Please use this identifier to cite or link to this item: https://doi.org/10.1038/s41598-021-90692-8
Title: The association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis
Authors: Wee, Ian
Chin, Brian
Syn, Nicholas
Lee, Keng Siang
Ng, Jun Jie 
Choong, Andrew MTL 
Keywords: Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
MATRIX METALLOPROTEINASE-2
RISK
EXPRESSION
MANAGEMENT
CELLS
Issue Date: 26-May-2021
Publisher: NATURE RESEARCH
Citation: Wee, Ian, Chin, Brian, Syn, Nicholas, Lee, Keng Siang, Ng, Jun Jie, Choong, Andrew MTL (2021-05-26). The association between fluoroquinolones and aortic dissection and aortic aneurysms: a systematic review and meta-analysis. SCIENTIFIC REPORTS 11 (1). ScholarBank@NUS Repository. https://doi.org/10.1038/s41598-021-90692-8
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.
Source Title: SCIENTIFIC REPORTS
URI: https://scholarbank.nus.edu.sg/handle/10635/205873
ISSN: 20452322
DOI: 10.1038/s41598-021-90692-8
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