infliximab for pneumonitis?

[Krista Rubin]

At your centers, is infliximab being used to treat steroid refractory pneumonitis? If so, what has the experience been?
Thank you

[Kathleen Madden]

No, Krista, we have been fortunate enough that even our most severe cases of pneumonitis have responded to high dose steroids, but I could see how the thought consideration could come up.
I suppose that we may in that instance consider temsirolimus or another anti-rejection med, which would be utilized with a patient who had a lung transplant- like we do with mycophenalate & irAE related hepatitis.

-Kathy

[Suzanne McGettigan]

Hi Krita–
We have utilized infliximab for a number of steroid-refractory immune related toxicities, including pneumonitis and myocarditis.
For hepatitis, we do not use infliximab and have used mycophenylate in the steroid-refractory setting.

[Kathleen Madden]

Suzanne, you make a good point that infliximab should not be administered for immune hepatitis, in the literature, this is noted as a contraindication due to it’s own potential for hepatotoxicity.

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