Side effects of drugs that act on the respiratory tract

Published data from this past year do not provide new insight on the safety and tolerability of phosphodiesterase inhibitors for respiratory diseases. For inhaled corticosteroids, a new report characterizes mood disturbances associated with these agents among children with asthma. For the leukotriene modifying agents (LTMA), additional reports and warning letters describe neuropsychiatric adverse events associated with montelukast. One case report for inhaled β2-agonist therapy describes visual hallucinations in an elderly male patient receiving albuterol, and another report describes prolonged hypotension and hypokalemia in a child taking low-dose albuterol nebulization. For inhaled anticholinergic drugs, published reports describe anisocoria, QTc prolongation, and oral mucosal dysfunction associated with these agents. For the antifibrotic drugs nintedanib and pirfenidone, reports describe the safety of these agents for novel indications, as well as the two the first-reported cases of drug desensitization. In addition, one case reports describe reactivation of tuberculosis with nintedanib, and one report describes cancerous skin lesions associated with pirfenidone. Lastly, there are new reports describing the safety of a new monoclonal antibody therapy for severe asthma (tezepelumab), the safety of omalizumab in specific subpopulations, as well as a few reports describing the combination of mepolizumab and omalizumab for refractory severe asthma. Case reports describing benralizumab-associated cystitis, mepolizumab-associated rheumatoid arthritis (RA) and posterior reversible encephalopathy syndrome (PRES), dupilumab-associated skin reactions, and larger analyses describing omalizumab and tezepelumab adverse events.