› Forums › General Melanoma Community › Iipilimumab irAE – endocrynopathy management
- This topic has 15 replies, 3 voices, and was last updated 9 years ago by
MoiraM.
- Post
-
- August 22, 2016 at 9:11 pm
Hello!
I wonder which steroids did you use and how did you tapper them if you have had an endocrinopaty namely pituitary inflammation?
Did you suspend ipi and for how long?
Did you use antibiotics?
How long did it take to resolve syptoms?
Did you make lumber puncture for proper diagnoses?
Thank you!
My Doc is not an expert in the field and I want to help him )
- Replies
-
-
- August 22, 2016 at 9:44 pm
Hi Mikers,
Similar IRAE profile for Keytruda- This is the management tool….
https://www.keytruda.com/static/pdf/adverse-reaction-management-tool.pdf
which gives advice for how this is handled with this drug.. would think the protocols would be similar for both drugs.
This is a link to a scientific paper that discusses ipi and pituitary inflammation
http://www.ncbi.nlm.nih.gov/pubmed/25078147 sorry not personal experience but might be worth letting your doc see…
All the best
Deb
-
- August 22, 2016 at 9:44 pm
Hi Mikers,
Similar IRAE profile for Keytruda- This is the management tool….
https://www.keytruda.com/static/pdf/adverse-reaction-management-tool.pdf
which gives advice for how this is handled with this drug.. would think the protocols would be similar for both drugs.
This is a link to a scientific paper that discusses ipi and pituitary inflammation
http://www.ncbi.nlm.nih.gov/pubmed/25078147 sorry not personal experience but might be worth letting your doc see…
All the best
Deb
-
- August 22, 2016 at 9:44 pm
Hi Mikers,
Similar IRAE profile for Keytruda- This is the management tool….
https://www.keytruda.com/static/pdf/adverse-reaction-management-tool.pdf
which gives advice for how this is handled with this drug.. would think the protocols would be similar for both drugs.
This is a link to a scientific paper that discusses ipi and pituitary inflammation
http://www.ncbi.nlm.nih.gov/pubmed/25078147 sorry not personal experience but might be worth letting your doc see…
All the best
Deb
-
- August 22, 2016 at 9:49 pm
I am in the UK.
I was treated with 3mg/kg Ipi – four infusions at three week intervals. In the UK, the standard treatment does not include maintenence doses.
I developed hypophysitis (inflamation of the pituitary gland) after my fourth infusion. As it was my last infusion, it did not affect my treatment with Ipi.
I became very unwell (headaches, increasing fatigue, no appetite, swollen ankles, poor balance) and was diagnosed through a blood test that measured hormone levels. I also had an MRI but that was later. No mention was made of a lumbar puncture and I cannot see that it would have shown anything. Antibiotics only work for bacteria infections. Hypophystis triggered by Ipi is more like an autoimmune condition.
I was referred to an endocrinologist by my melanoma specialist.
I have zero anterior pituitary gland function and have been that way for over a year now.
I was never put on high dose steroids to control the inflamation. To be honest, I think the damage had been done by the time I was diagnosed so high dose steroids would have just made matters worse. I was put on close to replacement levels of the missing hormones.
I was put on 10mg/day prednisolone and 75 mcg/day levothryroxine. As I am female, I did not need any tetesterone replacement. As I am an older female, I do not need replacement female hormones.
I am now on 8mg/day prednisolone (which is considered slightly high) and 82.5 mcg/day leveothyroxine.
-
- August 22, 2016 at 9:49 pm
I am in the UK.
I was treated with 3mg/kg Ipi – four infusions at three week intervals. In the UK, the standard treatment does not include maintenence doses.
I developed hypophysitis (inflamation of the pituitary gland) after my fourth infusion. As it was my last infusion, it did not affect my treatment with Ipi.
I became very unwell (headaches, increasing fatigue, no appetite, swollen ankles, poor balance) and was diagnosed through a blood test that measured hormone levels. I also had an MRI but that was later. No mention was made of a lumbar puncture and I cannot see that it would have shown anything. Antibiotics only work for bacteria infections. Hypophystis triggered by Ipi is more like an autoimmune condition.
I was referred to an endocrinologist by my melanoma specialist.
I have zero anterior pituitary gland function and have been that way for over a year now.
I was never put on high dose steroids to control the inflamation. To be honest, I think the damage had been done by the time I was diagnosed so high dose steroids would have just made matters worse. I was put on close to replacement levels of the missing hormones.
I was put on 10mg/day prednisolone and 75 mcg/day levothryroxine. As I am female, I did not need any tetesterone replacement. As I am an older female, I do not need replacement female hormones.
I am now on 8mg/day prednisolone (which is considered slightly high) and 82.5 mcg/day leveothyroxine.
-
- August 22, 2016 at 9:49 pm
I am in the UK.
I was treated with 3mg/kg Ipi – four infusions at three week intervals. In the UK, the standard treatment does not include maintenence doses.
I developed hypophysitis (inflamation of the pituitary gland) after my fourth infusion. As it was my last infusion, it did not affect my treatment with Ipi.
I became very unwell (headaches, increasing fatigue, no appetite, swollen ankles, poor balance) and was diagnosed through a blood test that measured hormone levels. I also had an MRI but that was later. No mention was made of a lumbar puncture and I cannot see that it would have shown anything. Antibiotics only work for bacteria infections. Hypophystis triggered by Ipi is more like an autoimmune condition.
I was referred to an endocrinologist by my melanoma specialist.
I have zero anterior pituitary gland function and have been that way for over a year now.
I was never put on high dose steroids to control the inflamation. To be honest, I think the damage had been done by the time I was diagnosed so high dose steroids would have just made matters worse. I was put on close to replacement levels of the missing hormones.
I was put on 10mg/day prednisolone and 75 mcg/day levothryroxine. As I am female, I did not need any tetesterone replacement. As I am an older female, I do not need replacement female hormones.
I am now on 8mg/day prednisolone (which is considered slightly high) and 82.5 mcg/day leveothyroxine.
-
- You must be logged in to reply to this topic.