Agamreevamorolone · Glucocorticoid receptor (dissociative)Glucocorticoid immunosuppression: TDAR inhibited in female mice and abolished in male mice at 100 mg/kg/day
Alyftrekvanzacaftor, tezacaftor and deutivacaftor · CFTR26-week rat: decreased lymphocytes in spleen, thymus and lymph nodes
Anzupgodelgocitinib · Pan-JAK (topical)Immunotoxic in a 4-week oral rat study, an expected immunosuppressive effect
Artesunateartesunate · Plasmodium (antimalarial)Increased leukocytes and fibrinogen, indicating an inflammatory response
Augtyrorepotrectinib · ROS1/TRKNon-adverse decreased lymphocytes in blood and lymphoid organs in rats and monkeys
Avmapki Fakzynja Co-packavutometinib and defactinib · RAF/MEK clamp; FAKAvutometinib: lymph node follicular hyperplasia, plasma cells and inflammatory infiltrates in rats and monkeys
Barhemsysamisulpride · Dopamine D2/D3 receptorHigh-dose males: 24% decrease in lymphocytes and 19% decrease in total white blood cells
Baxfendybaxdrostat · Aldosterone synthase (CYP11B2)Decreased lymphocytes in spleen, thymus and mesenteric lymph nodes in 39-week monkey study (non-adverse)
Beqalzisonrotoclax · BCL-2Lymphoid depletion; one mouse death from opportunistic infection secondary to lymphoid depletion
Blujepagepotidacin · Bacterial topoisomerases (gyrase/topo IV)Thymic lymphoid depletion in high-dose rats, considered stress-related
Brexafemmeibrexafungerp · Fungal glucan synthaseThymic lymphoid necrosis in high-dose rats (1-month study)
Brinsupribrensocatib · DPP1 (cathepsin C)No dedicated immunotoxicity studies; weight-of-evidence evaluation showed no concerning immunotoxic risk
Brukinsazanubrutinib · BTKLymphoid depletion in dogs (also rats); inflammatory responses with elevated WBCs
Bylvayodevixibat · IBATNo effects on thymus, spleen, lymph nodes or bone marrow; dedicated immunotoxicity studies not performed
Cabenuvacabotegravir and rilpivirine · HIV-1 integrase; NNRTINegative rat TDAR; no skin sensitization
Camzyosmavacamten · Cardiac myosinThymus decreased in size from decreased cellularity in rats and dogs
Cibinqoabrocitinib · JAK1Monkey KLH assay: dose-related reduction in IgG and IgM from 15 mg/kg/day, with partial recovery
Cobenfyxanomeline and trospium · Muscarinic M1/M4 agonist; peripheral antagonistModerate skin sensitizer in mouse LLNA (EC3 125 µg/cm2)
Coselatrilaciclib · CDK4/6Failure to clear catheter-related bacterial infections, suggesting compromised immune response from leukocyte suppression
Crenessitycrinecerfont · CRF1 receptorRat TDAR study: small changes in leukocytes, lymphocyte subsets and T-cell-dependent antibody response (males); no remarkable immunotoxicity
Dayvigolemborexant · Orexin OX1/OX2 receptorsNo drug-related findings in immune function assessments (immunophenotyping, NK activity, granulocyte function, cytokine release)
Defencathtaurolidine and heparin · Antimicrobial catheter lockNot irritating intradermally and nonsensitizing in guinea pigs
Duvyzatgivinostat · Histone deacetylase (class I/II)Lymphoid depletion with atrophy of thymus, lymph nodes, bone marrow and spleen; partially reversible
Egatentriclabendazole · Fasciola (tubulin)Guinea pig sensitization: no reaction after epidermal challenge; contact dermatitis unlikely
Ekterlysebetralstat · Plasma kallikreinThymus microscopic findings in monkeys at 300 mg/kg/day and above
Ensacoveensartinib · ALKSplenic lymphoid depletion and marked bone marrow hypocellularity in the 4-week dog study
Exblifepcefepime and enmetazobactam · PBPs; beta-lactamase (enmetazobactam)Guinea pig maximization test: no skin sensitization
Exkivitymobocertinib · EGFR exon 20 insertionIncreased lymphoid cellularity in lymph nodes in rats and dogs
Exxuagepirone · 5-HT1A receptorIncreased mesenteric lymph node plasmablasts at end of dosing (highest at 70 mg/kg), reversible after recovery
Fabhaltaiptacopan · Complement factor BMinimal TDAR effects in 39-week dog study: reduced IgM/IgG titers to KLH
Fetrojacefiderocol · Penicillin-binding proteinsSplenic germinal center development in 1- and 3-month rat studies, a response to weak antigenic stimulation; no anaphylaxis
Fruzaqlafruquintinib · VEGFR1-3Immune system (thymus, spleen, lymph nodes) a target organ in dog studies
