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

Background: 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. Methods: 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. Results: 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. Conclusions: 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.