Immune control point (ICI) inhibitors represent a significant advance in the management and survival of cancers such as melanoma or non-small cell bronchial carcinoma. However, they induce unusual side effects, such as hypophysitis, which are rarely described elsewhere. This nationwide retrospective study describes the characteristics of hypophysitis reported in the French pharmacovigilance database (FPVD). We requested for all cases of ICI-related hypophysitis registered in the FPVD before May 2018. An endocrinologist and a pharmacologist reviewed all cases. About 94 pituitary cases were selected, involving 49 females and 45 men. Ipilimumab alone or in combination was the most represented ICI (56%). Most cases (61%) were grade 3 severity and the majority (90%) were corticotropic deficiency cases. Cases with thyroid and/or gonadotropic involvement were 21% and 1% respectively. Five patients (8%) had panhypopituitarism. Pituitary MRI, when performed, was in favor of hypophysitis in 50%. No patient recovered his previous hormonal function. The mean time of onset was significantly shorter with ipilimumab than other ICIs. ICI-related hypophysitis generate deficits that do not spontaneously recover, even at a distance from the event, unlike thyroiditis. Patients must then benefit from long-term coordinated onco-endocrinological management, adapted to their own specific deficits.
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http://dx.doi.org/10.1038/s41598-019-56026-5 | DOI Listing |
Therapie
December 2024
Centre de biologie et de recherche en santé, pharmacologie, toxicologie et pharmacovigilance, CHU de Limoges, 87042 Limoges, France.
Therapie
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Équipe AHeaD, CHU de Bordeaux, service de pharmacologie clinique, BPH, université de Bordeaux, Inserm U1219, 33000 Bordeaux, France.
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View Article and Find Full Text PDFFront Public Health
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View Article and Find Full Text PDFBMC Complement Med Ther
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Department of Pharmacotherapy and Pharmaceutics, Faculty of Pharmacy, Université libre de Bruxelles (ULB), Brussels, Belgium.
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View Article and Find Full Text PDFTherapie
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Service de psychiatrie 'A', CHU Hedi Chaker, 3029 Sfax, Tunisie.
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