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纳武单抗诱发银屑病的临床特征、治疗及转归

Clinical features, treatment, and outcomes of nivolumab induced psoriasis.

作者信息

Zhao Shaoli, Sun Wei, Sun Jichun, Peng Liping, Wang Chunjiang

机构信息

Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China.

College of Pharmacy, Changsha Medical University, Changsha, Hunan, 410219, China.

出版信息

Invest New Drugs. 2025 Feb;43(1):42-49. doi: 10.1007/s10637-024-01494-4. Epub 2024 Dec 26.

Abstract

Psoriasis is an uncommon immune-mediated adverse event linked to nivolumab, and its clinical characteristics remain inadequately defined. This study aims to investigate the clinical features and patterns of nivolumab-induced psoriasis, providing insights for the identification and management of this condition. Case reports and case series of nivolumab related psoriasis were gathered by searching Chinese and English databases for retrospective analysis until June 30, 2024. A total of fifty-five patients (80.0% male) were included, with a median age of 65 years (range 41, 89). Among these, thirty-eight (69.1%) patients experienced new-onset psoriasis, while 17 (30.9%) patients exhibited exacerbation of pre-existing psoriasis. The median time to onset of psoriasis was 28 days (range 3, 360). The predominant clinical types identified were plaque psoriasis (65.5%), psoriatic arthritis (20.0%) and palmoplantar psoriasis (16.4%). Twenty-five (45.5%) patients discontinued nivolumab, whereas 19 (34.5%) patients continued the treatment. Following clinical intervention, 52 (94.5%) patients reported symptom improvement. It is crucial to closely monitor patients receiving nivolumab for the emergence of psoriasis to ensure timely identification and diagnosis. Those diagnosed with psoriasis should be provided with appropriate treatment, whether topical or systemic, tailored to their specific clinical circumstances.

摘要

银屑病是一种与纳武利尤单抗相关的罕见免疫介导不良事件,其临床特征仍未得到充分界定。本研究旨在调查纳武利尤单抗诱导的银屑病的临床特征和模式,为该病症的识别和管理提供见解。通过检索中英文数据库收集纳武利尤单抗相关银屑病的病例报告和病例系列进行回顾性分析,直至2024年6月30日。共纳入55例患者(男性占80.0%),中位年龄为65岁(范围41至89岁)。其中,38例(69.1%)患者出现新发银屑病,17例(30.9%)患者原有银屑病病情加重。银屑病发病的中位时间为28天(范围3至360天)。确定的主要临床类型为斑块状银屑病(65.5%)、银屑病关节炎(20.0%)和掌跖银屑病(16.4%)。25例(45.5%)患者停用了纳武利尤单抗,而19例(34.5%)患者继续治疗。经过临床干预后,52例(94.5%)患者报告症状改善。密切监测接受纳武利尤单抗治疗的患者是否出现银屑病至关重要,以确保及时识别和诊断。被诊断为银屑病的患者应根据其具体临床情况接受适当的局部或全身治疗。

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