Evidence map›Paper›PMID 39723254›Full record

ArticleFrontiers in pharmacology2024

Use of fluoroquinolones and risk of rhegmatogenous retinal detachment: a retrospective cohort study using two nationwide representative claims databases.

Ting-Yu Lin, Jiun-Ling Wang, Grace Hsin-Min Wang, Yu-Yun Huang, Ming-Ching Chen, Yaa-Hui Dong, Wei-Hsuan Lo-Ciganic

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Article in Frontiers in pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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7 authors.

Ting-Yu LinDepartment of Pharmacy, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Jiun-Ling WangDepartment of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Grace Hsin-Min WangDepartment of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, United States.
Yu-Yun HuangDepartment of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
Ming-Ching ChenDepartment of Pharmacy, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Yaa-Hui DongDepartment of Pharmacy, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Wei-Hsuan Lo-CiganicDivision of General Internal Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Although biological plausibility suggests that fluoroquinolones could lead to rhegmatogenous retinal detachment (RRD) through collagen degradation, real-world evidence on their relative risk of RRD is inconsistent, with limited information on absolute risk estimates. Objective: The study aimed to estimate the RRD risk associated with fluoroquinolones versus other antibiotics with similar indications (i.e., comparison antibiotics). Methods: We conducted a retrospective cohort study analyzing claims data from adult patients who initiated fluoroquinolones or amoxicillin/clavulanate or ampicillin/sulbactam or extended-spectrum cephalosporins using the Taiwan National Health Insurance Research Database (2009-2018) and the United States IBM MarketScan Database (2011-2020). Patients were followed for up to 90 days after cohort entry. For each country's data, after 1:1 propensity score (PS) matching, we used Cox regression models to estimate RRD risks, presented with hazard ratios (HR) with 95% confidence interval (95% CI). We used random-effects meta-analyses to derive pooled HRs across both counties. Results: Of 24,172,032 eligible patients comprising 7,944,620 insured Taiwanese (mean age [SD], 46 [18] years; 45% male) and 16,227,412 United States commercially insured individuals (mean age [SD], 47 [16] years; 40% male), 10,137,468 patients initiated fluoroquinolones, 10,203,794 initiated amoxicillin/clavulanate or ampicillin/sulbactam, and 3,830,770 initiated extended-spectrum cephalosporins. After PS matching, similar RRD incidence rates were observed between fluoroquinolones and amoxicillin/clavulanate or ampicillin/sulbactam users (0.33 [95% CI, 0.19-0.56] versus 0.35 [95% CI, 0.26-0.46] per 1,000 person-years), yielding an HR of 0.97 (95% CI, 0.76-1.23). The RRD incidence rates were also similar comparing fluoroquinolones to extended-spectrum cephalosporins (0.36 [95% CI, 0.22-0.57] versus 0.34 [95% CI, 0.22-0.50] per 1,000 person-years; HR, 1.08 [95% CI, 0.92-1.27]). The comparative safety profiles remained consistent by country, various patient characteristic (e.g., diabetes or ophthalmic conditions), type of fluoroquinolones, follow-up duration, or treatment setting. Conclusion: This large-scale study, leveraging real-world data from Taiwan and the United States, showed a low and comparable RRD risk among adults who initiated fluoroquinolones or other antibiotics with similar indications. This suggests that the RRD risk should not deter the use of fluoroquinolone when clinically indicated.

Indexed as

cohort studyfluoroquinolonespharmacoepidemiologyreal-world datarhegmatogenous retinal detachment

Identifiers

PMID39723254
PMCPMC11668581

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