1例维迪西妥单抗联合卡度尼利单抗治疗晚期膀胱癌致免疫相关性肝炎的病例分析

doi:10.3969/j.issn.2095-1264.2024.04.03

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1例维迪西妥单抗联合卡度尼利单抗治疗晚期膀胱癌致免疫相关性肝炎的病例分析
DOI:
                        10.3969/j.issn.2095-1264.2024.04.03
                    
作者:
                        
                        
                    
作者单位:1.山西省肿瘤医院/中国医学科学院肿瘤医院山西医院/山西医科大学附属肿瘤医院 药学部，山西 太原，030013;2.山西医科大学 药学院，山西 太原，030001
作者简介:郭一萌，女，硕士，主管药师，研究方向：临床合理用药。
通讯作者:郝志英，女，硕士研究生导师，主任药师，研究方向：临床药学、医院药学管理。
中图分类号:R979.1;R737.14
基金项目:

Analysis of a case of immune-related hepatitis caused by disitamab vedotin combined with cadonilimab in the treatment of advanced bladder cancer

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Affiliation:

1.Department of Pharmacy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, 030013, Shanxi, China;2.School of Pharmacy, Shanxi Medical University, Taiyuan, 030001, Shanxi, China

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摘要:

目的分析维迪西妥单抗联合卡度尼利单抗致免疫相关性肝炎的不良反应，为临床合理、安全使用卡度尼利单抗和维迪西妥单抗提供参考。方法临床药师通过回顾1例晚期膀胱癌患者使用维迪西妥单抗联合卡度尼利单抗治疗导致免疫相关性肝炎的临床表现、诊治思路、治疗结局，对病例进行分析。结果经过糖皮质激素治疗后，患者转氨酶及胆红素水平恢复，免疫相关性肝炎分级降至1级以下。结论免疫相关性肝炎临床表现不典型，不及时处理可能导致生命危险，医生应根据临床症状及相关检查及时发现免疫相关性肝炎并给予早期治疗，以预防严重不良反应。

Abstract:

Objective To analyze a case of immune-related hepatitis induced by the combination treatment of disitamab vedotin and cadonilimab, in order to provide references for the safe and rational clinical use of these drugs.Methods The clinical pharmacists analyzed the clinical manifestations, diagnostic and therapeutic approach, and treatment outcomes of a patient with advanced bladder cancer who developed immune-related hepatitis following treatment with disitamab vedotin and cadonilimab.Results After treatment with glucocorticoid, the patient's aminotransferase and bilirubin levels recovered, and the immune-related hepatitis grade dropped below grade 1.Conclusion The clinical manifestations of immune-related hepatitis are atypical, and it may be life-threatening if not treated in time. Physicians should promptly identify immune-related hepatitis based on clinical symptoms and relevant tests to implement early intervention and prevent severe adverse reactions.