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Противоопухолевые средства, прием которых ассоциирован с развитием лекарственно-индуцированного панкреатита

https://doi.org/10.21518/2079-701X-2021-9-114-121

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Аннотация

Частота лекарственно-индуцированного панкреатита (ЛИП) составляет от  2  до  5% от  всех случаев острого панкреатита (ОП), но значительно чаще он встречается в группах риска – среди детей и ВИЧ-инфицированных больных. Прием ряда лекарственных средств (ЛС) ассоциирован с развитием ЛИП, среди них особое место занимают противоопухолевые ЛС в связи с большой медикосоциальной значимостью онкологических заболеваний и появлением в последние годы большого количества новых противоопухолевых ЛС. Целью настоящей статьи является обзор данных литературы о противоопухолевых ЛС, прием которых ассоциирован с развитием ЛИП. Лекарственно-индуцированный острый панкреатит развился у 1,8% пациентов, получавших ниволумаб или пембролизумаб. Суммарно в 14 исследованиях 1–3-й фаз по изучению эффективности и безопасности ипилимумаба сообщалось о развитии ОП менее чем у 1% испытуемых. С развитием ОП ассоциирована и терапия молекулярно-нацеленными таргетными препаратами, такими как ингибиторы тирозинкиназы (ИТК) или другими представителями класса ингибиторов киназ. В базе данных безопасности лекарств (нежелательных лекарственных реакций) Всемирной организации здравоохранения (the WHO Global Medicines Safety Database – VigiAccess) содержатся сообщения об отдельных клинических случаях развития ОП на фоне лечения ингибиторами протеасом и конъюгатами «антитело-лекарственное средство». Известно, что с развитием панкреатита также ассоциирован прием следующих противоопухолевых ЛС: 6-меркаптопурина, L-аспарагиназы, тамоксифена, цисплатина, цитарабина, ифосфамида, паклитаксела, доцетаксела, оксалиплатина, капецитабина, алкалоидов барвинка, цитозина, цисплатина, интерферона альфа-2b, доксорубицина, тамоксифена, гефитиниба, винорелбина, левамизола, метотрексата, 5-фторурацила, капецитабина, трансретиноевой кислоты. Большинство случаев ЛИП, ассоциированных с приемом противоопухолевых ЛС, заканчивается выздоровлением после отмены препарата-индуктора, однако описаны и случаи тяжелого течения, в т. ч. летальные.

Об авторах

Н. А. Араблинский
Российский национальный исследовательский медицинский университет имени Н.И. Пирогова
Россия

Араблинский Никита Александрович, студент 6-го курса лечебного факультета

117997, Москва, ул. Островитянова, д. 1



О. Д. Остроумова
Российская медицинская академия непрерывного профессионального образования; Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)
Россия

Остроумова Ольга Дмитриевна, доктор медицинских наук, профессор, заведующая кафедрой терапии и полиморбидной патологии, Российская медицинская академия непрерывного профессионального образования; профессор кафедры клинической фармакологии и пропедевтики внутренних болезней, Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1,

119991, Москва, ул. Трубецкая, д. 8, стр. 2



А. В. Филиппова
Российская медицинская академия непрерывного профессионального образования
Россия

Филиппова Анастасия Витальевна, ординатор 1-го года кафедры терапии и полиморбидной патологии

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1



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Для цитирования:


Араблинский Н.А., Остроумова О.Д., Филиппова А.В. Противоопухолевые средства, прием которых ассоциирован с развитием лекарственно-индуцированного панкреатита. Медицинский Совет. 2021;(9):114-121. https://doi.org/10.21518/2079-701X-2021-9-114-121

For citation:


Arablinskiy N.A., Ostroumova O.D., Filippova A.V. Antineoplastic agents associated with the development of drug-induced pancreatitis. Meditsinskiy sovet = Medical Council. 2021;(9):114-121. (In Russ.) https://doi.org/10.21518/2079-701X-2021-9-114-121

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