Bilateral acute uveitis and conjunctivitis after zoledronic acid therapy

Durnian, J M; Olujohungbe, Adebayo; Kyle, G

doi:10.1038/sj.eye.6701461

Cited by 40 publications

(21 citation statements)

References 2 publications

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“…Severe anterior uveitis has been reported in patients who received alendronate and pamidronate [8][9][10][11]. However, only two cases who developed bilateral and unilateral anterior uveitis after the infusion of zoledronic acid have been reported [12,13]. One patient was treated with topical steroid (prednisone) and atropine, but the other received only topical steroid (1% cyclopentolate).…”

Section: Discussionmentioning

confidence: 97%

A case report: zoledronic acid-induced anterior uveitis

Kılıçkap

Özdamar²,

Altundag

et al. 2007

Med Oncol

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Section: Discussionmentioning

confidence: 97%

A case report: zoledronic acid-induced anterior uveitis

Kılıçkap

Özdamar²,

Altundag

et al. 2007

Med Oncol

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“…Cases of iritis, episcleritis and scleritis, but also conjunctivitis, have been reported after therapy with n-BPs (mainly alendronate, pamidronate disodium and zoledronic acid) in up to 1% [145–147]. This does not seem to constitute an exclusive complication for n-BPs, but they were rarely reported with first-generation BPs [148].…”

Section: Bisphosphonatesmentioning

confidence: 99%

Extraskeletal benefits and risks of calcium, vitamin D and anti-osteoporosis medications

et al. 2012

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SummaryDrugs used for the prevention and the treatment of osteoporosis exert various favourable and unfavourable extra-skeletal effects whose importance is increasingly recognized notably for treatment selection.IntroductionThe therapeutic armamentarium for the prevention and the treatment of osteoporosis is increasingly large, and possible extra-skeletal effects of available drugs could influence the choice of a particular compound.MethodsThe present document is the result of a national consensus, based on a systematic and critical review of the literature.ResultsObservational research has suggested an inverse relationship between calcium intake and cardiovascular diseases, notably through an effect on blood pressure, but recent data suggest a possible deleterious effect of calcium supplements on cardiovascular risk. Many diverse studies have implicated vitamin D in the pathogenesis of clinically important non-skeletal functions or diseases, especially muscle function, cardiovascular disease, autoimmune diseases and common cancers. The possible effects of oral or intravenous bisphosphonates are well-known. They have been associated with an increased risk of oesophageal cancer or atrial fibrillation, but large-scale studies have not found any association with bisphosphonate use. Selective oestrogen receptor modulators have demonstrated favourable or unfavourable extra-skeletal effects that vary between compounds. Strontium ranelate has a limited number of non-skeletal effects. A reported increase in the risk of venous thromboembolism is not found in observational studies, and very rare cases of cutaneous hypersensitivity reactions have been reported. Denosumab has been introduced recently, and its extra-skeletal effects still have to be assessed.ConclusionSeveral non-skeletal effects of bone drugs are well demonstrated and influence treatment choices.

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“…A range of ocular side effects of amino-bisphosphonate infusions have previously been reported, including acute anterior uveitis (AAU) [1], scleritis [2] and orbital inflammatory disease [3]. A recent prospective study of the incidence of ocular side effects after a single intravenous zoledronate infusion reported an incidence of AAU of 1.1 %, and the mean time from infusion to onset of symptoms was 3 days.…”

Section: Introductionmentioning

confidence: 97%

The Effects of Re-challenge in Patients with a History of Acute Anterior Uveitis Following Intravenous Zoledronate

et al. 2015

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To determine the incidence of adverse ocular side effects following re-challenge in patients who previously developed ocular symptoms following intravenous zoledronate. Secondary data analysis of a large, prospective, randomized, double-blind, placebo-controlled clinical trial was performed. Participants consisted of postmenopausal females with osteopenia randomized to placebo (N = 1000) or zoledronate 5 mg (N = 1001) intravenous infusion. Recruitment occurred over a 2-year period, with the first infusion being administered at recruitment, and subsequent infusions every 18 months. Eight participants developed acute anterior uveitis (AAU) (diagnosed by an ophthalmologist) following the first infusion of zoledronate. Following appropriate ophthalmic treatment, no patients had visual loss or other ocular sequelae. One further participant reported "sore red eyes" but did not attend for ophthalmology review. Six participants declined further infusions. The remaining three participants were administered two further zoledronate infusions, 18 months apart, and none developed any ocular symptoms following each infusion. As a precaution, two of these participants were examined by an ophthalmologist 3 days after their second infusion and neither had ocular symptoms or signs of AAU and no subsequent ocular side effects. AAU following zoledronate infusion is likely to be part of the acute phase response. If treated promptly under the care of an ophthalmologist, the visual prognosis is excellent. The results of this study suggest that the development of AAU should not be a contraindication to further infusion. However, in such cases, patients should be warned of the symptoms of AAU (ocular pain, redness, photophobia or blurred vision) and should be promptly referred to an ophthalmologist if symptoms develop.

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Bilateral acute uveitis and conjunctivitis after zoledronic acid therapy

Cited by 40 publications

References 2 publications

A case report: zoledronic acid-induced anterior uveitis

A case report: zoledronic acid-induced anterior uveitis

Extraskeletal benefits and risks of calcium, vitamin D and anti-osteoporosis medications

The Effects of Re-challenge in Patients with a History of Acute Anterior Uveitis Following Intravenous Zoledronate

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