Vedolizumab-associated lung toxicity：a case report and literature analysis
- VernacularTitle:维得利珠单抗相关肺毒性1例并文献分析
- Author:
Yu LIANG
1
;
Xueli DING
2
;
Jun WU
2
;
Xianghua QUAN
1
;
Jun ZHAO
1
;
Chuanzhou ZHANG
1
;
Man JIANG
1
Author Information
1. Dept. of Pharmacy，the Affiliated Hospital of Qingdao University，Shandong Qingdao 266003，China
2. Dept. of Gastroenterology，the Affiliated Hospital of Qingdao University，Shandong Qingdao 266003，China
- Publication Type:Journal Article
- Keywords:
vedolizumab;
lung toxicity;
interstitial pneumonia;
adverse drug reaction;
literature analysis
- From:
China Pharmacy
2024;35(20):2552-2558
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To introduce a case of interstitial pneumonia induced by vedolizumab （VDZ）， summarize and analyze the characteristics of the occurrence of VDZ-associated lung toxicity， and provide a reference for the clinically safe use of drugs. METHODS From the perspective of clinical pharmacists， the diagnosis and treatment of a case of VDZ-induced interstitial pneumonia were retrospectively analyzed， and the association of adverse drug reactions （ADR） was analyzed. Retrieving from Chinese and English databases such as CNKI， VIP， PubMed and Web of Science， case reports of VDZ-associated lung toxicity were summarized and analyzed. RESULTS The patient developed interstitial pneumonia during the use of VDZ and empirical anti- infective therapy with antibiotics was ineffective. After withdrawal of VDZ and treatment with methylprednisolone， symptoms and imaging examinations improved， but interstitial pneumonia still existed. According to Naranjo’s ADR evaluation scale and based on China Adverse Drug Reaction Reporting and Monitoring Manual， the association between VDZ and interstitial pneumonia was “very likely”. Results of the literature analysis showed that among 29 involved patients （including the patient reported in this article）， there were 19 males and 10 females， with an average age of （49.24±17.06） years. Lung toxicity mainly included VDZ- associated pneumonia， eosinophilic pneumonia， pulmonary granulomas or necrobiotic nodules， interstitial lung injury， etc.， which mostly occurred ≤24 weeks after medication （58.62%）. The main clinical manifestations included cough， dyspnea and fever. The vast majority of patients improved or recovered after drug withdrawal and/or glucocorticoid treatment， but one patient died of respiratory failure. CONCLUSIONS Lung toxicity is a rare ADR of VDZ with insidious onset and nonspecific symptoms. Once patients experience symptoms such as cough and dyspnea， early diagnosis，timely drug withdrawal，and symptomatic treatment measures such as glucocorticoid should be taken to ensure medication safety.
