佩米替尼(pemigatinib)的副作用和常见不良反应

While pemetinib plays a therapeutic role, it may also cause different types and varying degrees of adverse reactions due to differences in individual physical conditions. Users should pay attention to monitoring and consult a doctor promptly. ‌

Serious adverse reactions of pemigatinib‌

In addition to its therapeutic effect, the active ingredient pemigatinib may cause the following adverse reactions that require medical intervention. Not all reactions will occur, but if they occur, seek medical attention immediately:

‌1. Common adverse reactions (≥10%) ‌

Urinary system: bladder pain, hematuria/turbid urine, difficulty in urinating/burning sensation, frequent urination.

Cardiovascular: increased heart rate, irregular heartbeat, dizziness/fainting.

Eye: Dry eye syndrome, eye redness or eye pain, flashing sensation to light, partial or complete blockage of the field of vision, especially the occurrence of more serious complications such as retinal detachment.

Skin: Nail changes/looseness, periungual redness and swelling, pale skin/wrinkles.

Nervous system: confusion, numbness/tingling in limbs, tremors, seizures.

Others: bone pain, muscle spasms, unusual fatigue, weight loss.

‌2. Severe reactions requiring emergency treatment‌

Shortness of breath (may indicate pulmonary embolism), abnormal bleeding/bruising (sign of thrombocytopenia), edema of lower limbs (risk of cardiac insufficiency), severe abdominal pain (possible intestinal perforation).

‌3. Precautions‌

However, if visual symptoms such as flashes of light or abnormal visual fields occur, you should seek medical attention from an ophthalmologist within 24 hours. Persistent hematuria or pain during urination should rule out the possibility of cystitis. Patients with muscle spasms and muscle weakness should be monitored for the electrolytes involved.

The pictures are from public channels (such as the official website of the FDA, the official website of the original drug manufacturer, etc.) and are for reference only.

Common tolerable adverse reactions of pemigatinib‌

Based on the continuous advancement of treatment, most adverse reactions can gradually alleviate and do not require immediate medical intervention. The medical team can provide prevention or relief suggestions. If symptoms persist or affect your life, please consult in time:

‌1. Digestive system reactions‌

Acid reflux/heartburn, abdominal distension (face/limb edema), constipation or diarrhea, nausea and vomiting, oral mucosal inflammation.

‌2. Skin and joint reactions‌

Dry and flaky skin (especially hands and feet), temporary hair loss, joint pain and limited movement.

‌3. Other reversible reactions‌

Taste changes/loss of taste, rapid weight fluctuations, skin erythema or ulcers.

‌4. Monitoring recommendations‌

Weekly weight monitoring should pay attention to the occurrence of edema. At the same time, mild skin care products should be used to alleviate the problem of dry skin due to dehydration. In addition, try to eat small and frequent meals, which can not only reduce gastrointestinal discomfort but also play a role in weight control.

‌Recommendations for the management of pemigatinib side effects for medical professionals

‌1. General adverse reactions‌

The most common adverse reactions include: hyperphosphatemia (74%), alopecia (59%), diarrhea (50%), nail toxicity (62%), fatigue (44%), dysgeusia (40%), nausea (40%), constipation (35%), stomatitis (53%), dry eye (50%), dry mouth (34%), loss of appetite (33%), vomiting (27%), joint pain (25%), abdominal pain (35%), hypophosphatemia (23%), back pain (24%), dry skin (24%), rash (35%), anemia (35%), epistaxis (29%), retinal pigment epithelium Detachment (26%), limb pain (26%), indigestion (24%), blurred vision (21%), peripheral edema (21%), palmoplantar erythema syndrome (18%) and dizziness (21%).

‌2. Laboratory abnormalities (≥20%)‌

Elevated phosphate, lymphopenia, leukopenia, increased alkaline phosphatase, decreased hemoglobin, increased ALT, increased AST, neutropenia, increased creatinine, decreased phosphate, hyponatremia, hyperglycemia, thrombocytopenia, hypocalcemia, hypercalcemia, hypokalemia and elevated bilirubin.

‌3. Cutaneous system‌

‌Very common (≥10%)‌: nail toxicity (62%), alopecia (59%), rash (35%), dry skin (24%), palmoplantar erythema syndrome (18%).

‌Common (1-10%)‌: Abnormal hair growth.

Rare (0.1-1%): Skin calcification.

4‌. Gastrointestinal reactions‌

‌Very common (≥10%): stomatitis (53%), diarrhea (50%), nausea (40%), abdominal pain (35%), constipation (35%), dry mouth (34%), vomiting (27%), indigestion (24%).

‌5. Blood system‌

‌Very common (≥10%)‌: lymphopenia (65%), changes in white blood cells (65%), reduced hemoglobin (53%), neutropenia (45%), anemia (35%), thrombocytopenia (29%).

‌6. Hepatotoxicity‌

‌Very common (≥10%)‌: increased ALT (50%), increased AST (47%), increased bilirubin (26%).

‌7. Metabolic abnormalities‌

‌Very common (≥10%): hyperphosphatemia (74%), hyperglycemia (36%), anorexia (33%), hyperuricemia (30%), hypophosphatemia (23%).

‌8. Precautions‌

Cutaneous calcification (including non-uremic calcinosis) may be associated with hyperphosphatemia.

Long-term cases of retinal pigment epithelial detachment should be treated regularly at regular ophthalmology clinics.

Serious adverse reactions need to be dealt with according to the dose adjustment plan mentioned above.