Pneumotox » Drug » Immune checkpoint inhibitors (ICI) - ICI combinatorial Rx » I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS)

Immune checkpoint inhibitors (ICI) - ICI combinatorial Rx

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I.a Pneumonitis (ILD), acute and/or severe (may cause ARDS)

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Can be steroid-refractory (PMID 30176946, 30301729, 30837232)), requiring additional immunosuppression/modulation with e.g. IVIG, infliximab, or MMF. The development of ICPI-related ILD may negatively impact the outcome in lung cancer patients

Last update : 10/03/2019

Diagnosing DIRD

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Drug and radiation history

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Drug singularity - Correct identification of the drug

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Consistent timing of exposure v. onset of symptoms

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Clinical, imaging, BAL, pathological pattern consistent with the specific drug

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Careful exlusion of another cause

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Remission of symptoms with removal of drug

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Recurrence with rechallenge (rarely advisable)

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Causality assessment

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