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Table 1 Potential effects of targeted small molecule/monoclonal agents on risk of NTM Infection

From: ‘”Why me, why now?” Using clinical immunology and epidemiology to explain who gets nontuberculous mycobacterial infection

  Element of NTM immune response targeted?  
Target Example(s) T cells Mononuclear phagocytes Key cytokines Other Th1 cytokines Theoretical risk for NTM †
TNF Infliximab
Certolizumab
Adalimumab
Etanercept
Golimumab
N N Y N +++
IL-12/23 Ustekinumab N N Y N +++
JAK Ruxolitinib
Tofacitinib
? Y Y N +++
CD52 Alemtuzumab Y Y N ? ++
CD25/IL2R Basiliximab
Daclizumab
Y ? N ? ++
CD3 Muromonab Y N N N ++
α4-integrin component Natalizumab Y Y N N ++
IL-6R Tocilizumab N N N Y +
CTLA-4 (agonist) Abatacept
Belatacept
N Y ? Y +
IL-1R1/IL-1β Anakinra
Rilonacept
N N N Y +
CD30 Brentuximab Y N N N ±
RANKL Denosumab Y Y N N ±
CD20 Rituximab *
Ofatumumab *
N N N N -
BLyS/BAFF Belimumab * N ? N N -
Btk Ibrutinib * N ? N N -
HER-2/erbB Trastuzumab
Pertuzumab
Erlotinib
N N N N -
VEGF/VEGFR Bevacizumab
Ranibizumab
Aflibercept
Axitinib
Lapatinib
N N N N -
EGFR Panitumumab
Afatinib
Gefitinib
N N N N -
BcrAbl Bosutinib
Nilotinib
N N N N -
C5 Eculizumab N N N N -
IgE Omalizumab N N N N -
GPIIb/IIIa Abciximab N N N N -
  1. * Target B cells – note risk of hypogammaglobulinemia and secondary bronchiectasis
  2. † +++ very significant risk, ++ significant risk, + some risk, ± unclear risk, − no risk
  3. Y = Yes, N = No, ? = possible
  4. TNF, tumour necrosis factor; IL, interleukin; JAK, Janus activated kinase; CD, cluster of differentiation; CTLA-4, cytotoxic T-lymphocyte-associated protein 4; RANKL, Receptor activator of nuclear factor kappa-B ligand; BLyS, B lymphocyte stimulator; BAFF, B cell activating factor; Btk, Bruton’s tyrosine kinase; HER-2, Human epidermal growth factor receptor 2; VEGF(R), vascular endothelial growth factor (receptor); EGFR, epidermal growth factor receptor; C5, complement component C5; IgE, Immunoglobulin E; GPIIb/IIIa, Glycoprotein IIb/IIIa; NTM, nontuberculous mycobacteria; Th1, T helper 1