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门诊肿瘤患者单抗类药物超药品说明书使用分析

林永晴,乔涌起,戴媛媛   

  1. 中国药科大学,国家癌症中心/中国医学科学院北京协和医学院肿瘤医院,国家癌症中心/中国医学科学院北京协和医学院肿瘤医院
  • 收稿日期:2016-09-07 修回日期:2016-09-07 出版日期:2016-12-25 发布日期:2016-12-26

Survey on Off-label Drug Use of Monoclonal Antibody Antineoplastic Agents in Outpatients

乔涌起 and 戴媛媛   

  1. China Pharmaceutical University,Jiangsu Nanjing,Cancer Hospital,CAMS,
  • Received:2016-09-07 Revised:2016-09-07 Online:2016-12-25 Published:2016-12-26

摘要: 目的:分析肿瘤专科医院门诊患者单抗类抗肿瘤药超药品说明书使用情况,并初步分析用药的合理性。方法:选取2014年9月至2015年2月某院门诊患者单抗类药物处方,结合病案资料分析患者单抗类药物使用情况,查阅药品说明书、指南及相关文献分析超药品说明书用药情况及其合理性。结果:门诊单抗类药物处方1923张涉及568例患者,5种单抗类药物西妥昔单抗注射液、尼妥珠单抗注射液、贝伐珠单抗注射液、利妥昔单抗注射液、注射用曲妥珠单抗的应用与说明书的相符率分别为 63.16%,21.54%,44.67%,75.82%,99.59%;超药品说明书用药主要表现在超适应证用药,适应证符合说明书和/或相关指南之和的比率分别为89.47%,21.54%,89.33%,95.60%,99.59%。结论:门诊患者单抗类药物的使用存在不同程度的超药品说明书用药,超药品说明书用药基本符合指南或有相关临床研究支持,总体用药情况基本合理。

Abstract: Objective: To investigate the off-label drug use of monoclonal antibody antineoplastic agents in outpatients in a cancer hospital and to analyze their rationality. Methods: Prescriptions of outpatients taking monoclonal antibody antineoplastic agents were selected from Sep. 2014 to Feb. 2015, and off-label drug use was analyzed according to the package inserts. Evidence supporting off-label drug use was searched in Guidelines, PubMed and Wangfang Data to evaluate the rationality. Results: Of total 1923 prescriptions that included 568 cases, the ratio of the usage of Cetuximab, Nimotuzumab, Bevacizumab, Rituximab and Trastuzumab consistent with package inserts is 63.16%, 21.54%, 44.67%, 75.82%, 99.59% respectively. The main type of off-label drug use was off-label indication. The indications consistent with package inserts or NCCN Guidelines was 89.47%,21.54%,89.33%,95.60%,99.59% respectively. Conclusion:The ratio of off-label drug use of monoclonal antibody antineoplastic agents was common and different from each other. Off-label drug use was supported by evidence in NCCN guidelines and other results of clinical research.