摘要
目的评价利妥昔单抗(RTX)在视神经脊髓炎谱系疾病(NMOSD)和多发性硬化(MS)缓解期预防疾病复发治疗中的安全性。方法对127例NMOSD患者和27例MS患者(共533例次)RTX应用的输液相关不良反应(IRR)和输液后3个月内的后续不良反应进行回顾性分析。结果NMOSD患者127例中67例(52.8%),27例MS患者中12例(44.4%),共出现190例次IRR(占输注总例次的35.6%)。最常见的IRR为咽部不适感(咽痒、咽干、咽部异物感、咽部紧缩感等)共90例次(占IRR总例次数的47.4%),其他常见IRR还包括胸闷31例次(16.3%)、皮疹33例次(17.4%)等,持续时间为3 min~7 d,多数通过减慢输液速度可获缓解。输液后3个月内19例(15.0%)NMOSD患者和2例(7.41%)MS患者出现40例次输液后续不良反应,常见者包括感觉障碍10例次(25.0%),肺部感染7例次(17.5%),斑疹/斑丘疹、发热及荨麻疹各5例次(12.5%),其中因严重肺部感染、呼吸衰竭死亡1例。结论RTX的IRR发生率较高,但程度较轻,多可通过减慢输液速度来缓解症状。输液后有发生严重肺部感染的可能,应用前需评估感染风险,发生后及时处理。
Objective To evaluate the safety of rituximab(RTX)in neuromyelitis optica spectrum disorders(NMOSD)and multiple sclerosis(MS)as preventing therapy in remission phase.Methods One handred and twenty weven patients with NMOSD and 27 patients(533 infusions in total)who have been treated with RTX were included.Infusion-related reaction(IRR)and post-infusion adverse events(AEs)within 3 months were analyzed retrospectively.Results IRR occurred in 67 patients(52.8%)with NMOSD and 12 patients(44.4%)with MS,involving 190 infusions,accounting for 35.6%of total infusions.The most common IRR was pharyngeal discomfort(itching,drying,foreign body sensation,austerity,etc)(90 infusions,47.4%),other common IRRs included chest stuffiness(31 infusions,16.3%),rash(33 infusions,17.4%),etc.IRRs lasted for 3 minutes to 7 days and were mostly relieved by slowing the rate of infusion.Nineteen patients(15.0%)with NMOSD and 2 patients(7.4%)with MS experienced post-infusion AEs,involving 40 infusions.Common post-infusion AEs included sensory disorder(10 infusions,25.0%),pulmonary infection(7 infusions,17.5%),macula/maculopapule(5 infusions,12.5%),fever(5 infusions,12.5%),and urticaria(5 infusions,12.5%).One patient died of severe pulmonary infection and respiratory faliure.Conclusions The IRR of RTX was frequent but mild,and could be relieved by slowing the rate of infusion.Severe pulmonary infection possibly occurred.Hence,the risk of infection should be evaluated carefully before prescribing and be treated timely.
作者
何孜姿
武雷
黄德晖
王若愚
孙慧
张世敏
霍云云
杨扬
于生元
吴卫平
HE Zizi;WU Lei;HUANG Dehui;WANG Ruoyu;SUN Hui;ZHANG Shimin;HUO Yunyun;YANG Yang;YU Shengyuan;WU Weiping(不详;Department of Neurology,The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2022年第4期275-279,283,共6页
Chinese Journal of Neuroimmunology and Neurology
