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·药物与临床·
罗沙司他致不良反应的文献分析 Δ
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郑 丽 ,刘 明 ,孙雪林 (1.中国航天科工集团七三一医院药学部,北京 100074;2.兰州大学循证医学中
心,兰州 730013;3.北京医院药学部,北京 100010)
中图分类号 R969.3 文献标志码 A 文章编号 1001-0408(2022)20-2519-05
DOI 10.6039/j.issn.1001-0408.2022.20.17
摘 要 目的 研究罗沙司他致不良反应(ADR)的临床表现和特点,为其临床合理应用提供参考。方法 计算机检索 PubMed、
Web of Science、万方医学网、维普网及中国知网,收集罗沙司他致ADR的临床试验研究、病例报道(含病例系列研究和个案报道),
采用描述性方法分析患者的基本信息、累及系统/器官及主要临床表现,并比较临床试验研究中罗沙司他组和促红细胞生成素
(EPO)组患者的ADR发生率。结果与结论 共纳入文献17篇,包括14篇临床试验研究和3篇病例报道。临床试验研究中,使用罗
沙司他的患者共计4 033例,其中男性1 972例(48.9%)、女性2 061例(51.1%),年龄36~80岁;1项临床试验研究的患者类型为低
风险骨髓增生异常综合征,其余均为肾性贫血;用药剂量为40~120 mg,大多为每周3次给药;罗沙司他所致ADR(1~2级)累及
系统/器官以心脑血管系统、呼吸和胸部系统、消化系统、感染和侵染为主,所致严重不良反应(sADR)累及系统/器官以心脑血管系
统、感染和侵染为主;罗沙司他组患者的ADR总发生率与EPO组比较,差异无统计学意义(P>0.05),但罗沙司他组患者sADR的
发生率显著高于EPO组(P<0.05)。病例报道中,罗沙司他致ADR的临床表现为肺动脉高压、横纹肌溶解、疲劳。临床用药时需
注意患者相关系统/器官的变化,如发现相关ADR,应及时干预。
关键词 罗沙司他;不良反应;安全性;肾性贫血;文献分析
Literature analysis of adverse drug reactions induced by roxadustat
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ZHENG Li ,LIU Ming ,SUN Xuelin(1. Dept. of Pharmacy,No. 731 Hospital of China Aerospace Science &
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Industry Corporation, Beijing 100074, China; 2. Evidence-based Medicine Center, Lanzhou University,
Lanzhou 730013,China;3. Dept. of Pharmacy,Beijing Hospital,Beijing 100010,China)
ABSTRACT OBJECTIVE To study clinical manifestations and characteristics of adverse drug reactions (ADRs) induced by
roxadustat,and to provide reference for rational use of it in clinic. METHODS Retrieved from PubMed,Web of Science,Wanfang
Med,VIP and CNKI,clinical trials and case reports(including series studies and case reports)of ADRs induced by roxadustat
were collected;descriptive method was used to analyze patients’basic information,involved systems/organs and main clinical
manifestations. The incidence of ADR was compared between roxadustat group and erythropoietin (EPO) group. RESULTS &
CONCLUSIONS A total of 17 articles were included,including 14 clinical trials and 3 case reports. In the clinical trial studies,
there were 4 033 patients using roxadustat,including 1 972 males(48.9%)and 2 061 females(51.1%),aged from 36 to 80 years.
The type of patients in one clinical trial was low-risk myelodysplastic syndrome,and the others were renal anemia;they received
relevant drugs with dosage of 40-120 mg,mostly three times a week. Roxadustat-induced ADR(1-2 grade)involved systems/
organs mainly included cardiovascular system,respiratory and thoracic system,digestive system,infection and infestation. The
major systems/organs involved in serious adverse drug reaction (sADR) were cardiovascular system,infection and infestation;
there was no statistically significant difference in the incidence of ADR between roxadustat group and EPO group(P>0.05),but
the incidence of sADR in roxadustat group was significantly higher than that in EPO group (P<0.05). In the case reports,
pulmonary hypertension,rhabdomyolysis and fatigue were the clinical manifestations of ADRs induced by roxadustat. During
clinical medication,attention should be paid to the changes in relevant systems/organs of patients. If ADR is found,timely
intervention should be carried out.
Δ 基金项目 国家重点研发计划项目(No.2020YFC2009001)
*第一作者 主管药师,硕士。研究方向:临床药学。电话:010- KEYWORDS roxadustat; adverse drug reactions; safety;
88538319。E-mail:zhenglis1270755@163.com renal anemia;literature analysis
# 通信作者 副主任药师,博士。研究方向:临床药学。电话:010-
85133632。E-mail:sxl1220@163.com
中国药房 2022年第33卷第20期 China Pharmacy 2022 Vol. 33 No. 20 ·2519·