Immune Checkpoint Inhibitor Therapy Induced Hypophysitis; A Tertiary Care Centre Experience; Highlighting Detection, Treatment Outcomes and Long Term Endocrinopathies and Recovery
Authors' conclusion
ICI-Hp is common and potentially associated with serious complications in the absence of prompt recognition and treatment.
Study context
- Population
- Patients with immune checkpoint inhibitor (ICI)-induced hypophysitis (ICI-Hp) referred to a dedicated endocrine-ICI clinic; 55% female, median age 67 years (IQR 53, 74), 77% metastatic melanoma
- Participants
- 22 patients
- Outcome
- Diagnostic pattern, endocrinopathies and recovery of ICI-Hp
Methodological detailssingle-centre, tertiary care centre
- Single-centre
- Tertiary care centre
Main finding
As reported in the abstract
- Median time to onset of ICI-Hp, weeks (IQR 9, 17)
- 13
- Onset after cycle of therapy, median (IQR 3, 4)
- 3rd
- Ipilimumab + nivolumab combination
- 68%
- Headache at presentation
- 64%
- Fatigue at presentation
- 77%
- Nausea at presentation
- 64%
- Hyponatraemia at presentation
- 41%
- Secondary AI (secondary adrenal insufficiency (SAI))
- 100%
- Secondary hypothyroidism (SH)
- 41%
- Secondary hypogonadism (SHG)
- 27%
- Enlarged pituitary gland on imaging
- 64%
- Thickened stalk on imaging
- 50%
- Mild optic chiasm compression
- 3
- Asymptomatic pituitary enlargement
- 1
- Recovery of SAI during follow-up
- 0
- Recovery of SH
- 33%
- Recovery of SHG
- 67%
Observational data: associations, not effects.
Further findings
Glucocorticoid treatment outcomes
- IV methylprednisolone
- 4
- Prednisolone
- 8
- Dexamethasone
- 1
- Oral hydrocortisone stress dosing for 48 h
- 6
- Complete resolution of symptoms and significant resolution of imaging findings in all, independent of regimen
Safety
Adverse events
- Acute psychosis with IV MPP
- 1
- New-onset T1D
- 18%
- DKA
- 3 patients
Original publication
Immune Checkpoint Inhibitor Therapy Induced Hypophysitis; A Tertiary Care Centre Experience; Highlighting Detection, Treatment Outcomes and Long Term Endocrinopathies and Recovery. Clin Endocrinol (Oxf). Published 25 March 2026. doi:10.
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