies were included,involving 649 patients(679 case times of ADRs),including 444 males(68.41%)and 205 females(31.59%),with the mean age of(63.41±12.63)years.The primary disease of patients was mainly non-small cell lung cancer(219 cases,33.74%),followed by melanoma(203 cases,31.28%).A total of 505 cases(77.81%)were treated with nivolumab monotherapy,with four and 59 cases receiving the higher and lower dosages than requirements of the drug instructions respectively,and 144 cases(22.19%)were treated with nivolumab combined with other drugs.ADRs mainly occurred within six months after medication,mainly involving the endocrine system(105 case times),nervous system(95 case times),skin and its appendages(84 case times).Eight case times of ADRs(1.18%)showed the clinical symptoms that relieved spontaneously,576 case times(84.83%)showed improved clinical symptoms after symptomatic treatment,72 case times were fatal(10.60%,mainly involving the cardiovascular system,neural system,musculoskeletal system).Conclusion Males and patients aged 60 to 79 years are more likely to suffer from ADRs after using nivolumab,and most of ADRs occur within six months after medication.The ADRs involve many systems and are mostly mild,which can improved after clinical treatment.However,myocarditis,myasthenia gravis,myositis,transplantation rejection and immune-associated pneumonia should be paid more attention to prevent fatal ADRs.
nivolumabadverse drug reactionliterature analysisprogrammed death-1 inhibitor
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