TY  - JOUR
A1  - Amereller, Felix
A1  - Deutschbein, Timo
A1  - Joshi, Mamta
A1  - Schopohl, Jochen
A1  - Schilbach, Katharina
A1  - Detomas, Mario
A1  - Duffy, Leo
A1  - Carroll, Paul
A1  - Papa, Sophie
A1  - Störmann, Sylvère
T1  - Differences between immunotherapy-induced and primary hypophysitis—a multicenter retrospective study
JF  - Pituitary
N2  - Objective
Immune checkpoint inhibitors can cause various immune-related adverse events including secondary hypophysitis. We compared clinical characteristics of immunotherapy-induced hypophysitis (IIH) and primary hypophysitis (PH)

Design
Retrospective multicenter cohort study including 56 patients with IIH and 60 patients with PH.

Methods
All patients underwent extensive endocrine testing. Data on age, gender, symptoms, endocrine dysfunction, MRI, immunotherapeutic agents and autoimmune diseases were collected.

Results
Median time of follow-up was 18 months in IIH and 69 months in PH. The median time from initiation of immunotherapy to IIH diagnosis was 3 months. IIH affected males more frequently than PH (p < 0.001) and led to more impaired pituitary axes in males (p < 0.001). The distribution of deficient adenohypophysial axes was comparable between both entities, however, central hypocortisolism was more frequent (p < 0.001) and diabetes insipidus considerably less frequent in IIH (p < 0.001). Symptoms were similar except that visual impairment occurred more rarely in IIH (p < 0.001). 20 % of IIH patients reported no symptoms at all. Regarding MRI, pituitary stalk thickening was less frequent in IIH (p = 0.009). Concomitant autoimmune diseases were more prevalent in PH patients before the diagnosis of hypophysitis (p = 0.003) and more frequent in IIH during follow-up (p = 0.002).

Conclusions
Clinically, IIH and PH present with similar symptoms. Diabetes insipidus very rarely occurs in IIH. Central hypocortisolism, in contrast, is a typical feature of IIH. Preexisting autoimmunity seems not to be indicative of developing IIH.
KW  - primary hypophysitis
KW  - immunotherapy-induced hypophysitis
KW  - checkpoint inhibitors
KW  - immune-related adverse events
KW  - pembrolizumab
KW  - ipilimumab
KW  - nivolumab
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308704
SN  - 1386-341X
SN  - 1573-7403
VL  - 25
IS  - 1
ER  -