特立帕肽不良反应分析

doi:10.19803/j.1672-8629.2022.03.23

摘要/Abstract

摘要： 目的分析特立帕肽不良反应的发生规律及特点,为临床安全用药提供参考。方法检索2002年1月1日至2020年3月31日中国知网、维普网、万方数据、中国生物医学文献数据库、PubMed数据库、Embase,收集特立帕肽致不良反应的个案报道并进行统计分析。结果收集17篇文献20例不良反应个案报道,主要涉及肌肉骨骼损害、代谢和营养障碍和皮肤及其附件损害等。大部分不良反应在停药后能够很快痊愈,肌肉骨骼系统损害缓解常需数月甚至伴随终身。结论特立帕肽使用前,医师应掌握患者血钙、血磷、碱性磷酸酶和肌酐等基本生化指标,充分排除骨恶性肿瘤、骨转移及基线骨肉瘤风险增加的患者。

关键词: 特立帕肽, 甲状旁腺素, 骨质疏松, 不良反应

Abstract: Objective To analyze the patterns and characteristics of adverse reactions induced by teriparatide and to provide guidance for its rational use in clinic. Methods Domestic and foreign journals published between January 1, 2002 and March 31, 2020 were retrieved to collect data on cases of adverse reaction induced by teriparatide before statistical analysis. Results A total of 20 adverse reactions reported by 17 articles were collected, involving musculo-skeletal system disorders, metabolic and nutritional disorders and skin damage. Most of the adverse reactions were cured soon after discontinuation of medication, but musculo-skeletal system disorders might take months to cure or persist throughout one’s life. Conclusion Before prescribing teriparatide, doctors should find out about the basic biochemical indicators, such as blood calcium, phosphorus, alkaline phosphatase and creatinine and make sure that patients with bone malignant tumors, bone metastases, and at high risk of osteosarcoma are excluded from use.

Key words: teriparatide, parathyroid hormone, osteoporosis, adverse reactions

中图分类号:

R994.11

崔璨, 卫红涛, 程晟, 沈素. 特立帕肽不良反应分析[J]. 中国药物警戒, 2022, 19(3): 333-335.

CUI Can, WEI Hongtao, CHENG Sheng, SHEN Su. Adverse reactions induced by teriparatide[J]. Chinese Journal of Pharmacovigilance, 2022, 19(3): 333-335.

