Article(id=1322906875179708905, tenantId=1146029695717560320, journalId=1235980733773295621, issueId=1322906824709648449, articleNumber=null, orderNo=null, doi=null, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=1619971200000, acceptedDateStr=2021-05-03, onlineDate=1793335177463, onlineDateStr=2026-10-30, pubDate=1635523200000, pubDateStr=2021-10-30, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793335177463, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793335177463, creator=13701087609, updateTime=1793335177463, updator=13701087609, issue=Issue{id=1322906824709648449, tenantId=1146029695717560320, journalId=1235980733773295621, year='2021', volume='30', issue='20', pageStart='1825', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='1635523200000', pubDateStr='2021-10-30', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793335165428, creator='13701087609', updateTime=1793337419278, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322916278284976934, tenantId=1146029695717560320, journalId=1235980733773295621, issueId=1322906824709648449, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322916278284976935, tenantId=1146029695717560320, journalId=1235980733773295621, issueId=1322906824709648449, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1915, endPage=1920, ext={EN=ArticleExt(id=1322906875339092458, articleId=1322906875179708905, tenantId=1146029695717560320, journalId=1235980733773295621, language=EN, title=Literature analysis of programmed death 1/programmed death ligand 1 inhibitors-induced rare adverse drug reaction skin vasculitis, columnId=null, journalTitle=Chinese Journal of New Drugs, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective: To explore the clinical and pathological characteristics, treatment measures and clinical outcome of programmed death 1/programmed death ligand 1 (PD-1/PD-L1) inhibitors-induced skin vasculitis.
Methods: Relevant domestic and foreign databases (up to November 30, 2020) were searched, case reports and clinical research papers on skin vasculitis caused by PD-1/PD-L1 inhibitors were collected, and the characteristics of PD-1/PD-L1 inhibitor-induced skin vasculitis was analyzed using descriptive statistics.
Results: A total of 11 patients were included in the analysis. Patient medications included four cases of nivolumab, three cases of pembrolizumab, one case of duvaluzumab, one case of nivolumab combined with ipilimumab, and one case of pembrolizumab combined with ipilimumab. One patient did not provide the name of the drug. The time from the patients' start of using PD-1/PD-L1 inhibitor to the appearance of skin vasculitis was 1 to 28 weeks, with a median time of 8 weeks (3~13). The skin vasculitis manifested as skin purpura or skin necrosis, which may be accompanied by immune related adverse events of other systems, and skin biopsy showed perivascular neutrophil and lymphocyte infiltration with focal fibrinoid necrosis. Glucocorticoid therapy was the main treatment measure, and the prognosis was good. Most patients got remission. The recover time ranged from 2 to 60 days, with a median time of 30 (13~50) days.
Conclusion: Vasculitis is a rare adverse reaction of PD-1/PD-L1 inhibitors. Skin purpura is the main manifestation. Glucocorticoids can be used for treatment. The prognosis is good, but it may be combined with other serious adverse reactions, which should be paid attention to in clinical practice.
, authors=Xue-jia QIU, Bing-nan REN, Yu-fei LIAN, Ling-zhi FANG, authorsList=Xue-jia QIU, Bing-nan REN, Yu-fei LIAN, Ling-zhi FANG, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322906875594945003, articleId=1322906875179708905, tenantId=1146029695717560320, journalId=1235980733773295621, language=CN, title=PD-1/PD-L1抑制剂罕见不良反应皮肤血管炎分析, columnId=1236331163573342670, journalTitle=中国新药杂志, columnName=药物安全与合理应用, runingTitle=null, highlight=null, articleAbstract=
目的： 探讨程序性细胞死亡蛋白1（programmed death 1，PD-1）抗体及其配体程序性细胞死亡蛋白配体1（programmed death ligand 1，PD-L1）抗体抑制剂的罕见不良反应皮肤血管炎的临床、病理特点，治疗措施及临床转归。
方法： 检索国内外相关数据库（截至2020年11月30日），收集PD-1/PD-L1抑制剂导致皮肤血管炎的病例报告与临床研究论文，采用描述性统计方法分析PD-1/PD-L1抑制剂导致皮肤血管炎的临床和病理特点。
结果： 纳入分析的患者共11例，患者用药包括纳武单抗4例，派姆单抗3例，度伐鲁单抗1例及纳武单抗、派姆单抗联合伊匹木单抗各1例，1例患者未提供药物名称，患者从开始使用PD-1/PD-L1抑制剂到出现皮肤血管炎的时间为1~28周，中位时间为8（3~13）周，临床表现为皮肤紫癜或皮肤坏死，可伴有其他系统的免疫相关性不良事件（irAEs），皮肤活检表现为血管周围嗜中性和淋巴细胞浸润伴局灶性纤维蛋白样坏死。以糖皮质激素治疗为主，预后较好，多数患者可获得缓解，患者转归的时间范围为2~60 d，中位时间为30（13~50）d。
结论： 皮肤血管炎是PD-1/PD-L1抑制剂的一种罕见不良反应，以皮肤紫癜为主要表现，可采用糖皮质激素治疗，预后较好，但可能合并其他严重不良反应，临床中应予以重视。
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邱学佳，女，硕士，研究方向：临床药学抗肿瘤治疗。E-mail：xuejiaqiu@163.com。
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