The neonatal Fc receptor(FcRn)prolongs the half-life of immunoglobulin G(IgG)and promotes its recycling by binding to and making it an important receptor for maintaining serum IgG homeostasis.However,the abnormal accumulation of pathogenic IgG is closely related to the occurrence of various neuroimmune diseases.FcRn antagonists can significantly reduce the level of pathogenic IgG by blocking the binding of FcRn to IgG,thereby effectively alleviating the clinical symptoms of related diseases.As an emerging targeted therapeutic drug,FcRn antagonists have shown their potential in treating IgG-mediated neuroimmune diseases.This article summarizes the mechanism of action,types and clinical research progress of FcRn antagonists with the aim of providing new ideas for the precise treatment of IgG-mediated neuroimmune diseases.Future research should focus on the long-term safety of drugs,expansion of indications and individualized treatment strategies to further enhance their clinical application value.

The neonatal Fc receptor(FcRn)prolongs the half-life of immunoglobulin G(IgG)and promotes its recycling by binding to and making it an important receptor for maintaining serum IgG homeostasis.However,the abnormal accumulation of pathogenic IgG is closely related to the occurrence of various neuroimmune diseases.FcRn antagonists can significantly reduce the level of pathogenic IgG by blocking the binding of FcRn to IgG,thereby effectively alleviating the clinical symptoms of related diseases.As an emerging targeted therapeutic drug,FcRn antagonists have shown their potential in treating IgG-mediated neuroimmune diseases.This article summarizes the mechanism of action,types and clinical research progress of FcRn antagonists with the aim of providing new ideas for the precise treatment of IgG-mediated neuroimmune diseases.Future research should focus on the long-term safety of drugs,expansion of indications and individualized treatment strategies to further enhance their clinical application value.

Objective:To explore the risks and influencing factors of regorafenib related hepatobiliary system injury.Methods:Reports of regorafenib related hepatobiliary system adverse events received from 4th quarter, 2012 to 3rd quarter, 2018 in the US Food and Drug Administration Adverse Event Reporting System (FAERS) database were collected. The signal intensity of hepatobiliary system adverse events related to regorafenib was screened and statistically analyzed by report odds ratio ( ROR) and proportional report ratio ( PRR), and their influencing factors were analyzed by logistic regression analysis. Results:A total of 26 013 adverse event reports related to regorafenib were retrieved, and 28 preferred terms were screened as suspicious hepatobiliary system related adverse event signals. Results from sorting the signal intensity of adverse events using ROR, PRR and their lower limit of 95% confidence interval ( CI) showed that elevation of jaundice and bilirubin had the strongest signal ( ROR=8.56, 95 %CI lower limit: 7.66; PRR=8.46, 95 %CI lower limit: 7.58), followed by other laboratory abnormalities ( ROR=6.05, 95 %CI lower limit: 4.95; PRR=6.03, 95 %CI lower limit: 4.94) and then liver related diseases ( ROR=5.46, 95 %CI lower limit: 4.71; PRR=5.43, 95 %CI lower limit: 4.69). Logistic regression analysis showed that the risk of hepatobiliary system adverse events was higher when the regorafenib dose was>80~<160 mg/d, compared with the dose of ≤80 mg/d ( OR=1.702, 95 %CI: 1.230-2.356, P=0.001), and was lower in patients with gastrointestinal stromal tumors, compared with other tumors ( OR=0.436, 95 %CI: 0.240-0.792, P=0.006). Conclusion:Regorafenib has the risk of hepatobiliary system injury, and a higher dose may be related to the increased risk.

Objective:To explore the risks and influencing factors of regorafenib related hepatobiliary system injury.Methods:Reports of regorafenib related hepatobiliary system adverse events received from 4th quarter, 2012 to 3rd quarter, 2018 in the US Food and Drug Administration Adverse Event Reporting System (FAERS) database were collected. The signal intensity of hepatobiliary system adverse events related to regorafenib was screened and statistically analyzed by report odds ratio ( ROR) and proportional report ratio ( PRR), and their influencing factors were analyzed by logistic regression analysis. Results:A total of 26 013 adverse event reports related to regorafenib were retrieved, and 28 preferred terms were screened as suspicious hepatobiliary system related adverse event signals. Results from sorting the signal intensity of adverse events using ROR, PRR and their lower limit of 95% confidence interval ( CI) showed that elevation of jaundice and bilirubin had the strongest signal ( ROR=8.56, 95 %CI lower limit: 7.66; PRR=8.46, 95 %CI lower limit: 7.58), followed by other laboratory abnormalities ( ROR=6.05, 95 %CI lower limit: 4.95; PRR=6.03, 95 %CI lower limit: 4.94) and then liver related diseases ( ROR=5.46, 95 %CI lower limit: 4.71; PRR=5.43, 95 %CI lower limit: 4.69). Logistic regression analysis showed that the risk of hepatobiliary system adverse events was higher when the regorafenib dose was>80~<160 mg/d, compared with the dose of ≤80 mg/d ( OR=1.702, 95 %CI: 1.230-2.356, P=0.001), and was lower in patients with gastrointestinal stromal tumors, compared with other tumors ( OR=0.436, 95 %CI: 0.240-0.792, P=0.006). Conclusion:Regorafenib has the risk of hepatobiliary system injury, and a higher dose may be related to the increased risk.