Gavretopralsetinib · RETNo dedicated immunotoxicity studies; decreased cellularity of haematopoietic and lymphoid organs in rats and monkeys
Gomeklimirdametinib · MEK1/2Lymphoid hyperplasia, lymphoid depletion and increased plasma cells in lymph nodes of rats and dogs
Grafapextreosulfan · DNA alkylationMyeloablative and immunosuppressive in a murine allogeneic bone marrow transplant model
Hernexeoszongertinib · HER2 (mutant)4-week rat: slight to moderate fluctuations in blood, spleen and thymocyte populations
Ibtrozitaletrectinib · ROS1Thymic atrophy and lymph node erythrophagocytosis and foamy macrophages in monkeys
Idvynsodoravirine and islatravir · NNRTI; NRTTIDose- and duration-dependent lymphocyte decreases in two mouse strains
Inluriyoimlunestrant · Estrogen receptor (SERD)No dedicated immunotoxicity studies; TDAR effects in rats judged non-adverse as immune responses were still mounted
Inqovidecitabine and cedazuridine · DNMT (decitabine); cytidine deaminase (cedazuridine)Reversible thymic lymphoid depletion attributed to cedazuridine
Inrebicfedratinib · JAK2Bone marrow hypoplasia and lymphocyte depletion (spleen, thymus, lymph nodes) in all species; immunosuppressive
Iqirvoelafibranor · PPARα/δThymic atrophy in dogs from 30 mg/kg/day (females) and 100 mg/kg/day (males)
Isturisaosilodrostat · 11β-hydroxylase (CYP11B1)Strong skin sensitizer (Category 1A) in murine local lymph node assay
Jascaydnerandomilast · PDE4BIL-6 induction by high-dose PDE4 inhibition linked to rat mesenteric vasculitis
Jaypircapirtobrutinib · BTK (non-covalent)Decreased B lymphocytes and TDAR response to KLH; adverse only for the anti-KLH TDAR in male rats
Jideytrozidesamtinib · ROS1Dose-dependent lymphoid depletion (GALT, lymph nodes, spleen, thymus) in dogs, incompletely reversible at 4 mg/kg/day
Joenjaleniolisib · PI3KδLymphoid atrophy (lymph node, thymus, GALT) and immunosuppression-related skin lesions/infections in rats
Komziftiziftomenib · Menin-KMT2AThymic white blood cell infiltration, vacuolation and lymphoid depletion, persisting after recovery
Koselugoselumetinib · MEK1/2Secondary lymphoreticular changes with inflammatory/ulcerative GI findings in mice (~19.5x clinical free AUC)
Krazatiadagrasib · KRAS G12CLymphoid tissue changes not considered an immunotoxicity risk; no dedicated immunotoxicity studies
Kygevvidoxecitine and doxribtimine · Pyrimidine nucleoside replacement (TK2 deficiency)No hormonal or immune modulation in 26-week juvenile rat and 13-week dog studies
Lampitnifurtimox · Trypanosoma cruziDecreased thymus weights in high-dose rats without correlating histopathology
Leqselvideuruxolitinib · JAK1/JAK2Reduced WBC and lymphocytes; lymphoid depletion in spleen, thymus, lymph nodes and GALT
Lifyorlirelacorilant · Glucocorticoid receptor (antagonist)Generalized lymphoid depletion contributed to deaths in 2-week rat studies at ≥200 mg/kg/day
Litfuloritlecitinib · JAK3/TEC kinasesAdverse immunosuppression (skin mites, lung inflammation) at 40 mg/kg/day in the 39-week dog study
Livdelziseladelpar · PPARδNo immunotoxicity in repeat-dose studies; negative mouse local lymph node assay
Lupkynisvoclosporin · CalcineurinImmunosuppression: thymic medullary atrophy, absent germinal centers, lymphomas, decreased lymphocytes
Lybalviolanzapine and samidorphan · D2/5-HT2A; opioid receptors (samidorphan)Non-adverse, partially reversible thymus weight decrease with lymphoid depletion in male dogs
Lynkuetelinzanetant · NK1/NK3 receptorsThymus atrophy and lymphoid depletion, attributed to treatment-induced stress
Mayzentsiponimod · S1P1/S1P5 receptorLymphoid depletion with reduced WBC and lymphocytes in all species, attributed to pharmacology
Miplyffaarimoclomol · Heat-shock response amplifierLymphoid and bone marrow depletion, spleen and thymus atrophy at MTD or higher
Myqorzoaficamten · Cardiac myosinGuinea pig dermal sensitisation study (modified Buehler) negative: no erythema after topical application
Nextstellisdrospirenone and estetrol · Estrogen / progestin receptorsThymus weight reduction with minimal to severe lymphoid atrophy in all species
Nourianzistradefylline · Adenosine A2A receptorNo antigenicity: no anaphylaxis (ASA/PCA) reactions or drug-specific antibodies
