Lung injury has been linked to the use of certain medications, sometimes referred to as ‘breath-taking drugs.’
However, in daily clinical practice, this cause of lung damage often remains unrecognized and continues to be underestimated. We questioned whether inherited characteristics involved in drug metabolism might be linked to the development of lung injury. Is there an association between medication use and individual genetic (pharmacogenetic) profiles in the onset and/or progression of drug-induced interstitial lung disease (DI-ILD)?
In our study, Drug–gene risk stratification in patients with suspected drug-induced ILD, we investigated 467 patients referred to the ILD Center of Excellence at St. Antonius Hospital in Nieuwegein with suspected DI-ILD. Remarkably, 79% showed genetic variations associated with impaired metabolism of the medications they were using. In 60% of these patients, drug-induced lung disease was considered likely, while in 38% the diagnosis was considered highly likely. Statins appeared to play a significant role among men in the study population, whereas women were more frequently prescribed nitrofurantoin. Although nitrofurantoin is not affected by the tested genetic variants, it is well recognized as a potential cause of lung injury.
These findings highlight the importance of focusing not only on medication use itself, but also on the way an individual metabolizes these drugs, supported by pharmacogenetic testing. This personalized approach may help identify individual causes or contributing factors involved in the development or progression of severe and often unexplained interstitial lung diseases.
Drent M, Wijnen PA, Jessurun NT, Harmsze AM, Bekers O, Bast A. Drug–gene risk stratification in patients with suspected drug-induced interstitial lung disease. Drug Safety 2024. doi: 10.1007/s40264-024-01400-0. Link
