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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
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| 篇名： | 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 |
| TITLE： | Pharmaceutical care for a ulcerative colitis and ankylosing spondylitis patient who developed pustular psoriasis induced by infliximab |
| 摘要： | 目的 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。 |
| ABSTRACT： | OBJECTIVE 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 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 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 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. |
| 期刊： | 2025年第36卷第18期 |
| 作者： | 妥小玲；王钊；巨世杰；杨少奇；马丽娟 |
| AUTHORS： | TUO Xiaoling，WANG Zhao，JU Shijie，YANG Shaoqi，MA Lijuan |
| 关键字： | 英夫利西单抗；药学监护；脓疱型银屑病；溃疡性结肠炎；强直性脊柱炎 |
| KEYWORDS： | infliximab； pharmaceutical care； pustular |
| 阅读数： | 11 次 |
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