Analysis of a case of treatment for steroid-refractory immune related myocarditis with tofacitinib
10.12025/j.issn.1008-6358.2024.20232074
- VernacularTitle:托法替布用于类固醇难治性免疫相关性心肌炎病例分析
- Author:
Jinyin LI
1
;
Ling JIANG
;
Li CHEN
;
Liming WANG
;
Xiaoyan YANG
Author Information
1. 上海市徐汇区中心医院药剂科,上海 200031
- Keywords:
tofacitinib;
steroids;
immune related myocarditis;
immune checkpoint inhibitor
- From:
Chinese Journal of Clinical Medicine
2024;31(4):565-570
- CountryChina
- Language:Chinese
-
Abstract:
Immune checkpoint inhibitors(ICIs)are important ways of anti-tumor therapy in recent years,which have demonstrated significant clinical benefits.However,the immune-related adverse events caused by ICIs should not be ignored,especially ICIs-related myocarditis,which is rare but fatal.Glucocorticoids are the first choice and the core treatment for ICIs-associated myocarditis.In the process of hormone therapy,if the condition worsens,one of the drugs such as mycophenolate mofetil(MMF),tacrolimus,and infliximab can be combined.Alemtuzumab and abatacept may be effective for patients with severe myocarditis who do not respond to glucocorticoid therapy,but abatacept may promote tumor growth.This paper analyzed and discussed a case of immuno-related myocarditis in a colon cancer patient who was treated with toripalimab combined with cetuximab and irinotecan,oral tofacitinib was added after failure of treatment with glucocorticoid combined with intravenous immunoglobulin,then the biomarkers of myocardial injury decreased significantly.This paper provides a new idea for clinical treatment of steroid-refractory immune related myocarditis.
