ECE2020 Audio ePoster Presentations Pituitary and Neuroendocrinology (217 abstracts)
High-dose corticosteroid treatment of immunotherapy-induced hypophysitis: A multi-centric, restrospective analysis
Felix Amereller 1 , Mamta Joshi 2 , Timo DEUTSCHBEIN 3 , Leo Duffy 2 , Paul Carroll 2 , Sophie Papa 4 , Katharina Schilbach 1 , Jochen Schopohl 1 & Sylvère Störmann 1
1Medizinische Klinik und Poliklinik IV, Klinikum der Universität München; 2Department of Endocrinology, Guy’s & Street Thomas’ NHS Foundation Trust, London, UK; 3Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital Wuerzburg; 4Guy’s & Street Thomas’ NHS Foundation Trust, London, UK
Introduction: Hypophysitis is a frequent side effect of oncologic immunotherapy. The recommended standard treatment is systemic high-dose corticosteroids (HDS), however, recent studies have questioned the benefits of this treatment. We sought to examine the effect of HDS on immunotherapy-induced hypophysitis (IH) in a multi-centric cohort.
Methods: Medical records of 41 patients with IH treated by specialist endocrinologists at three tertiary referral centres in Germany and the UK were retrospectively analysed. Only patients with a follow-up of ≥6 months were included (mean 25 ± 14 months). While 29 patients did not receive specific treatment of IH, 12 were treated with HDS. Pituitary function, symptoms and MRI signs of IH during the course of disease were encoded into a database. We compared the groups using chi square test with a significance threshold of 0.05.
Results: The most frequently used drug for HDS was prednisolone (n = 10, 40–80 mg/day), the other two patients received dexamethasone. Pituitary function improved (i.e. at least one hormone axis recovered) more often after HDS (5/12) than w/o treatment (6/29), however, the level of significance was not met (P = 0.16). On the other hand, symptoms (mostly fatigue) resolved more often under hormonal substitution in untreated patients (15/29 vs 4/12; P = 0.28). An improvement of MRI findings was observed in a similar portion of patients in both groups (25% HDS; 24% w/o treatment; P = 0.95). Overall, none of the differences in outcomes reached the level of significance.
Conclusions: In our cohort, the course of IH did not differ significantly in patients with and w/o HDS. This finding aligns with other studies that could not find benefits of HDS. Instead, an appropriate replacement of hormone deficiencies seems sufficient.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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