The association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis

Abstract Previous studies have drawn causal associations between fluoroquinolone use and collagen pathologies including tendon rupture and retinopathy. This meta-analysis attempted to assess the association between fluoroquinolone use and the risk of aortic dissection or aortic aneurysm. A systemati...

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Autores principales:	Ian Wee, Brian Chin, Nicholas Syn, Keng Siang Lee, Jun Jie Ng, Andrew M. T. L. Choong
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/027a409794d14e189bcdadc66dd4f69e
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spelling	oai:doaj.org-article:027a409794d14e189bcdadc66dd4f69e2021-12-02T16:53:00ZThe association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis10.1038/s41598-021-90692-82045-2322https://doaj.org/article/027a409794d14e189bcdadc66dd4f69e2021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90692-8https://doaj.org/toc/2045-2322Abstract Previous studies have drawn causal associations between fluoroquinolone use and collagen pathologies including tendon rupture and retinopathy. This meta-analysis attempted to assess the association between fluoroquinolone use and the risk of aortic dissection or aortic aneurysm. A systematic search was performed on Medline, EMBASE, and the Cochrane library. 9 studies were included in final analysis. Primary random-effects meta-analysis of 7 studies, excluding 2 pharmacovigilance studies demonstrated statistically increased odds of aortic dissection (OR, 2.38; 95% CI, 1.71–3.32) aortic aneurysm (OR, 1.98; 95% CI, 1.59–2.48), and aortic aneurysm or dissection (OR, 1.47; 95% CI, 1.13–1.89; I2 = 72%) with current use of fluoroquinolones compared to their nonuser counterparts. Based on the “number needed-to-harm” analysis, 7246 (95% CI: 4329 to 14,085) patients would need to be treated with fluoroquinolones for a duration of at least three days in order for one additional patient to be harmed, assuming a population baseline incidence of aortic dissection and aneurysm rupture to be 10 per 100,000 patient-years. With strong statistical association, these findings suggest a causal relationship, warranting future research to elucidate the pathophysiological and mechanistic plausibility of this association. These findings however, should not cease prescription of fluoroquinolones, especially when clinically indicated.Ian WeeBrian ChinNicholas SynKeng Siang LeeJun Jie NgAndrew M. T. L. ChoongNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ian Wee Brian Chin Nicholas Syn Keng Siang Lee Jun Jie Ng Andrew M. T. L. Choong The association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis
description	Abstract Previous studies have drawn causal associations between fluoroquinolone use and collagen pathologies including tendon rupture and retinopathy. This meta-analysis attempted to assess the association between fluoroquinolone use and the risk of aortic dissection or aortic aneurysm. A systematic search was performed on Medline, EMBASE, and the Cochrane library. 9 studies were included in final analysis. Primary random-effects meta-analysis of 7 studies, excluding 2 pharmacovigilance studies demonstrated statistically increased odds of aortic dissection (OR, 2.38; 95% CI, 1.71–3.32) aortic aneurysm (OR, 1.98; 95% CI, 1.59–2.48), and aortic aneurysm or dissection (OR, 1.47; 95% CI, 1.13–1.89; I2 = 72%) with current use of fluoroquinolones compared to their nonuser counterparts. Based on the “number needed-to-harm” analysis, 7246 (95% CI: 4329 to 14,085) patients would need to be treated with fluoroquinolones for a duration of at least three days in order for one additional patient to be harmed, assuming a population baseline incidence of aortic dissection and aneurysm rupture to be 10 per 100,000 patient-years. With strong statistical association, these findings suggest a causal relationship, warranting future research to elucidate the pathophysiological and mechanistic plausibility of this association. These findings however, should not cease prescription of fluoroquinolones, especially when clinically indicated.
format	article
author	Ian Wee Brian Chin Nicholas Syn Keng Siang Lee Jun Jie Ng Andrew M. T. L. Choong
author_facet	Ian Wee Brian Chin Nicholas Syn Keng Siang Lee Jun Jie Ng Andrew M. T. L. Choong
author_sort	Ian Wee
title	The association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis
title_short	The association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis
title_full	The association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis
title_fullStr	The association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis
title_full_unstemmed	The association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis
title_sort	association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/027a409794d14e189bcdadc66dd4f69e
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The association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis

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