The Drug-Induced Respiratory Disease Website

Durvalumab

Myocarditis (can be fulminate/fulminant)

Typically acute. Can be fulminate/fulminant and fatal (PMID 30242316). General review at PMID 28540649. Recent addition to the lst of causal drugs include immune checkpoint inhibitors (PMID 28833116, 29801747)

Publications

Bae S, Vaysblat M, Ng J, Beccarino N, Makaryus J, Sarkar K

Durvalumab-Associated Myocarditis Initially Presenting With Sinus Bradycardia Progressing Into Complete Heart Block.

Cureus 2023 Jun;15;e40171 — 2023 Jun — e40171

Maetani T, Hamaguchi T, Nishimura T, Marumo S, Fukui M

Durvalumab-associated Late-onset Myocarditis Successfully Treated with Corticosteroid Therapy.

Internal medicine (Tokyo, Japan) 2021 Aug 24;; — 2021 Aug 24

Cham J, Ng D, Nicholson L

Durvalumab-induced myocarditis, myositis, and myasthenia gravis: a case report.

Journal of medical case reports 2021 May 31;15;278 — 2021 May 31 — 278

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

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

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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