Sirolimus and Everolimus Induced Pneumonitis in Adult Renal Allograft Recipients: Experience in a Center

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“…[6][7][8][9]11 The physiopathology is not clearly known, but it has been demonstrated that imTORs stimulate production of inflammatory cytokines and memory T cells, thus promoting proinflammatory effects in lung tissue. 8,9 No direct association has been demonstrated between imTOR levels and the development of pneumonitis.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Several risk factors for its development have been described, with infection by Epstein-Barr virus being a main cause of early-onset forms and chronic antigen stimulation of donors and/or accumulated immunosuppression as factors of later forms of lymphocyte transformation. 2 In the literature as a first-line treatment after PTLD diagnosis, in addition to specific treatments (chemoradiation, radiotherapy, and/or immunotherapy), it is recommended that either doses of calcineurin inhibitors be decreased or agent converted to inhibitors of mammalian target of rapamycin (imTOR), 10 since, with either, the reduction of immunosuppression would restore the ability of the receptor's immune system to control the uncontrolled proliferation of lymphomatous cells.…”

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“…Table 1 summarizes the literature, including detailed prescribed case or case series with pneumonitis developed after everolimus treatment in renal transplant recipients. 2,4,[6][7][8][9][10][11] In the literature, there are also several studies that evaluated the efficacy and effects of everolimus treatment in renal transplant recipients. [12][13][14][15] Although these studies rarely reported pneumonitis as an adverse event, patients' characteristics and details on pulmonary findings were not described.…”

“…The most common sign of pneumonitis is shortness of breath, which may be accompanied by a dry cough. Although pneumonitis usually develops within 1 year, especially within the first 3 months after initiation of mTOR inhibitors, [1][2][3] late occurrences have also been reported with sirolimus but rarely with everolimus. 4 In this report, we describe an unusual case of late-occurring pneumonitis 5 years after start of everolimus.…”

Salvage therapy with everolimus reduces the severity of treatment-refractory chronic GVHD without impairing disease control: A dual center retrospective analysis

“…24,25 Whether everolimus's slightly different mechanism of action is associated with an improved toxicity profile is unclear to date. 26,27 Everolimus is an approved drug for immunosuppressive treatment in solid organ transplantation as well as an approved anti-neoplastic agent in kidney, breast and neuroendocrine pancreatic cancer. [28][29][30][31] However, data on the use of everolimus in allo-SCT are very limited.…”