Nubeqadarolutamide · Androgen receptorIncreased thymus weight in male rats and dogs, possibly reduced thymic involution; no immunotoxicity studies
Nulibryfosdenopterin · cPMP replacement (MoCD type A)No antigenicity or immunotoxicity studies conducted
Nuzolvencezoliflodacin · Bacterial topoisomerase IIOne male dog at 500 mg/kg/day euthanized with marked necrosis and inflammation of ileum and gut-associated lymphoid tissue
Ogsiveonirogacestat · Gamma secretaseDecreased cellularity of gut-associated lymphoid tissue and mesenteric lymph nodes in rats
Ojemdatovorafenib · RAF (type II pan-RAF)Rat: minimal to mild thymus and mesenteric lymph node depletion, not reversed after recovery
Ojjaaramomelotinib · JAK1/JAK2/ACVR1Hematopoietic and lymphoid tissue targets: bone marrow, spleen, lymph node and thymus
Olinvykoliceridine · μ-opioid receptor (G-protein biased)Stress-related reductions in white blood cells and lymphocytes; minimal thymus atrophy
Ongentysopicapone · COMTSlight increase in T-helper lymphocytes in rats, with no functional change (sheep RBC response)
Orgovyxrelugolix · GnRH receptorNo immunotoxicity studies; no immune-system findings in general toxicity studies
Orladeyoberotralstat · Plasma kallikreinFoamy macrophages/histiocytes in spleen, thymus and intestine (phospholipidosis)
Orlynvahsulopenem etzadroxil and probenecid · Penicillin-binding proteinsDose-related positive Coombs test in monkeys, likely antibody-mediated minimal erythrocyte loss
Orserduelacestrant · Estrogen receptor (SERD)Macrophage and neutrophilic infiltrates in mesenteric lymph node, lung and intestines of rats and monkeys
Oxbrytavoxelotor · HbS polymerisationImmunosuppression: opportunistic infections in monkeys, reduced IgG/IgM titres, delayed antibody response
Palsonifypaltusotine · Somatostatin receptor 2No dedicated immunotoxicity study; no immunotoxicity findings in the nonclinical or clinical program
Piqrayalpelisib · PI3KαInflammation and/or suppression in bone marrow, spleen, thymus and lymph nodes
Ponvoryponesimod · S1P1 receptorReversible suppression of T-cell dependent antibody response during dosing
Pretomanidpretomanid · Mycobacterial cell wall / respirationLymphoid depletion (spleen, thymus, Peyer's patches, BALT) in all three species, at toxic doses
Qelbreeviloxazine · Norepinephrine reuptakeDecreased thymus weight, considered secondary to stress and poor condition; reversible
Rapiblyklandiolol · β1-adrenergic receptorDecreased thymus weight at the high dose in the rat fertility study
Rasonquedaraxonrasib · RAS(ON) multi-selectiveMonkey immune activation with fibrinogen elevation, thymic toxicity and myelosuppression
Revtorpykgedatolisib · PI3K/mTORDecreased white blood cells and lymphocytes, reduced bone marrow cellularity (rat) and lymphocyte depletion in thymus and spleen
Reyvowlasmiditan · 5-HT1F receptorSplenic marginal-zone lymphoid depletion and thymic involution at high dose in rats
Rezdiffraresmetirom · Thyroid hormone receptor βIncreased spleen weight in female mice without other immune findings; immunotoxicity risk low
Rezurockbelumosudil · ROCK2Thymic lymphoid depletion with reduced thymus weight at high dose; not seen after recovery
Rezzayorezafungin · Fungal glucan synthaseAcute transient histamine-release response in rats; mild histamine-like response in monkeys
Rhapsidoremibrutinib · BTKInhibited primary antibody responses to some antigens, attributed to BTK role in B cells
Rinvoqupadacitinib · JAK1Decreased circulating lymphocytes and lymphoid depletion in spleen, thymus and lymph nodes (JAK inhibition)
Romvimzavimseltinib · CSF1RRat: bone marrow suppression and lymphoid tissue hypocellularity/necrosis at the highest 28-day dose
Rozlytrekentrectinib · TRK/ROS1/ALKLymphoid depletion in rat spleen (≥25 mg/kg/day), lymph nodes and thymus (≥200 mg/kg/day)
Rukobiafostemsavir · HIV-1 gp120 (attachment)No immunotoxicity in TDAR assay within the 26-week rat study
Scemblixasciminib · BCR-ABL1 (STAMP, myristoyl pocket)Thymic lymphocyte necrosis and splenic lymphoid depletion in one rat at 200 mg/kg/day
Sephiencesepiapterin · Tetrahydrobiopterin precursorNo immune-system effects in repeat-dose studies; no immunotoxicity studies
