伊曲莫德的副作用如何缓解

Etrasimod is a new oral selective S1P receptor modulator, mainly used for adults with moderately to severely active ulcerative colitis. The drug reduces intestinal inflammatory response by regulating lymphocyte migration, but it may also cause infection, bradycardia, liver damage and other adverse reactions. Appropriate management of these side effects is critical to maintaining treatment continuity.

Side effects of Itrimod

During the treatment process, it may cause multi-system adverse reactions, among which infection, cardiovascular and liver-related side effects are the most common.

Increased risk of infection

Some patients develop infections, including urinary tract infections and herpes virus infections. Lymphopenia was the main cause, and the average lymphocyte count dropped to about 0.5×10⁹/L during treatment.

Effects on the cardiovascular system

A brief decrease in heart rate may occur after the first dose (average decrease 7.2bpm), and a few patients may develop first/second degree Mohs type I atrioventricular block. The risk of QT prolongation requires special attention.

Abnormal liver function

A small number of patients may have ALT >3 times the upper limit of the normal value, mostly 3 months before treatment. Jaundice and deepened urine are early warning signs of severe liver damage.

The side effects of istrimod involve multiple systems, and timely identification and intervention are crucial to ensure treatment safety.

How to alleviate the side effects of itrimod?

Based on the different side effects of itrimod, targeted management strategies need to be adopted to reduce symptoms and maintain treatment.

Infection Prevention and Management

Varicella-zoster virus vaccination should be completed before treatment. If fever or other infection symptoms occur, immediate evaluation should be carried out. Serious infections require suspension of medication. Avoid the use of live attenuated vaccines.

Cardiovascular monitoring

The heart rate needs to be monitored for 6 hours after the first dose, and the monitoring should be extended when the resting heart rate is <50bpm. If obvious bradycardia occurs, dose reduction or discontinuation may be considered. Avoid concomitant use of beta-blockers.

Treatment of abnormal liver function

Monthly monitor liver enzymes. Medication should be suspended when ALT is >3 times the upper limit of normal. If jaundice or coagulation abnormalities occur, the drug should be discontinued immediately. After recovery from mild to moderate liver injury, dose reduction and restart of treatment may be considered.

Through systematic monitoring and timely intervention, most of the side effects related to istrimod can be effectively controlled.

Contraindications of Itrimod

Itrimod is contraindicated in certain circumstances, and recognition of these contraindications is critical to preventing serious adverse events.

Severe cardiovascular disease

It is contraindicated in patients with myocardial infarction, stroke or unstable angina in the past 6 months. Patients with second-degree atrioventricular block without a pacemaker are also contraindicated.

Combination with specific drugs

It is prohibited to use in combination with strong CYP2C9/CYP3A4 inhibitors (such as fluconazole) or inducers (such as rifampicin). It is also contraindicated to use CYP2C8/CYP3A4 inhibitors in combination with poor metabolizers of CYP2C9.

Special physiological conditions

Contraindicated for pregnant women. Women of childbearing age need effective contraception until 1 week after stopping the drug. It is prohibited to use in patients with severe hepatic impairment (Child-Pugh class C).

Strict compliance with the contraindications of istrimod is the basis for ensuring drug safety, and the patient's condition should be fully assessed before clinical use.