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返回力比泰®（注射用培美曲塞二钠）
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据报道，未用皮质类固醇预处理的患者出现皮疹。 用地塞米松（或等效物）预处理可降低皮肤反应的发生率和严重程度。 在临床试验中，在培美曲塞给药的前一天、当天和后一天口服地塞米松 4 mg，每天两次 (BID)。1
- 一项前瞻性研究评估了以培美曲塞为基础的化疗前，单次静脉注射地塞米松可预防皮肤毒性。 70名晚期肺腺癌患者在接受培美曲塞之前接受了3天的口服地塞米松（4 mg，BID，从化疗前一天开始）或单次IV20mg地塞米松。 根据所用化疗方案的致吐潜力，两组患者在化疗后给予3-7剂量口服地塞米松剂量。 接受静脉注射地塞米松的患者在总共114个化疗周期中报告了10次皮疹发作（8.9％），而接受标准口服地塞米松的患者在总共154个周期中报告了9次皮疹发作（5.8％; p =.35）。 整个研究人群中未观察到3或4级皮疹。2
- 其他回顾性分析调查了地塞米松对培美曲塞治疗3-5和类固醇预服给药替代方案对皮疹发生的预防作用。6-9
参考文献
1. Data on file, Eli Lilly and Company and/or one of its subsidiaries.
2. Groleau A, Côté J. Comparison between two premedication regimens of dexamethasone before a pemetrexed-based chemotherapy: a single-center experience study. J Oncol Pharm Pract . 2020;26(3):612-618. https://doi.org/10.1177/1078155219862040
3. Rusthoven JJ, Eisenhauer E, Butts C, et al; National Cancer Institute of Canada Clinical Trials Group. Multitargeted antifolate LY231514 as first-line chemotherapy for patients with advanced non–small-cell lung cancer: a phase II study. J Clin Oncol. 1999;17(4):1194-1199. http://dx.doi.org/10.1200/jco.1999.17.4.1194
4. Usui N, Kondo Y, Okamoto N, et al. Evaluation of the preventive effect of dexamethasone for rash in patients treated with pemetrexed. Ann Oncol. 2014;25(suppl 5):v55. Japanese Society of Medical Oncology abstract O1-20-5. https://doi.org/10.1093/annonc/mdu435.49
5. Sakurada T, Kakiuchi S, Tajima S, et al. Pemetrexed-induced rash may be prevented by supplementary corticosteroids. Biol Pharm Bull. 2015;38(11):1752-1756. https://doi.org/10.1248/bpb.b15-00435
6. Elsoueidi R, Lander MJ, Richa EM, Adane ED. Single-dose dexamethasone for the prevention of pemetrexed associated cutaneous adverse reactions. J Oncol Pharm Pract. 2016;22(2):271-274. https://doi.org/10.1177/1078155215583523
7. Usui N, Kondo Y, Ryota N, et al. Mandatory dexamethasone strictly monitored by pharmacists reduces the severity of pemetrexed-induced skin rash. Eur J Hosp Pharm. 2017;24(5):283-285. https://doi.org/10.1136/ejhpharm-2016-000957
8. Clark SK, Anselmo LM. Incidence of cutaneous reactions with pemetrexed: comparison of patients who received three days of oral dexamethasone twice daily to patients who did not. J Oncol Pharm Pract. 2019;25(7):1645-1650. https://doi.org/10.1177/1078155218804869
9. Sakurada T, Nokihara H, Koga T, et al. Prevention of pemetrexed-induced rash using low-dose corticosteroids: a phase II study. Oncologist. 2022;27(7):e554-e560. https://doi.org/10.1093/oncolo/oyab077
