Interstitial pneumonia and other adverse events in riluzole-administered amyotrophic lateral sclerosis patients: a retrospective observational study
Interstitial pneumonia and other adverse events in riluzole-administered amyotrophic lateral sclerosis patients: a retrospective observational study
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DOI：
10.1186/s12883-019-1299-1
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发表时间：
2019-04-27
期刊：
影响因子：
2.6
通讯作者：
Aoki, Masashi
中科院分区：
文献类型：
--
作者：
Inoue-Shibui, Aya;Kato, Masaaki;Aoki, Masashi
背景利鲁唑是目前唯一被批准的治疗肌萎缩侧索硬化症(ALS)的口服药物。我们进行了一项回顾性研究，包括使用利鲁唑治疗的ALS患者，重点关注不良事件。方法纳入2011年1月至2017年9月期间在本中心根据修订的El Ecore ial标准(世界神经病学联合会)诊断为ALS的患者，口服利鲁唑50 mg，每天两次，从治疗开始至死亡至少随访6个月。收集了有关性别、年龄、疾病类型、初始症状、服用利鲁唑前后的生化分析和病史的数据。记录停药原因、停药时间、用药时间。结果92例患者入选。停用利鲁唑20例(21.7%)。停药的最常见原因是肝酶升高(n=5，5.4%)，其次是间质性肺炎(IP)、恶心和食欲不振、头晕、全身不适、舌头感觉异常和尿急。在两个病例中，主要是因为延髓麻痹的进展而停止给药。所有不良事件均发生在治疗开始后6个月内，停药后很快好转。3例IP患者发生严重呼吸衰竭，需激素治疗。结论92例患者中有20例停用利鲁唑。在利鲁唑开始给药后的头六个月里，仔细的随访是很重要的，包括根据需要通过访谈、化学分析和胸部X光检查。
BackgroundRiluzole is the only approved oral drug for amyotrophic lateral sclerosis (ALS). We performed a retrospective study including ALS patients treated with riluzole, focusing on adverse events.MethodsPatients diagnosed with ALS according to the revised El Escorial criteria (World Federation of Neurology) in our center and who were administered 50mg oral riluzole twice daily between January 2011 and September 2017 and followed up for at least 6months from treatment initiation or until death were included. Data regarding sex, age, disease type, initial symptoms, biochemical analyses performed before and after riluzole administration, and medical history were collected. In case of withdrawal, cause of discontinuation and durations of disease and drug administration were recorded.ResultsA total of 92 cases were enrolled. Riluzole administration was discontinued in 20 cases (21.7%). The most frequent reason for discontinuation was elevated liver enzymes (n=5, 5.4%), followed interstitial pneumonia (IP), nausea and appetite loss, dizziness, general malaise, tongue paresthesia, and urinary urgency. In two cases, administration was discontinued primarily because of progression of bulbar palsy. All adverse events occurred within 6months from treatment initiation and improved soon after its discontinuation. Three IP cases developed severe respiratory failure and required steroid treatment.ConclusionRiluzole administration was discontinued in 20 cases among total of 92 cases. Careful follow-up is important for the first six months after the initiation of riluzole administration, including through interviews, chemical analyses, and chest X-rays, as required.