The Drug-Induced Respiratory Disease Website

Natalizumab

Rechallenge can lead to relapse of AE/ILD

When available, likelihood and risk given for specific drug

Arwi G, Chhor L, Malipatil V

Recrudescence of Natalizumab-Induced Pneumonitis and Peripheral Hypereosinophilia: Case Report and Literature Review.

Respirology case reports 2025 Apr;13;e70191 — 2025 Apr — e70191

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

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