Myocarditis induced by the combination of disitamab vedotin and toripalimab
10.3760/cma.j.cn114015-20230801-00572
- VernacularTitle:维迪西妥单抗与特瑞普利单抗联用致心肌炎
- Author:
Chaojin LIN
1
;
Guilin HE
;
Nuan JIA
;
Suichen CHEN
;
Chaoran LIU
Author Information
1. 南方科技大学医院药学部，深圳 518055
- Publication Type:Journal Article
- Keywords:
Immune checkpoint inhibitors;
Myocarditis;
Atrial fibrillation;
Cardiotoxicity;
Antibody-drug conjugates;
Urothelial carcinoma;
Disitamab vedotin;
Toripalima
- From:
Adverse Drug Reactions Journal
2024;26(3):190-192
- CountryChina
- Language:Chinese
-
Abstract:
A 68-year-old female patient with invasive urothelial carcinoma received immune treatments with disitamab vedotin 120 mg and toripalimab 240 mg intravenously on the first day, and 14 days was a cycle. Nineteen days after the first medication, the patient complained of lower back muscle soreness. Laboratory tests showed creatine kinase (CK) 1 079 U/L and CK-MB 33 U/L. The 2nd cycle of immunotherapy was suspended and prednisone 20 mg orally once daily was given. Five days later, the patient felt chest tightness, and laboratory tests showed CK 3 366 U/L, CK-MB 91 U/L, lactic dehydrogenase 518 U/L, myoglobin 1 282 μg/L, high-sensitivity troponin T 0.068 μg/L, and N-terminal pro-brain natriuretic peptide 148 ng/L. Myocarditis caused by the combination of disitamab vedotin and toripalimab was considered, referring to the cardiac color Doppler ultrasound examination. Prednisone was switched to IV infusion of methylprednisolone 160 mg once daily. The above laboratory test indicators gradually decreased, but the electrocardiogram showed ectopic heart rhythm. Amiodarone was added. After 11 days of methylprednisolone treatment by IV infusion, methylprednisolone 20 mg orally once daily was given, which was gradually reduced and discontinued finally. Four days later, the patient′s laboratory indicators and electrocardiogram showed no abnormalities in the re-examination.
