Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA.
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Arch Dermatol Res. 2023 Oct;315(8):2347-2350. doi: 10.1007/s00403-023-02623-4. Epub 2023 Apr 12.
A major side effect of anti-neoplastic immunotherapy is the onset of dermatologic toxicities following the administration of several different immunotherapy drugs. We sought to assess the incidence and mortality of anti-neoplastic immunotherapy-associated dermatologic toxicities using a nationally representative sample of United States (US) adults. The National Inpatient Sample database was queried for encounters undergoing anti-neoplastic immunotherapy. Multiple logistic regression models were constructed to analyze incidence of dermatologic toxicity and associated mortality as well as calculate adjusted odds ratios (aOR) after controlling for age, race, sex, household income, and cancer type. Immunotherapy patients demonstrated greater odds of developing pruritus (aOR = 7.59; 95% CI 5.17-11.2; P < 0.001), rash (aOR = 2.81; 95% CI 2.00-3.94, P < 0.001), generalized (aOR = 5.32; 95% CI 3.35-8.43; P < 0.001) and localized (aOR = 2.67; 95% CI 1.01-7.05; P < 0.001) skin eruptions, and vitiligo (aOR = 13.3; 95% CI 5.15-34.4; P < 0.001) compared to patients who did not receive anti-neoplastic immunotherapy. There were no significant differences observed in incidence of non-scarring alopecia (P = 0.7), psoriasis (P = 0.094), and dermatitis (P = 0.9) between the two groups. Patients who underwent immunotherapy were more likely to develop dermatologic toxicity (aOR = 3.93; 95% CI 3.12-4.94; P < 0.001), however, no significant differences in mortality were observed. Patients undergoing anti-neoplastic immunotherapy have an increased risk of developing dermatologic toxicity compared to patients who did not receive anti-neoplastic immunotherapy.
抗肿瘤免疫治疗的一个主要副作用是在使用几种不同的免疫治疗药物后出现皮肤科毒性。我们试图使用美国成年人的全国代表性样本评估抗肿瘤免疫治疗相关皮肤科毒性的发生率和死亡率。国家住院患者样本数据库被查询以进行接受抗肿瘤免疫治疗的就诊。构建了多个逻辑回归模型来分析皮肤科毒性的发生率和相关死亡率，并在控制年龄、种族、性别、家庭收入和癌症类型后计算调整后的优势比（aOR）。免疫治疗患者出现瘙痒（aOR=7.59；95%CI 5.17-11.2；P<0.001）、皮疹（aOR=2.81；95%CI 2.00-3.94，P<0.001）、全身性（aOR=5.32；95%CI 3.35-8.43；P<0.001）和局限性（aOR=2.67；95%CI 1.01-7.05；P<0.001）皮肤疹和白癜风（aOR=13.3；95%CI 5.15-34.4；P<0.001）的可能性高于未接受抗肿瘤免疫治疗的患者。两组患者在非瘢痕性脱发（P=0.7）、银屑病（P=0.094）和皮炎（P=0.9）的发生率方面无显著差异。接受免疫治疗的患者发生皮肤科毒性的可能性更高（aOR=3.93；95%CI 3.12-4.94；P<0.001），但死亡率无显著差异。与未接受抗肿瘤免疫治疗的患者相比，接受抗肿瘤免疫治疗的患者发生皮肤科毒性的风险增加。