Skyclarysomaveloxolone · Nrf2 activatorNo dedicated immunotoxicity studies; not required for this small molecule
Sotyktudeucravacitinib · TYK2Immunosuppression: lower lymphocyte counts, lymphoid depletion and reduced TDAR to KLH in rats; reduced TDAR in monkeys
Sunlencalenacapavir · HIV-1 capsidPositive in two of three in vitro skin sensitisation assays; negative in vivo
Sunosisolriamfetol · Dopamine/norepinephrine reuptakeDose-dependent changes in immune cell counts and immune organ weight/morphology, most prominent in rats
Tavneosavacopan · C5a receptor (C5aR1)No effect on monkey TDAR, peripheral immunophenotyping or lymphoid organ histology
Tazveriktazemetostat · EZH2Monkey: lymphoid hyperplasia in mesenteric lymph node of a single male at 600 mg/kg/day
Turaliopexidartinib · CSF1RThymic lymphoid depletion with decreased thymus weight and lymphocytes; lymphoid hyperplasia with lymph node enlargement
Utebzitebipenem pivoxil · Penicillin-binding proteinsNegative in guinea pig delayed hypersensitivity and mouse/guinea pig antigenicity studies
Vafseovadadustat · HIF prolyl hydroxylaseNo immunotoxic signals in rat and dog repeat-dose studies; no dedicated immunotoxicity studies
Vekluryremdesivir · SARS-CoV-2 RNA polymeraseNo dedicated immunotoxicity studies; no concerns in repeat-dose studies
Velsipityetrasimod · S1P1/S1P4/S1P5 receptorsDose-dependent lymphocyte decreases in rats and dogs; lymphoid depletion in rat lymph nodes and spleen (pharmacological)
Veozahfezolinetant · Neurokinin-3 receptorNo antigenicity or immunotoxicity studies conducted (not considered necessary)
Verquvovericiguat · Soluble guanylate cyclaseNo indicators of immune-system effects; no further immunotoxicity evaluation
Vonjopacritinib · JAK2/FLT3Lymphoid tissue depletion with white blood cell changes consistent with bone marrow suppression in mice, rats and dogs
Voranigovorasidenib · IDH1/IDH2Lymphoid organs (lymph nodes, Peyer's patches, spleen, thymus) among rat target organs
Voydeyadanicopan · Complement factor DAlternative-pathway blockade may impair serum bactericidal activity (meningococcal infection risk) when antibody titers are low
Vtamatapinarof · Aryl hydrocarbon receptorLymphoid depletion with decreased thymus weights in rats at 10 and 40 mg/kg/day subcutaneously
Wakixpitolisant · Histamine H3 receptorNo changes in haematology, immune organ weights/histology or infections in 6-month rat and 9-month monkey studies; not investigated further
Winleviclascoterone · Androgen receptor (topical)Lymphocyte decreases and lymphoid organ atrophy attributed to weak glucocorticoid activity
Xcopricenobamate · Sodium channel / GABA-ABone marrow lymphoid hyperplasia in 52-week monkey study, persisting after recovery at high dose
Xenletalefamulin · Bacterial ribosome (50S PTC)Splenic lymphoid sheath reduction and thymic cortical atrophy in rats after IV dosing
Xocovaensitrelvir · SARS-CoV-2 3CL protease20-40% decreases in T- and B-cell populations in 4-week monkey study
Zavzpretzavegepant · CGRP receptorNon-dose-related lower spleen and thymus weights in monkey without histopathological correlates
Zenbexusiberdomide · Cereblon (CELMoD)Immune suppression from lymphoid depletion; decreased neutrophils and lymphocytes, matching clinical neutropenia and infections
Zeposiaozanimod · S1P1/S1P5 receptorDecreased T and B lymphocytes; suppressed T-dependent IgM and IgG antibody responses
Zepzelcalurbinectedin · DNA minor groove (transcription)Lymphocyte and neutrophil decreases suggest a general decrease in immune responsiveness
Zokinvylonafarnib · FarnesyltransferaseLymphoid hypocellularity in spleen, thymus and mesenteric lymph node after 3 months in rats
Ztalmyganaxolone · GABA-A receptor (positive modulator)No antigenicity or immunogenicity studies conducted
Zulressobrexanolone · GABA-A receptor (positive modulator)No dermal irritation, skin sensitization or hemolytic potential
Azstarysserdexmethylphenidate and dexmethylphenidate · Dopamine/norepinephrine reuptakeNot stated in public reviews
Recarbrioimipenem, cilastatin and relebactam · Beta-lactamase (relebactam)Not stated in public reviews
Relyvriosodium phenylbutyrate and taurursodiol · ER stress / mitochondrial (proposed)Not stated in public reviews