知识与财富的链接
目的 探讨白癜风的发生与程序性死亡受体 1（PD-1）/程序性死亡配体1（PD-L1）抑制剂治疗临床获益之间的关系;为临床安全用药和不良反应监测提供参考。方法 分析1例肺腺癌患者应用信迪利单抗致白癜风病例;并检索PubMed、Web of Science、中国知网全文数据库中自2000年1月1日至2024年9月1日 PD-1/PD-L1抑制剂引起皮肤白癜风的报道进行讨论。结果 本例患者在使用PD-1抑制剂33个月后发生白癜风。结合患者临床表现和用药时间的相关性;考虑白癜风很可能由信迪利单抗引起。经文献分析;纳入分析的患者共20例;首次使用 PD-1/PD-L1抑制剂至发生白癜风最短时间为免疫治疗第1个月后;最长是第20个月后;15例出现在免疫治疗的3～8个月。结论 临床应用PD-1/PD-L1抑制剂要关注发生白癜风的风险;白癜风的发生可能与免疫治疗预后良好密切相关。
Objective To investigate the relationship between the occurrence of vitiligo and the clinical benefits of programmed cell death-1(PD-1)/ programmed cell death-ligand 1(PD-L1) inhibitors in order to provide a reference for clinical safety and monitoring of Adverse Drug Reactions. Methods One case of vitiligo induced by sintilimab in a patient with pulmonary adenocarcinoma was analyzed. Case reports of vitiligo caused by PD-1/PD-L1 inhibitors collected between January 1, 2000 and September 1, 2024 were retrieved from PubMed, Web of Science and CNKI full-text databases. Descriptive statistical analysis was performed. Results The patient developed vitiligo 33 months after usingPD-1 inhibitors. The correlation between clinical manifestations and the duration of medication suggested that vitiligo was likely to be caused by sintilimab. Based on the literature review, a total of 20 patients were included in the analysis. The earliest onset was one month after immunotherapy with PD-1/PD-L1 inhibitors, and the longest one 20 months later. Fifteen cases occurred within 3 to 8 months of immunotherapy. Conclusion Clinicians who prescribe PD-1/PD-L1 inhibitors should be alert to the risk of vitiligo. The occurrence of vitiligo may be closely related to the good prognosis of immunotherapy.
