A pilot study on the incidence of severe photosensitivity reactions leading to hospitalization linked to topical ketoprofen and other medications in selected European regions

Abstract

The aim of this study was to assess the prevalence of exposure to topical nonsteroidal anti‐inflammatory drugs (NSAIDs), particularly ketoprofen, in a convenience sample of the population, to obtain estimates of the incidence of severe photosensitivity leading to hospitalization, and to assess causative factors in three catchment areas: the Paris metropolitan area, the Lombardy region (Italy) and the Prague area. All cases of severe photosensitivity not explained by underlying conditions and admitted to hospitals in the selected areas were included in the study. Controls were patients consecutively admitted to hospitals, in the same areas, for an acute condition or for an elective procedure not suspected of being related to medication use. From October 2012 to September 2013, 920 controls were recruited (median age 44 years, 50.8% females); 8 severe photosensitivity cases were reported in the population aged 18–74 years of the 3 geographical areas during the 1‐year surveillance period, corresponding to an incidence rate of 4.81 cases per 10 million person‐years (95% confidence interval – CI, 2.07–9.48). Six controls reported 1‐month exposure to topical ketoprofen, with an estimated prevalence of 0.65% (95% CI, 0.24–1.42). The population attributable risk for severe photosensitivity reactions linked to ketoprofen was 11.92% (95% CI, −0.12–52.99). This study was conducted in selected European areas and showed that the incidence of severe photosensitivity reactions leading to hospitalization as well as the exposure rate to topical ketoprofen were low. Among topical NSAIDs, topical ketoprofen was the leading cause of photosensitivity reactions but accounted for a limited number of hospitalized cases. Probably most of the relevant reactions were managed in the outpatient setting and a community based case–control study is advisable.

Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies

“…One 55 showed that the reporting OR for topical ketoprofen was 3.9 (95% CI 2.4 to 6.4) and the proportional reporting ratio was 3.4 (95% CI 2.1 to 5.5), versus other topical NSAIDs. The other 56 reported that the overall population attributable risk (PAR) for severe photosensitivity reactions linked to topical ketoprofen was 11.92% (–0.12 to 52.99) and the PAR for other topical NSAIDs was 2.47% (–3.17 to 29.99). Another case-control study 57 showed that topical NSAIDs might decrease the risk of squamous cell carcinoma (ever use vs non-use, incidence rate ratio (IRR): 0.85, 0.76 to 0.94) and malignant melanoma (IRR: 0.87, 0.80 to 0.95).…”