Analysis of adverse reactions of bevacizumab-induced osteonecrosis and pharmaceutical care

WANG Lei; FU Zhonghua; SHI Zuxuan; ZHAO Chenglong

doi:10.6039/j.issn.1001-0408.2024.22.21

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Analysis of adverse reactions of bevacizumab-induced osteonecrosis and pharmaceutical care

更新时间：2024-11-26

- Analysis of adverse reactions of bevacizumab-induced osteonecrosis and pharmaceutical care
- ZHONGGUO YAOFANG Vol. 35, Issue 22, Pages: 2828-2831(2024)
- 作者机构：
  
  1.河南省人民医院药学部，郑州　450003
  2.河南省人民医院肿瘤中心，郑州　450003
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2024.22.21
  CLC： R969.3;R979.1
- Published：30 November 2024，
  
  Received：04 July 2024，
  
  Revised：29 October 2024，
- 稿件说明：
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王雷,付中华,史祖宣等.贝伐珠单抗致骨坏死的不良反应分析及药学监护 ^Δ[J].中国药房,2024,35(22):2828-2831.

WANG Lei,FU Zhonghua,SHI Zuxuan,et al.Analysis of adverse reactions of bevacizumab-induced osteonecrosis and pharmaceutical care[J].ZHONGGUO YAOFANG,2024,35(22):2828-2831.
王雷,付中华,史祖宣等.贝伐珠单抗致骨坏死的不良反应分析及药学监护 ^Δ[J].中国药房,2024,35(22):2828-2831. DOI： 10.6039/j.issn.1001-0408.2024.22.21.

WANG Lei,FU Zhonghua,SHI Zuxuan,et al.Analysis of adverse reactions of bevacizumab-induced osteonecrosis and pharmaceutical care[J].ZHONGGUO YAOFANG,2024,35(22):2828-2831. DOI： 10.6039/j.issn.1001-0408.2024.22.21.

摘要

目的

为准确识别和治疗贝伐珠单抗致骨坏死的不良反应提供参考。

方法

临床药师参与1例成人脑胶质瘤患者使用贝伐珠单抗后出现股骨头坏死的治疗过程，通过检索美国FDA不良事件报告系统（FAERS）及查询相关文献和药品说明书，评估股骨头坏死与贝伐珠单抗的关联性，并为医师提供用药建议，对患者进行用药教育。

结果

患者股骨头坏死与贝伐珠单抗的关联性评估为“可能相关”。医师采纳临床药师的建议，停用贝伐珠单抗，改用安罗替尼继续抗肿瘤治疗。患者也接受临床药师的建议，避免长时间站立，复查时，其疼痛症状已得到控制，股骨头坏死未进展。

结论

长期使用贝伐珠单抗的患者应加强对骨痛、骨坏死的关注，定期进行影像检查，及早发现并对症治疗，以避免严重骨坏死的发生。

Abstract

OBJECTIVE

To provide a reference for accurately identifying and treating adverse reactions of osteonecrosis induced by bevacizumab.

METHODS

Clinical pharmacists participated in the treatment process of an adult patient with glioma who developed femoral head necrosis after the use of bevacizumab. By searching the FDA Adverse Event Reporting System （FAERS） and consulting relevant literature and drug instructions， the association between femoral head necrosis and bevacizumab was assessed. Medication recommendations were provided to the physician， and medication educations were provided to the patient.

RESULTS

The association between the patient’s femoral head necrosis and bevacizumab was assessed as “possibly related”. The physicians accepted the clinical pharmacists’ advice to discontinue bevacizumab and switched to anlotinib to continue antitumor treatment. The patient also followed the clinical pharmacists’ advice to avoid prolonged standing. Upon re-examination， the patient’s pain symptoms were under control， and the femoral head necrosis had not progressed.

CONCLUSIONS

Patients who receive long-term bevacizumab should attach great importance to bone pain and osteonecrosis， undergo regular imaging examinations， and detect and treat symptoms early to prevent the occurrence of severe osteonecrosis.

关键词

股骨头坏死贝伐珠单抗FDA不良事件报告系统不良反应

Keywords

bevacizumabFAERSadverse reactions

references

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