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生物制剂在治疗免疫检查点抑制剂相关皮肤免疫相关不良事件中的应用:病例报告综述。

The Use of Biologic Agents for the Treatment of Cutaneous Immune-Related Adverse Events from Immune Checkpoint Inhibitors: A Review of Reported Cases.

机构信息

Yale University School of Medicine, New Haven, CT, USA.

Department of Dermatology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.

出版信息

Am J Clin Dermatol. 2024 Jul;25(4):595-607. doi: 10.1007/s40257-024-00866-z. Epub 2024 May 20.

Abstract

Cutaneous immune-related adverse events encompass a spectrum of dermatological manifestations, including lichenoid reactions, psoriasiform eruptions, eczematous dermatitis, immunobullous disorders, granulomatous reactions, pruritus, vitiligo, and severe cutaneous adverse reactions such as Stevens-Johnson syndrome. The conventional approach to treating high-grade or refractory cutaneous immune-related adverse events has involved high-dose systemic corticosteroids. However, their use is limited owing to the potential disruption of antitumor responses and associated complications. To address this, corticosteroid-sparing targeted immunomodulators have been explored as therapeutic alternatives. Biologic agents, commonly employed for non-cutaneous immune-related adverse events such as colitis, are increasingly recognized for their efficacy in treating various patterns of cutaneous immune-related adverse events, including psoriasiform, immunobullous, and Stevens-Johnson syndrome-like reactions. This review consolidates findings from the English-language literature, highlighting the use of biologic agents in managing diverse cutaneous immune-related adverse event patterns, also encompassing maculopapular, eczematous, and lichenoid eruptions, pruritus, and transient acantholytic dermatosis (Grover disease). Despite the established efficacy of these agents, further research is necessary to explore their long-term effects on antitumor responses.

摘要

皮肤免疫相关不良反应包括一系列皮肤表现,包括苔藓样反应、银屑病样皮疹、湿疹性皮炎、免疫性大疱病、肉芽肿反应、瘙痒、白癜风和严重皮肤不良反应,如史蒂文斯-约翰逊综合征。治疗高级别或难治性皮肤免疫相关不良反应的常规方法涉及大剂量全身性皮质类固醇。然而,由于它们可能破坏抗肿瘤反应和相关并发症,其使用受到限制。为了解决这个问题,已经探索了皮质类固醇保留的靶向免疫调节剂作为治疗替代方案。生物制剂通常用于非皮肤免疫相关不良反应,如结肠炎,越来越多地被认为对治疗各种皮肤免疫相关不良反应模式有效,包括银屑病样、免疫性大疱病和史蒂文斯-约翰逊综合征样反应。本综述综合了英语文献中的研究结果,重点介绍了生物制剂在治疗多种皮肤免疫相关不良反应模式中的应用,包括斑丘疹、湿疹性皮炎和苔藓样皮疹、瘙痒和暂时性棘层松解性皮病(Grover 病)。尽管这些药物已被证实有效,但仍需要进一步研究以探讨它们对抗肿瘤反应的长期影响。

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