| アブストラクト | 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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| 投稿者 | Garon-Czmil, Julie; Petitpain, Nadine; Rouby, Franck; Sassier, Marion; Babai, Samy; Yelehe-Okouma, Melissa; Weryha, Georges; Klein, Marc; Gillet, Pierre |
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| 組織名 | Department of Clinical Pharmacology and Pharmacovigilance, University Hospital of;Nancy Brabois, Biologie Medicale & Biopathologie, Rue du Morvan, 54511,;Vandoeuvre Les Nancy, France.;Department of Endocrinology and Medical Gynecology, University Hospital of Nancy,;rue du Morvan, 54500, Vandoeuvre-les-Nancy, France.;UMR 7365 CNRS-Universite de Lorraine, IMoPA, Campus Brabois Sante, 9 Avenue de la;foret de Haye, BP 20199, 54505, Vandoeuvre-les-Nancy, France.;Marseille, 270 Boulevard Sainte Marguerite, 13009, Marseille, France.;Department of Pharmacology, University Hospital of Caen, Avenue de la Cote de;Nacre, 14000, Caen, France.;Department of Pharmacovigilance, Hopital Henri Mondor, Assistance Publique;Hopitaux de Paris, Henri Mondor Hospital, 94010, Creteil, France.;Vandoeuvre Les Nancy, France. pierre.gillet@univ-lorraine.fr.;pierre.gillet@univ-lorraine.fr. |
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