参考文献

[1] CHEN JF, YANG KH, ZHANG ZL, et al.A systematic review on the use of daily subcutaneous administration of teriparatide for treatment of patients with osteoporosis at high risk for fracture in Asia[J]. Osteoporos Int, 2015, 26(1): 11-28.
[2] ELRAIYAH T, GIONFRIDDO MR, MURAD MH.Acting on black box warnings requires a GRADE evidence table and an implementation guide: the case of teriparatide[J]. J Clin Epidemiol, 2015, 68(6): 698-702.
[3] Osteoporosis and bone mineral disease branch of Chinese medical association. Guidelines for diagnosis and treatment of primary osteoporosis(2017)[J]. CHIN J Osteoporosis & Bone Mineral Res(中华骨质疏松和骨矿盐疾病杂志), 2017, 38(2): 127-150.
[4] PANDIT A, KHARB S, GARG MK.Raised CA19.9 and hepatic space occupying lesion after teriparatide therapy in a case of polyostotic fibrous dysplasia[J]. Indian J Endocrinol Metab, 2013, 17(5): 947-949.
[5] THIRUCHELVAM N, RANDHAWA J, SADIEK H, et al. Teriparatide induced delayed persistent hypercalcemia[J/OL]. (2014-06-13)[2014-08-18]. 802473.https://www.hindawi.com/journals/crie/2014/802473/.
[6] ROSCHGER P, RINNERTHALER S, YATES J, et al.Alendronate increases degree and uniformity of mineralization in cancellous bone and decreases the porosity in cortical bone of osteoporotic women[J]. Bone, 2001, 29(2): 185-191.
[7] HAJIME M, OKADA Y, MORI H, et al.A case of teriparatide-induced severe hypophosphatemia and hypercalcemia[J]. J Bone Miner Metab, 2014, 32(5): 601-604.
[8] KARATOPRAK C, KAYATAS K, KILICASLAN H, et al.Severe hypercalcemia due to teriparatide[J]. Indian J Pharmacol, 2012, 44(2): 270-271.
[9] AYASREH N, FERNANDEZ-LLAMA P, LLORET MJ, et al.Recombinant PTH associated with hypercalcaemia and renal failure[J]. Clin Kidney J, 2013, 6(1): 93-95.
[10] KHARB S, GUNDGURTHI A, PANDIT A, et al.Hypercalcemic encephalopathy due to milk alkali syndrome and injection teriparatide[J]. Indian J Endocrinol Metab, 2012, 16(6): 1026-1028.
[11] LICATA AA.Osteoporosis, teriparatide, and dosing of calcium and vitamin D[J]. N Engl J Med, 2005, 352(18): 1930-1931.
[12] KAKARIA PJ, NASHEL DJ, NYLEN ES.Debilitating muscle cramps after teriparatide therapy[J]. Ann Intern Med, 2005, 142(4): 310-317.
[13] LUIGETTI M, CAPONE F, MONFORTE M, et al.Muscle cramps and weakness after teriparatide therapy: a new drug-induced myopathy?[J]. Muscle Nerve, 2013, 47(4): 615-623.
[14] BIAN PD, PAN HW.Leg muscle cramps induced by teriparatide in three osteoporosis women[J] Chin J New Drugs Clin Rem(中国新药与临床杂志), 2015, 34(1): 77-78.
[15] ECHEVERRI AF, OSPINA FE, CANAS CA, et al.Worsening of calcinosis cutis with teriparatide treatment in two osteoporotic patients[J]. Br J Dermatol, 2016, 175(5): 1049-1051.
[16] HEARD LK, RICHARDSON VN, LEWIS CM, et al.A case of autoinflammatory skin and bone disease flared by a change in osteop-orosis management[J]. JAAD Case Rep, 2017, 3(2): 103-105.
[17] CHU H, KIM DS.Eczematous dermatitis due to subcutaneous teriparatide injection[J]. Endocrine, 2016, 52(2): 395-396.
[18] HARPER KD, KREGE JH, MARCUS R, et al.Osteosarcoma and teriparatide?[J]. J Bone Miner Res, 2007, 22(2): 334-335.
[19] OGAWA T, OHSHIKA S, YANAGISAWA M, et al.Teriparatide may accelerate the growth of a pre-existing malignant tumor in an elderly patient with osteoporosis: a case report[J]. Mol Clin Oncol, 2020, 12(2): 144-147.
[20] SUBBIAH V, MADSEN VS, RAYMOND AK, et al.Of mice and men: divergent risks of teriparatide-induced osteosarcoma[J]. Osteoporos Int, 2010, 21(6): 1041-1045.
[21] PAL R, AGRAWAL K, GUPTA S, et al.Worsening of unrecognized tumour-induced osteomalacia with inadvertent use of recombinant human parathyroid hormone[J]. Endokrynol Pol, 2020, 71(1): 102-103.
[22] GILSENAN A, HARDING A, KELLIER-STEELE N, et al.The Forteo Patient Registry linkage to multiple state cancer registries: study design and results from the first 8 years[J]. Osteoporos Int, 2018, 29(10): 2335-2343.
[23] NISHIKAWA A, ISHIDA T, TAKETSUNA M, et al.Safety and effectiveness of daily teriparatide in a prospective observational study in patients with osteoporosis at high risk of fracture in Japan: final report[J]. Clin Interv Aging, 2016, 11: 913-925.
[24] ZIFFRA JB, Jr., Olshansky B. Teriparatide-induced atrial tachycardia[J/OL]. BMJ Case Rep, 2018, 1-3 [2018-01-30].http://dx.doi.org/10.1136/bcr-2017-223035.
[25] ENISHI T, UEMURA H, KATOH S, et al.Transient severe hypotension with once-weekly subcutaneous injection of teriparatide in osteoporotic patient: a case report and insight for the drug interaction between hypotensive agents and teriparatide[J]. J Med Invest, 2015, 62(1-2): 93-96.
[26] CAI Y.A case of anaphylactic shock caused by teriparatide[J].Pharmaceutical & Clin Res(药物与临床研究), 2015, (6): 601-601.