A VigiBase descriptive study of fluoroquinolone induced disabling and potentially permanent musculoskeletal and connective tissue disorders

Sci Rep. 2021 Jul 13;11(1):14375. doi: 10.1038/s41598-021-93763-y.

Abstract

Recent drug safety concerns described fluoroquinolone (FQ)-induced serious musculoskeletal reactions. The objective of this study was to characterize reports with FQ-associated disabling musculoskeletal disorders, from VigiBase. The analysis included all FQ-induced musculoskeletal and connective tissue disorders adverse drug reaction (ADR) reports (up to July-2019), (disabling/incapacitating, or recovered/resolved with sequelae or fatal). We described aspects like reporter, suspected FQs, ADRs, associated corticosteroid therapy. We also looked into the disproportionality data in terms of proportional reporting ratio (PRR) and information component (IC) values. A total of 5355 reports with 13,563 ADRs and 5558 FQs were reported. The majority of reports were for patients aged 18-64 (62.67%), and the female gender prevailed (61.76%). Consumers reported almost half (45.99%), with a peak in reporting rates in 2017. Top reported ADRs were arthralgia (16.34%), tendonitis (11.04%), pain in extremity (9.98%), tendon pain (7.63%), and myalgia (7.17%). Top suspected FQs were levofloxacin (50.04%), ciprofloxacin (38.41%), moxifloxacin (5.16%), ofloxacin (3.17%) and norfloxacin (1.01%). For these, FQs-ADR association was supported by the disproportionality analysis. Corticosteroids were associated with about 7% of tendon related reports. The results augment the existing data on FQs safety concerns, specifically their potential effect on the musculoskeletal system.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / adverse effects
  • Adult
  • Adverse Drug Reaction Reporting Systems
  • Arthralgia / chemically induced
  • Ciprofloxacin / adverse effects
  • Connective Tissue Diseases / drug therapy*
  • Databases, Factual
  • Drug-Related Side Effects and Adverse Reactions*
  • Female
  • Fluoroquinolones / pharmacology*
  • Humans
  • Levofloxacin / adverse effects
  • Male
  • Middle Aged
  • Moxifloxacin / adverse effects
  • Musculoskeletal Diseases / drug therapy*
  • Myalgia / chemically induced
  • Norfloxacin / administration & dosage
  • Ofloxacin / administration & dosage
  • Pain / chemically induced
  • Pain / drug therapy
  • Risk Factors
  • Tendinopathy / chemically induced
  • Tendons / pathology
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Fluoroquinolones
  • Ciprofloxacin
  • Levofloxacin
  • Ofloxacin
  • Norfloxacin
  • Moxifloxacin