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环孢素所致脱发:一例报告、美国食品药品监督管理局不良事件报告系统分析及文献评估

Cyclosporine-induced alopecia:a case report, FDA adverse event reporting system analysis and literature assessment.

作者信息

Wang Ying, Wang Youhong, Xu Ping

机构信息

Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha, China.

Institute of Clinical Pharmacy, Central South University, Changsha, China.

出版信息

Front Pharmacol. 2024 Aug 28;15:1453034. doi: 10.3389/fphar.2024.1453034. eCollection 2024.

DOI:10.3389/fphar.2024.1453034
PMID:39263573
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11387167/
Abstract

Cyclosporine is a potent immunosuppressive drug for various immune-mediated diseases in children. Cyclosporine's expected therapeutic effect also carries a wide range of side effects. One of the most common and intriguing dermatological side effects is hypertrichosis. However, recent reports have recognized alopecia as a potential adverse effect of cyclosporine. Here, we report a case of a 29-month-old boy diagnosed with aplastic anemia. During cyclosporine therapy, the patient presented with hair loss on the scalp, which and subsequently spread to the eyebrows and eyelashes. The alopecic symptoms were not relieved following topical minoxidil liniment interventions. When the cyclosporine was discontinued, a remarkable improvement was observed in the scalp, with complete hair regrowth. Data concerning cyclosporine from the FDA Adverse Event Reporting System (FAERS) database were extracted from January 2004 to January 2023. Within FAERS, our post-marketing pharmacovigilance analysis detected the reporting association of cyclosporine and alopecia. In monotherapy, cyclosporine-induced alopecia was observed in 118 cases, and tacrolimus-induced alopecia signals were detected in 197 cases. Although the potential mechanism of medication-induced hair loss is unclear, we identified a potential correlation between alopecia and cyclosporine, and it is still necessary to adequately recognize and clinically monitor this paradoxical reaction.

摘要

环孢素是一种用于治疗儿童各种免疫介导疾病的强效免疫抑制药物。环孢素预期的治疗效果也伴随着广泛的副作用。最常见且引人关注的皮肤副作用之一是多毛症。然而,最近的报告已认识到脱发是环孢素的一种潜在不良反应。在此,我们报告一例29个月大被诊断为再生障碍性贫血的男孩。在环孢素治疗期间,该患者出现头皮脱发,随后蔓延至眉毛和睫毛。局部外用米诺地尔搽剂干预后,脱发症状未缓解。停用环孢素后,头皮情况有显著改善,头发完全重新生长。从美国食品药品监督管理局不良事件报告系统(FAERS)数据库中提取了2004年1月至2023年1月有关环孢素的数据。在FAERS内,我们的上市后药物警戒分析检测到环孢素与脱发之间的报告关联。在单一疗法中,观察到118例环孢素引起的脱发,检测到197例他克莫司引起的脱发信号。尽管药物性脱发的潜在机制尚不清楚,但我们确定了脱发与环孢素之间的潜在相关性,充分认识并临床监测这种矛盾反应仍然很有必要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c506/11387167/2c76ea863b07/fphar-15-1453034-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c506/11387167/8481880e6599/fphar-15-1453034-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c506/11387167/b80492c9b5b4/fphar-15-1453034-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c506/11387167/2c76ea863b07/fphar-15-1453034-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c506/11387167/8481880e6599/fphar-15-1453034-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c506/11387167/b80492c9b5b4/fphar-15-1453034-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c506/11387167/2c76ea863b07/fphar-15-1453034-g003.jpg

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本文引用的文献

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European expert consensus statement on the systemic treatment of alopecia areata.欧洲斑秃系统性治疗专家共识声明。
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What causes aplastic anaemia?什么导致再生障碍性贫血?
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Alopecia Areata: Case report and review of pathophysiology and treatment with Jak inhibitors.斑秃:病例报告及对发病机制和使用JAK抑制剂治疗的综述
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