GPT and hypothyroidism: In the ten included studies, the main adverse events associated with serplulimab were increased alanine aminotransferase, vomiting, anemia, decreased neutrophil count, decreased appetite, increased aspartate aminotransferase, asthenia, increased blood bilirubin, constipation, diarrhea, decreased lymphocyte count, elevated γ-glutamyltransferase, hyperthyroidism, hypokalemia, hyponatremia, hypothyroidism, nausea, decreased platelet count, pneumonia, proteinuria, pruritus, pyrexia, rash, thrombocytopenia, and weight loss, as well as decreased WBC count.