糖皮质激素治疗免疫检查点抑制剂介导的肝损伤的剂量争议

摘要/Abstract

摘要： 免疫检查点抑制剂(ICIs)极大地改善了难治性恶性肿瘤患者的预后,但随着在临床中的广泛应用,ICIs介导的肝损伤(IMH)也受到临床专家的日益重视。相关指南推荐应用糖皮质激素治疗ICIs,但缺乏较高级别的循证医学证据支持。近期发表的一项回顾性研究针对3~4级IMH的激素应用剂量及患者获益进行了评估,发现与高剂量激素组相比,低剂量激素组疗效相当,且不良反应较少。但低剂量激素组(每天1 mg/kg)的激素剂量仍然偏高,且该研究也存在某些偏倚及外延性受限的问题。期待未来的随机临床试验可以证实上述研究的结论,并为IMH的管理提供更高级别的循证医学证据。

关键词: 免疫检查点抑制剂, 免疫相关不良事件, 肝损伤, 糖皮质激素

李涛, 王磊. 糖皮质激素治疗免疫检查点抑制剂介导的肝损伤的剂量争议[J]. 肝脏, 2022, 27(6): 615-617.

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