Drug-Induced Interstitial Lung Disease: A Systematic Review

Journal of Clinical Medicine

Conal Hayton¹  Maya Buch¹  Stephen Bianchi¹  Alexander Oldroyd¹  Nicholas Weatherley²  JamesM. Wild²  Sarah Skeoch³  Alessandro Giollo³  Nazia Chaudhuri⁴  AndrewJ. Swift⁵  Christopher Johns⁵  Colm Leonard⁵  JohnC. Waterton⁵  IanN. Bruce⁶  Kim Linton⁷ 

[1] Cardiovascular Disease, University of Sheffield, Sheffield S10 2TN, UK;Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9PL, UK;;Arthritis Research UK Centre for Epidemiology, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine &Bioxydyn Limited, Rutherford House, Manchester Science Park, Manchester M15 6SZ, UK;;Department of Infection, Immunity &Leeds Institute of Rheumatic and Musculoskeletal Medicine, NIHR Leeds Biomedical Research Centre, University of Leeds, Leeds LS2 9JT, UK;North West Lung Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK;

关键词: drug-induced interstitial lung disease;    pulmonary toxicity;    drug-induced pneumonitis;   

DOI  :  10.3390/jcm7100356

来源: DOAJ

【 摘 要 】

Background: Drug-induced interstitial lung disease (DIILD) occurs as a result of numerous agents, but the risk often only becomes apparent after the marketing authorisation of such agents. Methods: In this PRISMA-compliant systematic review, we aimed to evaluate and synthesise the current literature on DIILD. Results: Following a quality assessment, 156 full-text papers describing more than 6000 DIILD cases were included in the review. However, the majority of the papers were of low or very low quality in relation to the review question (78%). Thus, it was not possible to perform a meta-analysis, and descriptive review was undertaken instead. DIILD incidence rates varied between 4.1 and 12.4 cases/million/year. DIILD accounted for 3–5% of prevalent ILD cases. Cancer drugs, followed by rheumatology drugs, amiodarone and antibiotics, were the most common causes of DIILD. The radiopathological phenotype of DIILD varied between and within agents, and no typical radiological pattern specific to DIILD was identified. Mortality rates of over 50% were reported in some studies. Severity at presentation was the most reliable predictor of mortality. Glucocorticoids (GCs) were commonly used to treat DIILD, but no prospective studies examined their effect on outcome. Conclusions: Overall high-quality evidence in DIILD is lacking, and the current review will inform larger prospective studies to investigate the diagnosis and management of DIILD.

【 授权许可】

Unknown