# Evaluation of the Effect of IL‐1 Antagonists on Pituitary Function

## TL;DR

This study examines how IL-1 inhibitors affect pituitary function in patients with Familial Mediterranean Fever.

## Contribution

The study provides new insights into the impact of IL-1 antagonists on pituitary hormone levels in FMF patients.

## Key findings

- No significant differences were found in TSH, ACTH, cortisol, LH, estradiol, IGF-1, or PRL levels between groups.
- Differences were observed in FSH, total testosterone, and GH levels between the IL-1 inhibitor and control groups.
- No significant adrenal or pituitary insufficiencies were observed in patients using IL-1 inhibitors.

## Abstract

Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease frequently observed in populations along the Eastern Mediterranean coast, characterized by recurrent fever, abdominal pain, and joint inflammation. The disease results from mutations in the MEFV gene, which plays a critical role in regulating IL‐1β secretion. Mutations in pyrin lead to uncontrolled IL‐1β release, driving FMF’s inflammatory symptoms. IL‐1 inhibitors, such as anakinra, rilonacept, and canakinumab, have been introduced as adjunctive treatments. This paper aims to investigate the effects of IL‐1 inhibitors on pituitary functions in FMF patients.

The study was conducted at Sivas Cumhuriyet University Hospital and included patients who had been using IL‐1 inhibitors for at least 6 months. The control group consisted of patients receiving colchicine treatment only. Blood samples were collected to measure various pituitary and endocrine hormones. Patients with conditions like corticosteroid use, cancer, or hemodialysis were excluded. Hormonal levels were analyzed, and cortisol‐deficient patients underwent a Synacthen test.

No significant differences were found in TSH, ACTH, cortisol, LH, estradiol, IGF‐1, or PRL levels between the groups. However, differences were noted in FSH, total testosterone, and GH levels, with higher FSH and GH in the control group and higher testosterone in the experimental group.

Although IL‐1 plays a role in hormone secretion pathways, further studies are needed to better understand the effect of IL‐1 antagonists on pituitary function, as no significant adrenal or pituitary insufficiencies were observed.