■氟喹诺酮类药物摄入与跟腱病(AT)或跟腱断裂(ATR)之间的关联已被广泛记录。然而,目前尚不清楚不同的分子是否对这些并发症有相同的影响。这项研究的目的是记录大多数规定的氟喹诺酮类药物分子的跟腱并发症。
■在Pubmed,科克伦,Embase,和截至2023年4月的WebofScience数据库。纳入标准:任何水平的证据的研究,用英语写的,记录服用氟喹诺酮类药物后AT/ATR的患病率,并对每种分子的结果进行分层。DownsandBlack的“质量测量清单”用于评估偏差的风险。
■纳入了12项研究,调查了439,299名患者(59.7%的女性,40.3%男性,平均年龄:53.0±15.6岁)。左氧氟沙星的AT/ATR的预期风险为0.17%(95%CI:0.15-0.19,标准误差(s.e.):0.24),环丙沙星为0.17%(95%CI:0.16-0.19,s.e.:0.20),氧氟沙星为1.40%(95%CI:0.88-2.03,s.e.:2.51),其他分子为0.31%(95%CI:0.23-0.40,s.e.:0.77)。组间比较证明氧氟沙星组的AT/ATR率显著较高(每次比较P<0.0001)。左氧氟沙星和环丙沙星显示出相同的风险(P=n.s.)。纳入的研究总体质量较好。
■氧氟沙星在成人人群中表现出明显更高的AT/ATR并发症发生率,而与所有其他分子相比,左氧氟沙星和环丙沙星显示出更安全的特征。需要更多的数据来确定影响肌肉骨骼并发症风险的其他患者和治疗相关因素。
UNASSIGNED: The association between fluoroquinolone intake and Achilles tendinopathy (AT) or Achilles tendon rupture (ATR) is widely documented. However, it is not clear whether different molecules have the same effect on these complications. The purpose of this study was to document Achilles tendon complications for the most prescribed fluoroquinolones molecules.
UNASSIGNED: A literature search was performed on Pubmed, Cochrane, Embase, and Web of Science databases up to April 2023. Inclusion criteria: studies of any level of evidence, written in English, documenting the prevalence of AT/ATR after fluoroquinolone consumption and stratifying the results for each type of molecule. The Downs and Black\'s \'Checklist for Measuring Quality\' was used to evaluate the risk of bias.
UNASSIGNED: Twelve studies investigating 439,299 patients were included (59.7% women, 40.3% men, mean age: 53.0 ± 15.6 years). The expected risk of AT/ATR was 0.17% (95% CI: 0.15-0.19, standard error (s.e.): 0.24) for levofloxacin, 0.17% (95% CI: 0.16-0.19, s.e.: 0.20) for ciprofloxacin, 1.40% (95% CI: 0.88-2.03, s.e.: 2.51) for ofloxacin, and 0.31% (95% CI: 0.23-0.40, s.e.: 0.77) for the other molecules. The comparison between groups documented a significantly higher AT/ATR rate in the ofloxacin group (P < 0.0001 for each comparison). Levofloxacin and ciprofloxacin showed the same risk (P = n.s.). The included studies showed an overall good quality.
UNASSIGNED: Ofloxacin demonstrated a significantly higher rate of AT/ATR complications in the adult population, while levofloxacin and ciprofloxacin showed a safer profile compared to all the other molecules. More data are needed to identify other patient and treatment-related factors influencing the risk of musculoskeletal complications.