

浏览全部资源
扫码关注微信
1.宁夏医科大学总医院药剂科,银川 750004
2.宁夏医科大学药学院,银川 750004
3.北京大学第一医院宁夏妇女儿童医院药剂科,银川 750001
4.银川市良田镇卫生院,银川 750001
5.宁夏医科大学总医院消化内科,银川 750004
Received:08 April 2025,
Revised:2025-08-27,
Accepted:28 August 2025,
Published:30 September 2025
移动端阅览
妥小玲,王钊,巨世杰,等.英夫利西单抗致溃疡性结肠炎合并强直性脊柱炎患者脓疱型银屑病的药学监护[J].中国药房,2025,36(18):2312-2316.
TUO Xiaoling,WANG Zhao,JU Shijie,et al.Pharmaceutical care for a ulcerative colitis and ankylosing spondylitis patient who developed pustular psoriasis induced by infliximab[J].ZHONGGUO YAOFANG,2025,36(18):2312-2316.
妥小玲,王钊,巨世杰,等.英夫利西单抗致溃疡性结肠炎合并强直性脊柱炎患者脓疱型银屑病的药学监护[J].中国药房,2025,36(18):2312-2316. DOI: 10.6039/j.issn.1001-0408.2025.18.17.
TUO Xiaoling,WANG Zhao,JU Shijie,et al.Pharmaceutical care for a ulcerative colitis and ankylosing spondylitis patient who developed pustular psoriasis induced by infliximab[J].ZHONGGUO YAOFANG,2025,36(18):2312-2316. DOI: 10.6039/j.issn.1001-0408.2025.18.17.
目的
2
为使用英夫利西单抗后出现脓疱型银屑病的溃疡性结肠炎(UC)合并强直性脊柱炎(AS)患者的药学监护提供参考。
方法
2
临床药师参与1例UC合并AS患者在使用英夫利西单抗后出现脓疱型银屑病的诊疗过程。临床药师通过Naranjo’s评估量表判断患者发生的脓疱型银屑病与英夫利西单抗的相关性为“很可能”。针对患者使用英夫利西单抗后出现的脓疱型银屑病,建议停用英夫利西单抗,改用乌帕替尼缓释片;针对患者使用乌帕替尼后出现的皮肤过敏反应,临床药师建议继续使用乌帕替尼,并密切监测患者在治疗期间可能出现的不良反应。
结果
2
医师采纳临床药师建议。经治疗后,患者病情好转,准予带药出院;出院后随访显示治疗有效、可耐受。
结论
2
临床药师分析了英夫利西单抗与脓疱型银屑病的因果关系,通过皮损动态监测、治疗反应评估、药物方案优化等药学服务手段,协助医师制定个体化用药方案,保障了患者用药的安全性和有效性。
OBJECTIVE
2
To provide a reference for pharmaceutical care in patients with ulcerative colitis (UC) and ankylosing spondylitis (AS) who developed pustular psoriasis induced by infliximab.
METHODS
2
Clinical pharmacists participated in the pharmaceutical care process of a patient with UC and AS who developed pustular psoriasis after using infliximab. The clinical pharmacists determined, using Naranjo’s Scale, that the correlation between the patient’s pustular psoriasis and infliximab was “likely”. Regarding the patient’s development of pustular psoriasis after using infliximab, the clinical pharmacists recommended discontinuing infliximab and switching to Upadacitinib extended-release tablets. For the patient’s skin allergic reaction after using upadacitinib, the clinical pharmacists advised continuing the use of upadacitinib and closely monitoring any potential adverse reactions during the treatment period.
RESULTS
2
The clinicians adopted the clinical pharmacists’ recommendation. Following the treatment, the patient’s symptoms were significantly alleviated, and the patient was discharged with medication. The follow-up after discharge showed that the treatment was effective and well-tolerated.
CONCLUSIONS
2
The clinical pharmacists analyzed the causal relationship between infliximab and pustular psoriasis. Through pharmaceutical care measures such as dynamic monitoring of skin lesions, evaluation of treatment responses, and optimization of drug regimens, they assisted the physicians in formulating an individualized medication plan, ensuring the safety and efficacy of the patient’s medication use.
NOVIELLO D , MAGER R , RODA G , et al . The IL23-IL17 immune axis in the treatment of ulcerative colitis:successes,defeats,and ongoing challenges [J ] . Front Immunol , 2021 , 12 : 611256 .
SCHINOCCA C , RIZZO C , FASANO S , et al . Role of the IL-23/IL-17 pathway in rheumatic diseases:an overview [J ] . Front Immunol , 2021 , 12 : 637829 .
张瀚予 , 罗娟 , 董明志 , 等 . 英夫利西单抗及维得利珠单抗治疗中重度溃疡性结肠炎的回顾性队列研究 [J ] . 昆明医科大学学报 , 2024 , 45 ( 10 ): 36 - 44 .
张才英 , 蒋雪生 . 英夫利西单抗注射剂治疗强直性脊柱炎的临床研究 [J ] . 中国临床药理学杂志 , 2017 , 33 ( 1 ): 21 - 24 .
VAN VOLLENHOVEN R , TAKEUCHI T , PANGAN A L , et al . Efficacy and safety of upadacitinib monotherapy in methotrexate-naive patients with moderately-to-severely active rheumatoid arthritis(SELECT-EARLY):a multicenter,multi-country,randomized,double-blind,active comparator-controlled trial [J ] . Arthritis Rheumatol , 2020 , 72 ( 10 ): 1607 - 1620 .
