Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China.
Drug Saf. 2019 Sep;42(9):1025-1033. doi: 10.1007/s40264-019-00828-z.
It has been suggested that fluoroquinolone antibiotics increase the risk of developing collagen-associated adverse events such as aortic dissection and aortic aneurysm. These are life-threatening emergencies that need to be prevented.
We performed this systematic review to clarify the association between fluoroquinolones and three collagen-associated adverse events: aortic aneurysm or aortic dissection, retinal detachment, and tendon disorders.
We searched PubMed, Embase, and Scopus for observational studies up to January 2019. Cohort and case-control studies were included if they reported data on the risk of collagen-related adverse events associated with fluoroquinolone exposure versus no exposure. We assessed the quality of the included studies using the Newcastle-Ottawa Scale. Effect statistics were pooled using random-effects models. Sensitivity and subgroup analyses were performed to identify any source of heterogeneity.
After screening 2729 citations, we included 22 observational studies (12 cohort studies and ten case-control studies) with 19,207,552 participants. Current use of fluoroquinolones was significantly associated with aortic aneurysm and aortic dissection (odds ratio [OR] 2.20; 95% confidence interval [CI] 1.92-2.52), tendon disorders (OR 1.89; 95% CI 1.53-2.33), and retinal detachment (sensitivity analysis, OR 1.25; 95% CI 1.01-1.53). Past fluoroquinolone use (> 30 and ≤ 365 days) was associated with retinal detachment (OR 1.27; 95% CI 1.09-1.47).
Fluoroquinolone use incurs a risk of developing three collagen-associated diseases (aortic aneurysm or aortic dissection, retinal detachment, and tendon disorders). Patients at an increased risk of collagen-associated diseases should not use fluoroquinolones unless no other options are available.
有研究表明，氟喹诺酮类抗生素会增加发生与胶原相关的不良事件的风险，如主动脉夹层和主动脉瘤。这些都是需要预防的危及生命的紧急情况。
我们进行了这项系统评价，以明确氟喹诺酮类药物与三种与胶原相关的不良事件（主动脉瘤或主动脉夹层、视网膜脱离和肌腱疾病）之间的关联。
我们在 PubMed、Embase 和 Scopus 中搜索了截至 2019 年 1 月的观察性研究。如果队列研究和病例对照研究报告了与氟喹诺酮类药物暴露相关的胶原相关不良事件风险的数据，且未报告与氟喹诺酮类药物暴露相关的胶原相关不良事件风险的数据，则纳入研究。我们使用纽卡斯尔-渥太华量表评估纳入研究的质量。使用随机效应模型汇总效应统计数据。进行敏感性和亚组分析，以确定任何异质性来源。
在筛选了 2729 条引文后，我们纳入了 22 项观察性研究（12 项队列研究和 10 项病例对照研究），共涉及 19207522 名参与者。目前使用氟喹诺酮类药物与主动脉瘤和主动脉夹层（优势比[OR] 2.20；95%置信区间[CI] 1.92-2.52）、肌腱疾病（OR 1.89；95%CI 1.53-2.33）和视网膜脱离（敏感性分析，OR 1.25；95%CI 1.01-1.53）显著相关。过去使用氟喹诺酮类药物（>30 天且≤365 天）与视网膜脱离（OR 1.27；95%CI 1.09-1.47）相关。
氟喹诺酮类药物的使用会增加三种与胶原相关疾病（主动脉瘤或主动脉夹层、视网膜脱离和肌腱疾病）的发病风险。患有胶原相关疾病风险增加的患者不应使用氟喹诺酮类药物，除非没有其他选择。
