The Drug-Induced Respiratory Disease Website and App

Tocilizumab

For those ILD cases exposed to methotrexate concomitantly, drug causality assessment can be difficult. A meta-analysis in 2018 'did not reveal an increase in the risk of non-infectious respiratory AEs in adult patients with RA who were treated with tocilizumab compared with other DMARDs' (PMID 30183597)

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 - Interstitial/parenchymal lung disease

I.a

Pneumonitis (interstitial lung disease/ILD)

I.e

Organizing pneumonia pattern (an area or areas of consolidation on imaging)

I.z

Progression, acceleration or exacerbation of preexisting ILD/fibrosis

XLIV - Central-large-upper airway (incl. pharyngeal-nasal) involvement

XLIV.f

Vocal cord dysfunction, adduction, closure, injury

XLIX - Systemic/Distant conditions, syndromes and reactions

XLIX.m

Sarcoid-like granulomatosis (endo-/extrathoracic)

LI - Cardiovascular involvement / toxicity

LI.c

Pericardial effusion (w/wo tamponade)

LIX - Infections & related conditions

LIX.b

Opportunistic pulmonary/systemic infections

LIX.g

Tuberculosis (pulmonary, pulmonary, extrapulmonary or disseminated). Reactivation or de novo

LIX.ag

Pulmonary pasteurellosis