Pharmaceutical care and individualized selection of liver protective drugs in a case of severe liver injury caused by pezopanib tablets

Published on Jan. 15, 2023Total Views: 1127 times Total Downloads: 524 times Download Mobile

Author: Zhi-Tao WANG ¹ Ling-Fang HE ²  Yong-Hai LOU ¹

Affiliation: 1. Taizhou Hospital of Zhejiang Province, Linhai 317000, Zhejiang Province, China 2. Linhai Hospital of Traditional Chinese Medicine, Linhai 317000, Zhejiang Province, China

Keywords: Pezopanib Liver injury Adverse drug reactions Individualized administration Pharmaceutical care

DOI: 10.19960/j.issn.1005-0698.202301018

Reference: Zhi-Tao WANG, Ling-Fang HE, Yong-Hai LOU.Pharmaceutical care and individualized selection of liver protective drugs in a case of severe liver injury caused by pezopanib tablets[J].Yaowu Liuxingbingxue Zazhi,2023, 32(1): 116-120.DOI: 10.19960/j.issn.1005-0698.202301018.[Article in Chinese]  Copied

Abstract
Full-text
References

Abstract

Clinical pharmacists participated in the liver protection treatment process of a patient with advanced renal cell carcinoma with severe liver injury. By analyzing the patient's previous med-ication history, combined with laboratory examination, the possibility of severe liver dysfunction caused by pezopanib tablets was evaluated by using Naranjo's adverse drug reaction probability scale. Through consulting the literature and combined with the characteristics of patients' laboratory ex-amination, the possible mechanism of liver injury caused by pezopanib tablets was analyzed. It was suggested that the clinical drug should be stopped in time and individualized liver protection treat-ment should be carried out. Finally, the patient's liver injury was significantly improved. In this case, the clinical pharmacist combined pharmaceutical knowledge and clinical practice to provide effective pharmaceutical suggestions for the clinic, which fully reflects the value of the clinical pharmacist and provides a certain reference for the severe liver injury caused by pezopanib tablets in the future.

Full-text

Please download the PDF version to read the full text: download

References

1.Hsieh JJ, Purdue MP, Signoretti S, et al. Renal cell carcinoma[J].Nat Rev Dis Primers, 2017, 3: 17009. DOI: 10.1038/nrdp.2017.9.

2.中国医促会泌尿健康促进分会,中国研究型医院学会泌尿外科学专业委员会. 肾癌靶向药物治疗安全共识[J]. 现代泌尿外科杂志, 2019, 24(10): 791-800. DOI: 10.3969/j.issn. 1009-8291.2019.10.003.

3.中国晚期肾癌靶向治疗不良反应管理专家共识专家组. 中国晚期肾癌靶向治疗不良反应管理专家共识(2015年版)[J]. 中国癌症杂志, 2015, 25(8): 561-565. DOI: 10.3969/j.issn.1007-3639.2015.08.001.

4.Karczmarek-Borowska B, Sałek-Zań A. Hepatotoxicity of molecular targeted therapy[J]. Contemp Oncol (Pozn), 2015, 19(2): 87-92. DOI: 10.5114/wo.2014.43495.

5.Shantakumar S, Nordstrom BL, Djousse L, et al. Occurrence of hepatotoxicity with pazopanib and other anti-VEGF treatments for renal cell carcinoma: an observational study utilizing a distributed database network[J]. Cancer Chemoth Pharmacol, 2016, 78(3): 559-566. DOI: 10.1007/s00280-016-3112-9.

6.National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) v5.0[S]. 2017.

7.中华医学会肝病学分会药物性肝病学组. 药物性肝损伤诊治指南[J]. 肝脏, 2015, (10): 750-767. DOI: 10.3969/j.issn. 1008-1704.2015.10.002.

8.Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reac-tions[J]. Clin Pharmacol Ther, 1981, 30: 239-245. DOI: 10.1038/clpt.1981.154.

9.Sternberg CN, Davis ID, Mardiak J, et al. Pazopanib in locally advanced or metastatic renal cell carcino-ma: results of a randomized phase Ⅲ trial[J]. J Clin Oncol, 2010, 28: 1061-1068. DOI: 10.1200/JCO.2009.23.9764.

10.Powles T, Bracarda S, Chen M, et al. Characterisation of liver chemistry abnormalities associated with pazopanib monotherapy: a systematic review and meta-analysis of clinical trials in advanced cancer pa-tients[J]. Eur J Cancer, 2015, 51(10): 1293-1302. DOI: 10.1016/j.ejca.2015.03.019.

11.Kapadia S, Hapani S, Choueiri TK, et al. Risk of liver toxicity with the angiogenesis inhibitor pazopanib in cancer patients[J]. Acta Oncol, 2013, 52(6): 1202-1212. DOI: 10.3109/0284186X.2013.782103.

12.Pazopanib[A]. In: LiverTox: clinical and research information on drug-induced liver injury[M]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases, 2012.

13.Vincenzi B, Armento G, Spalato CM, et al. Drug-induced hepatotoxicity in cancer patients-implication for treatment[J]. Expert Opin Drug Saf, 2016, 15(9): 1219-1238. DOI: 10.1080/14740338.2016.1194824.

14.Henriksen JN, Bøttger P, Hermansen CK, et al. Pazopanib-induced liver toxicity in patients with metastat-ic renal cell carcinoma: Effect of UGT1A1 polymorphism on pazopanib dose reduction, safety, and pa-tient outcomes[J]. Clin Genitourin Cancer, 2020, 18(1): 62-68. DOI: 10.1016/j.clgc.2019.09.013.

15.Xiang Q, Zhang Z, Wu YC, et al. HLA polymorphisms and TKI-induced liver injury in patients with cancer: a meta-analysis[J]. J Cancer, 2019, 10(10): 2161-2168. DOI: 10.7150/jca.26727.

16.Xu CF, Johnson T, Wang X, et al. HLA-B*57:01 confers susceptibility to pazopanib-associated liver injury in patients with cancer[J]. Clin Cancer Res, 2016, 22(6): 1371-1378. DOI: 10.1158/1078-0432.CCR-15-2044.

17.Kleiner DE, Chalasani NP, Lee WM, et al. Hepatic histological findings in suspected drug-induced liver injury: systematic evaluation and clinical associations[J]. Hepatology, 2014, 59(2): 661-670. DOI: 10.1002/hep.26709.

18.Chalasani NP, Maddur H, Russo MW, et al. ACG Clinical Guideline: Diagnosis and Management of Idio-syncratic Drug-Induced Liver Injury[J]. Am J Gastroenterol, 2021, 116(5): 878-898. DOI: 10.14309/ajg.0000000000001259.

19.Li L, Jiang W, Wang JY. Clinical analysis of 275 cases of acute drug-induced liver disease[J]. Front Med China, 2007, 1(1): 58-61. DOI: 10.1007/s11684-007-0012-8.

20.Hayashi PH, Fontana RJ. Clinical features, diagnosis, and natural history of drug-induced liver injury[J]. Semin Liver Dis, 2014, 34(2): 134-144. DOI: 10.1055/s-0034-1375955.