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Hypocalcemia with Immune Checkpoint Inhibitors: The Disparity among Various Reports
Joint Authors
Piranavan, Paramarajan
Nalluru, Swarna Sri
Ning, Ying
Ackula, Haritha
Siddiqui, Ahmad D.
Trivedi, Nitin
Source
International Journal of Endocrinology
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-06-06
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Immune-related adverse events affecting parathyroid function are rarely reported with immune checkpoint inhibitors (ICPIs).
Activating calcium-sensing receptor antibodies causing autoimmune hypoparathyroidism with nivolumab was recently reported.
KEYNOTE-189 and CHECKMATE-067 trials reported a 21–29% hypocalcemia event rate, but the etiology of hypocalcemia was not reported.
A chart review was performed to study patients receiving ICPI from 2015 to 2018 at multiple sites affiliated with Saint Vincent Hospital.
The study population was divided into two groups based on the presence or absence of calcium altering conditions or medications.
True hypocalcemia incidence was calculated after correcting calcium for albumin from the initiation of ICPI to their last follow-up.
Group 1 (n = 83) includes patients with no calcium altering conditions or medications.
Group 2 (n = 98) includes patients on calcium supplements (n = 17), vitamin D (n = 44), bisphosphonates (n = 24), >stage IIIB chronic kidney disease (CKD) (n = 5), and bone metastasis (n = 38).
Hypocalcemia events in Group 1 vs.
Group 2 were 8.4% and 19.3%, respectively.
Our entire study demonstrated 26.8% vs.
1.1% of Grade I vs.
II hypocalcemia events.
However, after correcting the calcium for albumin, hypocalcemia incidence was 0.56% (n = 1).
No further workup was done to investigate the etiology as that patient passed away.
Our data suggest that the true hypocalcemia incidence after using albumin-corrected calcium values is very low in patients receiving IPCI, even in the presence of calcium altering factors.
The percentage of patients with hypocalcemia is much higher and similar to the KEYNOTE-189 and CHECKMATE-067 trials when serum calcium values without albumin correction are used.
Thus, the higher reported incidence of hypocalcemia in these trials is likely due to the reporting of serum calcium without albumin correction.
American Psychological Association (APA)
Nalluru, Swarna Sri& Piranavan, Paramarajan& Ning, Ying& Ackula, Haritha& Siddiqui, Ahmad D.& Trivedi, Nitin. 2020. Hypocalcemia with Immune Checkpoint Inhibitors: The Disparity among Various Reports. International Journal of Endocrinology،Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1170475
Modern Language Association (MLA)
Nalluru, Swarna Sri…[et al.]. Hypocalcemia with Immune Checkpoint Inhibitors: The Disparity among Various Reports. International Journal of Endocrinology No. 2020 (2020), pp.1-6.
https://search.emarefa.net/detail/BIM-1170475
American Medical Association (AMA)
Nalluru, Swarna Sri& Piranavan, Paramarajan& Ning, Ying& Ackula, Haritha& Siddiqui, Ahmad D.& Trivedi, Nitin. Hypocalcemia with Immune Checkpoint Inhibitors: The Disparity among Various Reports. International Journal of Endocrinology. 2020. Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1170475
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1170475