ABSTRACT
No published data from this past year provide new insight on the safety and tolerability of corticosteroids, β2-adrenoreceptor agonists, or phosphodiesterase inhibitors as they pertain to respiratory diseases. While systemic corticosteroids have become a valuable therapeutic agent in treating Covid-19 pneumonia, there have been no new or unexpected adverse events reported within this context. For the leukotriene modifying agents (LTMA), the safety of leukotriene receptor antagonists (LTRA) in pediatric patients was evaluated in a systematic review, providing confirmation of known psychiatric and gastrointestinal adverse events for this drug class. In addition, a retrospective study reported that parasthesia in the extremeties developed during montelukast use in pediatric patients. This adverse event has not been previously reported. For inhaled anticholinergic drugs, published reports have recently described the safety of umeclidinium, revafenacin, and glycopyrolate in Asian patients. In addition, new insight into the association between ipratropium and mydriasis has been described in a few case reports as well as a cohort study. For the antifibrotic drugs nintedanib and pirfenidone, new reports describe the safety of these drugs for new indications, including Covid-19 pneumonia. There are also case reports describing unique side effects of these drugs, including anti-cancer effects. 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.
ABSTRACT
No published data from this past year provide new insight on the safety and tolerability of corticosteroids, β2-adrenoreceptor agonists, or phosphodiesterase inhibitors as they pertain to respiratory diseases. While systemic corticosteroids have become a valuable therapeutic agent in treating Covid-19 pneumonia, there have been no new or unexpected adverse events reported within this context. Reports evaluating the psychiatric and vascular side effect profile of the leukotriene modifier, montelukast, are described below. For inhaled anticholinergic drugs, meta-analyses describe the cardiovascular safety of these agents, as well as the safety of tiotropium in pediatric patients. A case of mydriasis associated with ipratropium therapy is described. In addition, the safety of umeclidinium as part of a triple-drug inhaler was evaluated in a large randomized clinical trial. For the antifibrotic drugs nintedanib and pirfenidone, there are a number of reports describing the safety of these drugs in specific populations, and there are a number of case reports describing unique side effects. Lastly, there are new reports describing the safety of monoclonal antibody therapy for moderate to severe asthma, as well as a few case reports describing rare adverse events associated with benralizumab, dupilumab, mepolizumab, omalizumab, and reslizumab.