A systematic review and meta‐analysis of the association between systemic fluoroquinolones and retinal detachment

Alves, Carlos; Penedones, Ana; Mendes, Diogo; Marques, Francisco Batel

doi:10.1111/aos.12931

Cited by 20 publications

(18 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our analysis supports these findings, as the percentage of serious ADRs was significantly correlated with the number of ingested medications and with patient age. A previous meta-analy-sis of the relationship between systemic fluoroquinolones and retinal detachment did not show any significant association [18]. In our data we found 26 cases of retinal detachment and only one case (3.85%) was associated with the intake of fluoroquinolones, supporting the conclusion of the meta-analysis.…”

Section: Discussionsupporting

confidence: 85%

Pharmacovigilance in ophthalmology in Switzerland: an analysis of the most frequently reported ocular adverse drug reactions within the last 25 years

et al. 2019

View full text Add to dashboard Cite

AIMS OF THE STUDY: Although systemic drugs can exert local effects on the eye, ophthalmology is a medical specialty with perhaps the fewest assessed adverse drug reactions (ADRs), representing a particular challenge in pharmacovigilance. Our aim was to quantify ADRs in ophthalmology in Switzerland, with a focus on angiogenesis inhibitors.METHODS: Individual case safety reports (ICSRs) on suspected ADRs reported in Switzerland from January 1991 to June 2016 were extracted from the WHO Global ICSR database, VigiBase™. ICSRs were analysed in relation to treatment duration, patient age, route of administration, patient sex and reported symptoms. RESULTS: A total of 80,515 ICSRs were reported in Switzerland during the reference period. Reactions linked to eye disorders accounted for 2793 (3.5%) cases. The main Anatomic Therapeutic Chemical / Defined Daily Dose drug classes associated with eye disorders were drugs acting on the nervous system (27.7%) followed by drugs "acting on sensory organs" (20.2%) and antineoplastic agents (18.0%). Most cases involved adult patients (70.6%). Patients over 60 years accounted for 815 (29.2%) ICSRs, and reactions in children were significantly less frequent (8.2%). Older patients were exposed to a higher number of drugs, and the majority of serious reactions involved children and older patients. A significant positive correlation between polypharmacy and seriousness of reported reactions was observed. The reported drugs were categorised as "suspected" in 51.1%, "concomitant" in 43.3% and "interacting" in 2.6% of cases. "Visual impairment" was the most commonly reported adverse reaction, experienced by 635 (22.7%) of patients (7.2% of all reported eye-related symptoms). The majority of reactions were transient, as 4173 (47.1%) completely resolved. Severe reactions included fatal outcome in 18 patients (0.6%) and blindness in 78 patients (2.6%). Since 2000, the intravitreous vascular endothelial growth factor (VEGF) inhibitors bevacizumab, aflibercept and ranibizumab accounted for 99 ICSRs. Retinal haemorrhage (reporting odds ratio [ROR] 10.36, 95% confidence interval [95% CI] 2.65-40.50; p <0.001), blindness (ROR 3.73,; p = 0.04) and uveitis (ROR 6.91,; p = 0.01) were significantly more frequently reported for aflibercept than for bevacizumab and ranibizumab.CONCLUSIONS: ADRs that affect the eye represented 3.5% of all pharmacovigilance reports during the reporting period. Whereas retinal haemorrhage and uveitis are known adverse reactions to angiogenesis inhibitors, the reported cases of blindness and death should heighten awareness of potential safety issues associated with VEGF inhibitors for the treatment of proliferative eye disorders.

show abstract

Section: Discussionsupporting

confidence: 85%

Pharmacovigilance in ophthalmology in Switzerland: an analysis of the most frequently reported ocular adverse drug reactions within the last 25 years

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Recent epidemiological literature has suggested several additional risk factors, although the evidence is not conclusive. These include recent oral fluoroquinolones use,3 and hypertension and obesity 4…”

Section: Introductionmentioning

confidence: 99%

Occupational lifting and rhegmatogenous retinal detachment: a follow-up study of Swedish conscripts

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Similar to efficacy systematic reviews, systematic reviews focusing on drug’s safety could present a broad or narrow review question [11]. A systematic review studying the association of a class of medicines with a specific adverse drug reaction (for example, the development of retinal detachment after fluoroquinolones exposure [12]) has a narrow focus, while a systematic review studying all adverse drug reactions associated with a class of medicines (for example, the safety profile of ophthalmic anti-angiogenesis inhibitors [13]) has a broad focus [11].…”

Section: Discussionmentioning

confidence: 99%

A comparison between two recommendations to conduct and report systematic reviews on drug’s safety

Penedones

Marques

2019

Syst Rev

Self Cite

View full text Add to dashboard Cite

Background Several recommendations are available to conduct and report a systematic review of adverse drug reactions. This study is aimed at identifying and comparing the methodologies of the two most commonly used recommendations to conduct and report systematic reviews on drug’s safety. Methods Two systematic reviews were conducted following the recommendations “Cochrane Handbook for Systematic Reviews of Interventions” and “Systematic Reviews’ Centre for Reviews and Dissemination guidance for undertaking reviews in healthcare.” The methods of each recommendation were characterized, and the results and the discussion of each systematic review were also evaluated. Results The methodologies of both recommendations are similar. The review question was structured. Both recommendations suggest to include pre- and post-marketing data. The recommended data sources differed and, consequently, the results of the systematic reviews (37 vs. 35 studies). Other aspects of search literature were identical. Different tools are suggested to evaluate the methodological quality of the included studies. For case reports, both recommendations only report some questions that may be helpful to assess risk of bias. The reporting of the results and discussion is also identical for both recommendations. Conclusions Few methodological differences were observed between the analyzed recommendations to conduct a systematic review on drug’s safety. Combining their methods into a single and recognized recommendation could be of great value.

show abstract

A systematic review and meta‐analysis of the association between systemic fluoroquinolones and retinal detachment

Cited by 20 publications

References 29 publications

Pharmacovigilance in ophthalmology in Switzerland: an analysis of the most frequently reported ocular adverse drug reactions within the last 25 years

Pharmacovigilance in ophthalmology in Switzerland: an analysis of the most frequently reported ocular adverse drug reactions within the last 25 years

Occupational lifting and rhegmatogenous retinal detachment: a follow-up study of Swedish conscripts

A comparison between two recommendations to conduct and report systematic reviews on drug’s safety

Contact Info

Product

Resources

About