Sumimoto Takahiro, Tanaka Ryota, Shiraiwa Ken, Tatsuta Ryosuke, Itoh Hiroki
Department of Clinical Pharmacy, Oita University Hospital, Oita, Japan.
J Clin Pharm Ther. 2022 Apr;47(4):552-555. doi: 10.1111/jcpt.13541. Epub 2021 Oct 20.
Clinical cases of attenuation of opioid analgesic effect by administration of immune checkpoint inhibitors has not been reported. We present a case of head and neck cancer under pain management with opioids, in which cancer pain was exacerbated after administration of nivolumab.
A male patient with head and neck cancer was hospitalized for the second-line treatment of nivolumab. He had complained of head and neck pain after admission, but the pain was especially worse after nivolumab administration. The dose of opioids was eventually increased by approximately 320% (morphine equivalent dose) compared to before administering nivolumab.
When administering immune checkpoint inhibitors such as nivolumab in clinical practice, the possibility of attenuation of opioid analgesic effect should be considered.
尚未有关于使用免疫检查点抑制剂导致阿片类镇痛效果减弱的临床病例报道。我们报告一例接受阿片类药物进行疼痛管理的头颈癌患者，其在使用纳武单抗后癌痛加剧。
一名头颈癌男性患者因纳武单抗二线治疗入院。入院后他一直主诉头颈疼痛，但在使用纳武单抗后疼痛尤其加重。与使用纳武单抗前相比，阿片类药物剂量最终增加了约320%（吗啡当量剂量）。
在临床实践中使用纳武单抗等免疫检查点抑制剂时，应考虑阿片类镇痛效果减弱的可能性。