GUERRA I , PÉREZ-JELDRES T , IBORRA M , et al . Incidence,clinical characteristics,and management of psoriasis induced by anti-TNF therapy in patients with inflammatory bowel disease:a nationwide cohort study [J ] . Inflamm Bowel Dis , 2016 , 22 ( 4 ): 894 - 901 .
徐梦骏 , 郑敏 . 银屑病生物制剂治疗与炎症性肠病 [J ] . 皮肤科学通报 , 2020 , 37 ( 5 ): 477 - 479 .
SAGONAS I , ILIOPOULOS G , BARALIAKOS X , et al . Anti-TNF-α induced paradoxical psoriasis in patients with ankylosing spondylitis:a systematic review [J ] . Clin Exp Rheumatol , 2024 , 42 ( 1 ): 178 - 184 .
陈静静 , 钱佩佩 , 曹凯 等 . 我国药品不良反应关联性评价方法与诺氏评估量表法的对比与分析 [J ] . 中国药事 , 2020 , 34 ( 8 ): 988 - 992 .
CICCARELLI F , DE MARTINIS M , SIRUFO M M , et al . Psoriasis induced by anti-tumor necrosis factor alpha agents:a comprehensive review of the literature [J ] . Acta Dermatovenerol Croat , 2016 , 24 ( 3 ): 169 - 174 .
何梓阳 , 陈信生 . 英夫利西单抗诱发脓疱性银屑病一例 [J ] . 实用皮肤病学杂志 , 2021 , 14 ( 4 ): 244 - 246 .
游晓炎 , 郑盈盈 , 王宪英 . 基于FAERS数据库的英夫利西单抗不良事件信号挖掘分析 [J ] . 中国药物警戒 , 2024 , 21 ( 3 ): 335 - 340 .
GARCOVICH S , DE SIMONE C , GENOVESE G , et al . Paradoxical skin reactions to biologics in patients with rheumatologic disorders [J ] . Front Pharmacol , 2019 , 10 : 282 .
XIE W H , XIAO S Y , HUANG H , et al . Incidence of and risk factors for paradoxical psoriasis or psoriasiform lesions in inflammatory bowel disease patients receiving anti-TNF therapy:systematic review with meta-analysis [J ] . Front Immunol , 2022 , 13 : 847160 .
TILLACK C , EHMANN L M , FRIEDRICH M , et al . Anti-TNF antibody-induced psoriasiform skin lesions in patients with inflammatory bowel disease are characterised by interferon-γ-expressing Th1 cells and IL-17A/IL-22-expressing Th17 cells and respond to anti-IL-12/IL-23 antibody treatment [J ] . Gut , 2014 , 63 ( 4 ): 567 - 577 .
LI S J , PEREZ-CHADA L M , MEROLA J F . TNF inhibitor-induced psoriasis:proposed algorithm for treatment and management [J ] . J Psoriasis Psoriatic Arthritis , 2019 , 4 ( 2 ): 70 - 80 .
LITTMAN D R , RUDENSKY A Y . Th17 and regulatory T cells in mediating and restraining inflammation [J ] . Cell , 2010 , 140 ( 6 ): 845 - 858 .
OLTEANU R , ZOTA A . Paradoxical reactions induced by tumor necrosis factor-alpha antagonists:a literature review based on 46 cases [J ] . Indian J Dermatol Venereol Leprol , 2016 , 82 ( 1 ): 7 - 12 .
刘明伟 , 彭慧 , 冷晓杰 . 英夫利西单抗治疗重度斑块状银屑病的临床疗效及其对PD-1和PD-L1表达水平的影响 [J ] . 临床和实验医学杂志 , 2022 , 21 ( 24 ): 2660 - 2664 .
ZIPPI M , PICA R , DE NITTO D , et al . Biological therapy for dermatological manifestations of inflammatory bowel disease [J ] . World J Clin Cases , 2013 , 1 ( 2 ): 74 - 78 .
单芳芳 . TNF-α拮抗剂诱发或加重银屑病的临床特征与处理 [D ] . 苏州 : 苏州大学 , 2019 .
WOLLINA U , HANSEL G , KOCH A , et al . Tumor necrosis factor-alpha inhibitor-induced psoriasis or psoriasiform exanthemata:first 120 cases from the literature including a series of six new patients [J ] . Am J Clin Dermatol , 2008 , 9 ( 1 ): 1 - 14 .
许馨文 , 周群燕 , 陈中霞 , 等 . 生物制剂治疗中重度溃疡性结肠炎的研究进展 [J ] . 胃肠病学 , 2021 , 26 ( 6 ): 363 - 367 .
MARITS P , LANDUCCI L , SUNDIN U , et al . Trough s-infliximab and antibodies towards infliximab in a cohort of 79 IBD patients with maintenance infliximab treatment [J ] . J Crohns Colitis , 2014 , 8 ( 8 ): 881 - 889 .
PROTIC M , SCHOEPFER A , YAWALKAR N , et al . Development of psoriasis in IBD patients under TNF-antagonist therapy is associated neither with anti-TNF-antagonist antibodies nor trough levels [J ] . Scand J Gastroen-terol , 2016 , 51 ( 12 ): 1482 - 1488 .
谭书法 , 张磊昌 , 高强强 , 等 . 生物制剂和小分子药物治疗溃疡性结肠炎有效性与安全性的网状Meta分析 [J ] . 中国全科医学 , 2024 , 27 ( 17 ): 2155 - 2166 .
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
公网安备50010302001817