The Drug-Induced Respiratory Disease Website and App

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

I.b

Pneumonitis (interstitial lung disease/ILD)

Publications

Gökten DB, Mercan R

Methotrexate-Associated Hypersensitivity Pneumonitis After 15 Years of Use: A Case Report and Literature Review.

Mediterranean journal of rheumatology. 2025;36(2):316-321

Agarwal M, Sharma KK, Deokar K, Bharti N

Methotrexate pneumonitis in a patient with gestational trophoblastic neoplasia.

African journal of thoracic and critical care medicine. 2022;28(3)

Conway R, Low C, Coughlan RJ, O'Donnell MJ, Carey JJ

Methotrexate and lung disease in rheumatoid arthritis: a meta-analysis of randomized controlled trials.

Arthritis & rheumatology (Hoboken, N.J.). 2014;66(4):803-12

D'Elia T

Methotrexate-induced pneumonitis: heterogeneity of bronchoalveolar lavage and differences between cancer and rheumatoid arthritis.

Inflammation & allergy drug targets. 2014;13(1):25-33

Massey H, Darby M, Edey A

Thoracic complications of rheumatoid disease.

Clinical radiology. 2013;68(3):293-301

Arakawa H, Yamasaki M, Kurihara Y, Yamada H, Nakajima Y

Methotrexate-induced pulmonary injury: serial CT findings.

Journal of thoracic imaging. 2003;18(4):231-6

Fuhrman C, Parrot A, Wislez M, Prigent H, Boussaud V, Bernaudin JF, Mayaud C, Cadranel J

Spectrum of CD4 to CD8 T-cell ratios in lymphocytic alveolitis associated with methotrexate-induced pneumonitis.

American journal of respiratory and critical care medicine. 2001;164(7):1186-91

Zisman DA, McCune WJ, Tino G, Lynch JP 3rd

Drug-induced pneumonitis: the role of methotrexate.

Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG. 2001;18(3):243-52

Imokawa S, Colby TV, Leslie KO, Helmers RA

Methotrexate pneumonitis: review of the literature and histopathological findings in nine patients.

The European respiratory journal. 2000;15(2):373-81

Cannon GW

Methotrexate pulmonary toxicity.

Rheumatic diseases clinics of North America. 1997;23(4):917-37

Sharma A, Provenzale D, McKusick A, Kaplan MM

Interstitial pneumonitis after low-dose methotrexate therapy in primary biliary cirrhosis.

Gastroenterology. 1994;107(1):266-70

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Acute lymphocytic leukemia in children: maintenance therapy with methotrexat administered intermittently. Acute Leukemia Group B.

JAMA. 1969;207(5):923-8