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)

Although a temporal association with exposure to the drug may exist, evidence for causality is not strong.�For those cases exposed to methotrexate concomitantly, drug causality assessment is even more difficult.�Ruling out an infection is crucially important. Epidemiological studies tend to rule out an association (PMID: 23359391)

Publications

Nakashita T, Ando K, Kaneko N, Takahashi K, Motojima S

Potential risk of TNF inhibitors on the progression of interstitial lung disease in patients with rheumatoid arthritis.

BMJ open. 2014;4(8):e005615

Picchianti Diamanti A, Germano V, Bizzi E, Laganà B, Migliore A

Interstitial lung disease in rheumatoid arthritis in the era of biologics.

Pulmonary medicine. 2011;2011:931342

Leger S, Etienne M, Duval-Modeste AB, Roussel A, Caron F, Thiberville L

[Interstitial pneumonia after infliximab therapy for psoriasis].

Annales de dermatologie et de venereologie. 2011;138(6-7):499-503

Perez-Alvarez R, Perez-de-Lis M, Diaz-Lagares C, Pego-Reigosa JM, Retamozo S, Bove A, Brito-Zeron P, Bosch X, Ramos-Casals M

Interstitial lung disease induced or exacerbated by TNF-targeted therapies: analysis of 122 cases.

Seminars in arthritis and rheumatism. 2011;41(2):256-64

Khasnis AA, Calabrese LH

Tumor necrosis factor inhibitors and lung disease: a paradox of efficacy and risk.

Seminars in arthritis and rheumatism. 2010;40(2):147-63