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In this analysis, we focus on these events by including the most recent publications and reports from early phase I\/II and phase III clinical trials and comparing the incidence and risks across different ICI regimens. PubMed, Embase, and the Cochrane Library were systematically searched from inception to April 2019 for clinical trials that reported on pituitary\u2010adrenal dysfunction. The rates of events, odds ratios (ORs), and 95% confidence intervals (CIs) were obtained using random effects meta\u2010analysis. The analyses included data from 160 trials involving 40\u00a0432 participants. The rate was 2.43% (95% CI, 1.73%\u20103.22%) for all\u2010grade adrenal insufficiency and 3.25% (95% CI, 2.15%\u20104.51%) for hypophysitis. Compared with the placebo or other therapeutic regimens, ICI agents were associated with a higher incidence of serious\u2010grade adrenal insufficiency (OR 3.19, 95% CI, 1.84 to 5.54) and hypophysitis (OR 4.77, 95% CI, 2.60 to 8.78). Among 71 serious\u2010grade hypopituitarism instances in 12\u00a0336 patients, there was a significant association between ICIs and hypopituitarism (OR 3.62, 95% CI, 1.86 to 7.03). Substantial heterogeneity was noted across the studies for the rates of these events, which in part was attributable to the different types of ICIs and varied phases of the clinical trials. Although the rates of these events were low, the risk was increased following ICI\u2010based treatment, particularly for CTLA\u20104 inhibitors, which were associated with a higher incidence of pituitary\u2010adrenal dysfunction than PD\u20101\/PD\u2010L1 inhibitors.<\/jats:p>","DOI":"10.1002\/cam4.2661","type":"journal-article","created":{"date-parts":[[2019,11,3]],"date-time":"2019-11-03T22:18:20Z","timestamp":1572819500000},"page":"7503-7515","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Immune checkpoint inhibitor\u2010associated pituitary\u2010adrenal dysfunction: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7411-1430","authenticated-orcid":false,"given":"Jingli","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Pharmacy The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan 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