Aim: Chimeric antigen receptor (CAR)-T cell therapy represents a revolutionary immunotherapy and cutting-edge strategy for cancer treatment. However, the pharmacological safety of this approach in the endocrine system has yet to be sufficiently validated. This study aims to explore the potential toxicity signals of CAR T-cell therapy in the endocrine system and their clinical relevance. Methods: This study utilized data from the FDA Adverse Event Reporting System (FAERS) database, covering 2017 to the first quarter of 2023 (Q1). Signal detection of adverse events was achieved through the information component method combined with the reporting odds ratio method. Results: A total of 34,216,716 records were available in the FAERS database, and 60,730 records were screened for CAR T-cell therapy as the primary or secondary suspected agent, identifying 12 positive endocrine signals (preferred term), which represent a rare occurrence in the existing literature on CAR T-cell therapy. Hyperglycemia topped the list with 42 reported cases (ROR025=1.01), followed by hypercalcemia (n=26,ROR025=1.45) and adrenal insufficiency (n=15,ROR025=0.66). Exophthalmos-related reports for tisagenlecleucel therapy showed the highest death rate among the positive signals detected (5/6, 83.3%). Adverse event reports related to conditions with fatal outcomes, such as adrenal insufficiency (7/15, 46.7%), and hypercalcemia (13/25, 52.0%), demonstrate significant overlap with cytokine release syndrome (CRS). Conclusions: It is crucial for healthcare professionals to closely monitor the potential adverse events related to the endocrine system that may arise from CAR T-cell therapy. These events necessitate thorough observation after treatment administration and the creation of targeted prevention and treatment strategies

Aim: With the widespread use of SGLT2i, various adverse events (AEs) have been reported. This study aimed to describe the distribution of SGLT2i-related AEs in different systems, quantify the association of important medical events (IMEs) and SGLT2i regimens, and build a signal profile of SGLT2i- induced IMEs. Methods: Data from 2015 Q1 to 2020 Q4 in the FDA Adverse Event Reporting System database (FAERS) were selected to conduct disproportionality analysis. Two signal indicators, the reported odds ratio (ROR) and information component (IC), were used to evaluate the correlation between SGLT2i and IMEs. The lower end of the 95% confidence interval of IC (IC025) exceeding zero was deemed a signal. For ROR, it was defined a signal if ROR025 over one, with at least 3 cases. Results: A total of 45,771,436 records were involved, including 111,564 records related to SGLT2i, with 38,366 records of SGLT2i-induced IMEs. Overall, SGLT2i was significantly associated with IMEs (IC=0.36, 95% CI: 0.35-0.38; ROR=1.44, 95% CI: 1.42-1.46). Most SGLT2i-related adverse events occurred in monotherapy (92.93%). Diabetic ketoacidosis was the most IMEs. Specifically, acute osteomyelitis has the strongest signal of all SGLT2i (IC025=7.83), and it was unique to canagliflozin. Diabetic ketoacidosis, acute kidney injury, ketoacidosis, Fournier’s gangrene, and euglycemic diabetic ketoacidosis were common to the four FDA-approved SGLT2i. Conclusion: Our study demonstrated that different SGLT2i regimens lead to different important adverse events, but there are overlapping events. Early identification and management of SGLT2i-associated IMEs are essential for clinical practice.