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乌帕替尼治疗重度特应性皮炎后出现的带状疱疹和静脉血栓栓塞

Herpes Zoster and Venous Thromboembolism Following Upadacitinib Treatment for Severe Atopic Dermatitis.

作者信息

Aoki Kawaiola Cael, Burnette Colin, Bartos Simona

机构信息

Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA.

Dermatology, Imperial Dermatology, Hollywood, USA.

出版信息

Cureus. 2024 Oct 7;16(10):e71007. doi: 10.7759/cureus.71007. eCollection 2024 Oct.

DOI:10.7759/cureus.71007
PMID:39507180
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11539937/
Abstract

New medications targeting the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway have been developed through emerging biologics research. However, due to documented adverse effects, including herpes zoster (HZ) and venous thromboembolism (VTE), an extensive patient workup and counseling are necessary before prescribing. We present the case of an 81-year-old patient with severe atopic dermatitis on upadacitinib, a selective JAK1 inhibitor, who developed HZ and VTE, requiring hospitalization. This study emphasizes the need for further research, continuous monitoring, and risk management for HZ and VTE in patients undergoing upadacitinib treatment, especially in high-risk populations.

摘要

通过新兴的生物制品研究，已经开发出了针对Janus激酶（JAK）-信号转导子和转录激活子（STAT）通路的新型药物。然而，由于已记录的不良反应，包括带状疱疹（HZ）和静脉血栓栓塞（VTE），在开处方前需要对患者进行全面检查和咨询。我们报告了一例81岁患有重度特应性皮炎的患者，使用选择性JAK1抑制剂乌帕替尼治疗后发生了HZ和VTE，需要住院治疗。本研究强调了对接受乌帕替尼治疗的患者，尤其是高危人群，进行HZ和VTE进一步研究、持续监测和风险管理的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ae1/11539937/7472dfd47468/cureus-0016-00000071007-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ae1/11539937/eb4884926031/cureus-0016-00000071007-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ae1/11539937/5fb3e49ef7c6/cureus-0016-00000071007-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ae1/11539937/0b43ebd7aadc/cureus-0016-00000071007-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ae1/11539937/00f18e14b7e2/cureus-0016-00000071007-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ae1/11539937/7472dfd47468/cureus-0016-00000071007-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ae1/11539937/eb4884926031/cureus-0016-00000071007-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ae1/11539937/5fb3e49ef7c6/cureus-0016-00000071007-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ae1/11539937/0b43ebd7aadc/cureus-0016-00000071007-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ae1/11539937/00f18e14b7e2/cureus-0016-00000071007-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ae1/11539937/7472dfd47468/cureus-0016-00000071007-i05.jpg

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本文引用的文献

1
Long-term Effectiveness and Safety of Upadacitinib for Atopic Dermatitis in a Real-world Setting: An Interim Analysis Through 48 Weeks of Observation.在真实环境中乌帕替尼治疗特应性皮炎的长期疗效和安全性：观察 48 周的中期分析。
Am J Clin Dermatol. 2023 Nov;24(6):953-961. doi: 10.1007/s40257-023-00798-0. Epub 2023 Jun 15.
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Safety profile of upadacitinib in patients at risk of cardiovascular disease: integrated post hoc analysis of the SELECT phase III rheumatoid arthritis clinical programme.在有心血管疾病风险的患者中，upadacitinib 的安全性特征：SELECT Ⅲ期类风湿关节炎临床项目的事后综合分析。
Ann Rheum Dis. 2023 Sep;82(9):1130-1141. doi: 10.1136/ard-2023-223916. Epub 2023 Jun 12.
3
Venous thromboembolism with JAK inhibitors and other immune-modulatory drugs: a Swedish comparative safety study among patients with rheumatoid arthritis.
静脉血栓栓塞症与 JAK 抑制剂和其他免疫调节药物：一项在类风湿关节炎患者中进行的瑞典比较安全性研究。
Ann Rheum Dis. 2023 Feb;82(2):189-197. doi: 10.1136/ard-2022-223050. Epub 2022 Sep 23.
4
Efficacy and Safety of Upadacitinib in Patients With Moderate to Severe Atopic Dermatitis: Analysis of Follow-up Data From the Measure Up 1 and Measure Up 2 Randomized Clinical Trials.度普利尤单抗治疗中重度特应性皮炎的疗效和安全性：来自两项随机临床试验 MEASURE UP 1 和 MEASURE UP 2 的随访数据分析。
JAMA Dermatol. 2022 Apr 1;158(4):404-413. doi: 10.1001/jamadermatol.2022.0029.
5
A phase 3 randomized, multicenter, double-blind study to evaluate the safety of upadacitinib in combination with topical corticosteroids in adolescent and adult patients with moderate-to-severe atopic dermatitis in Japan (Rising Up): An interim 24-week analysis.一项在日本开展的3期随机、多中心、双盲研究，旨在评估乌帕替尼联合外用皮质类固醇激素治疗中度至重度特应性皮炎青少年及成年患者的安全性（Rising Up）：一项24周中期分析。
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6
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Dermatol Ther. 2021 Mar;34(2):e14890. doi: 10.1111/dth.14890. Epub 2021 Feb 23.
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Safety profile of upadacitinib in rheumatoid arthritis: integrated analysis from the SELECT phase III clinical programme.在类风湿关节炎中使用 upadacitinib 的安全性概况：SELECT 三期临床项目的综合分析。
Ann Rheum Dis. 2021 Mar;80(3):304-311. doi: 10.1136/annrheumdis-2020-218510. Epub 2020 Oct 28.
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