The Risk of Adrenal Insufficiency After Treatment With Relatlimab in Combination With Nivolumab is Higher Than Expected
Authors' conclusion
This study is the first cohort analysis of hypophysitis in patients treated with relatlimab-nivolumab compared to nivolumab monotherapy. Combination treatment with relatlimab-nivolumab confers a significantly higher risk of developing adrenal insufficiency, likely secondary to hypophysitis, compared to nivolumab alone.
Study context
- Population
- Mass General Brigham healthcare system patients receiving relatlimab-nivolumab (2015–2023), for unresectable or metastatic melanomamatched cohort
- Exposure
- Relatlimab-nivolumab vs nivolumab monotherapy
- Outcome
- Prevalence of central adrenal insufficiency
Methodological detailsmatched by age, sex and race
- Matched by age, sex and race
Main finding
As reported in the abstract
Adrenal insufficiency
Relatlimab-nivolumab
8%
10 events
Nivolumab
<1%
1 events
P = 0.00056
Observational data: associations, not effects.
Further findings
Number of doses received, within relatlimab-nivolumab
P = 0.03
Age and sex, within relatlimab-nivolumab
- Median age and sex were comparable in patients who developed adrenal insufficiency vs those who did not
Presenting symptoms
- Most common presenting symptoms: fatigue, anorexia, nausea and vomiting
Additional anterior pituitary hormone deficiencies or AVP-D
- No patients diagnosed with additional anterior pituitary hormone deficiencies or AVP-D
- Not all patients were evaluated for these diagnoses
Original publication
The Risk of Adrenal Insufficiency After Treatment With Relatlimab in Combination With Nivolumab is Higher Than Expected. J Clin Endocrinol Metab. Published 26 February 2025. doi:10.
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