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: Residual neuromuscular blockade is a common complication after general anaesthesia. Sugammadex can reverse the action of aminosteroid neuromuscular blockers. Our study aimed to explore sugammadex safety issues in the real world and determine the spectrum of adverse reactions. Methods: All sugammadex-related adverse events reported in VigiBase between 2010 and 2019 were classified by group queries according to the Medical Dictionary for Regulatory Activities. A disproportionality analysis of data was performed using the information component (IC); positive IC values were deemed significant. Results: Overall, 16,219,410 adverse events were reported, and 2032 were associated with sugammadex. The most frequent reactions were recurrence of neuromuscular blockade (n = 54, IC: 6.74, 95% credibility interval [CI]: 6.33–7.10), laryngospasm (n = 53, IC: 6.05, IC025:5.64), bronchospasm (n = 119, IC: 5.63 , IC025:5.36), and bradycardia (n = 169, IC: 5.13, IC025:4.90). Fatal cases were more likely with cardiac disorders, especially in patients over 65 years. In addition, the common adverse drug reactions (ADRs) differed between different age groups (P < 0.01). The ADRs were higher between 0–17 years than in other age groups. The onset time of common ADRs was typically within one day, and 68.9% occurred within half an hour after sugammadex administration. Conclusions: Anaesthesiologists should carefully monitor the anaesthesia recovery period to correct the adverse drug reactions caused by sugammadex and recommend monitoring neuromuscular function throughout the anaesthesia process. Sugammadex should be used carefully in patients with cardiovascular diseases, and ECG and hemodynamic changes monitored after medication.