Positive Association Between Fluoroquinolone Exposure and Tendon Disorders: A Nationwide Population-Based Cohort Study in Taiwan
Introduction: Fluoroquinolone exposure is reportedly associated with a higher risk of tendon disorders, tendonitis, or tendon rupture. However, studies in East Asian populations have not confirmed these risks in patients with comorbidities or concomitant medication use. This cohort study was designe...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-03-01
|
| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.814333/full |
| _version_ | 1818317344374521856 |
|---|---|
| author | Chun-Kai Chang Chun-Kai Chang Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Wan-Fu Hsu Hao-Yu Chiao Chi-Hsiang Chung Chi-Hsiang Chung Chi-Hsiang Chung Yuan-Sheng Tzeng Shao-Wei Huang Kuang-Ling Ou Chih-Chien Wang Shyi-Jou Chen Der-Shiun Wang Der-Shiun Wang |
| author_facet | Chun-Kai Chang Chun-Kai Chang Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Wan-Fu Hsu Hao-Yu Chiao Chi-Hsiang Chung Chi-Hsiang Chung Chi-Hsiang Chung Yuan-Sheng Tzeng Shao-Wei Huang Kuang-Ling Ou Chih-Chien Wang Shyi-Jou Chen Der-Shiun Wang Der-Shiun Wang |
| author_sort | Chun-Kai Chang |
| collection | DOAJ |
| description | Introduction: Fluoroquinolone exposure is reportedly associated with a higher risk of tendon disorders, tendonitis, or tendon rupture. However, studies in East Asian populations have not confirmed these risks in patients with comorbidities or concomitant medication use. This cohort study was designed to investigate the associations among fluoroquinolone exposure, comorbidities, medication use, and tendon disorders in Taiwan.Materials and Methods: This population-based, nationwide, observational, cohort study used data from the National Health Insurance Research database in Taiwan, a nationwide claims database that covers more than 99% of the Taiwanese population. The study period was from January 2000 to December 2015, and the median follow-up time was 11.05 ± 10.91 years. Patients who were exposed to fluoroquinolones for more than three consecutive days were enrolled, and patients without fluoroquinolone exposure who were matched by age, sex, and index year were enrolled as controls. The associations of comorbidities and concomitant medication use with tendon disorder occurrence were analyzed using Cox regression models.Results: The incidence of tendon disorders were 6.61 and 3.34 per 105 person-years in patients with and without fluoroquinolone exposure, respectively (adjusted hazard ratio, 1.423; 95% confidence interval [1.02,1.87]; p = 0.021). Sensitivity analyses yielded similar results. Patients under 18 and over 60 years with fluoroquinolone exposure; those with chronic kidney disease, diabetes, rheumatologic disease, cardiac disease, lipid disorder, or obesity; and those who concomitantly used statins, aromatase inhibitors, or glucocorticoids, had a significantly higher risk of tendon disorders.Conclusion: The long-term risk of tendon disorders was higher in patients with fluoroquinolone exposure than in those without fluoroquinolone exposure. Clinicians should assess the benefits and risks of fluoroquinolone use in patients at high risk of tendon disorders who require fluoroquinolone administration. |
| first_indexed | 2024-12-13T09:35:50Z |
| format | Article |
| id | doaj.art-2cf659bab6a14a0494555752699572de |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-13T09:35:50Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-2cf659bab6a14a0494555752699572de2022-12-21T23:52:21ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-03-011310.3389/fphar.2022.814333814333Positive Association Between Fluoroquinolone Exposure and Tendon Disorders: A Nationwide Population-Based Cohort Study in TaiwanChun-Kai Chang0Chun-Kai Chang1Wu-Chien Chien2Wu-Chien Chien3Wu-Chien Chien4Wan-Fu Hsu5Hao-Yu Chiao6Chi-Hsiang Chung7Chi-Hsiang Chung8Chi-Hsiang Chung9Yuan-Sheng Tzeng10Shao-Wei Huang11Kuang-Ling Ou12Chih-Chien Wang13Shyi-Jou Chen14Der-Shiun Wang15Der-Shiun Wang16Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Surgery, Zouying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, TaiwanDepartment of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanSchool of Public Health, National Defense Medical Center, Taipei, TaiwanGraduate Institute of Life Sciences, National Defense Medical Center, Taipei, TaiwanDepartment of Pediatrics, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, TaiwanDivision of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanSchool of Public Health, National Defense Medical Center, Taipei, TaiwanTaiwanese Injury Prevention and Safety Promotion Association, Taipei, TaiwanDivision of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Pediatrics, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, TaiwanDivision of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Pediatrics, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, TaiwanDepartment of Pediatrics, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, TaiwanDepartment of Pediatrics, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, TaiwanGraduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, TaiwanIntroduction: Fluoroquinolone exposure is reportedly associated with a higher risk of tendon disorders, tendonitis, or tendon rupture. However, studies in East Asian populations have not confirmed these risks in patients with comorbidities or concomitant medication use. This cohort study was designed to investigate the associations among fluoroquinolone exposure, comorbidities, medication use, and tendon disorders in Taiwan.Materials and Methods: This population-based, nationwide, observational, cohort study used data from the National Health Insurance Research database in Taiwan, a nationwide claims database that covers more than 99% of the Taiwanese population. The study period was from January 2000 to December 2015, and the median follow-up time was 11.05 ± 10.91 years. Patients who were exposed to fluoroquinolones for more than three consecutive days were enrolled, and patients without fluoroquinolone exposure who were matched by age, sex, and index year were enrolled as controls. The associations of comorbidities and concomitant medication use with tendon disorder occurrence were analyzed using Cox regression models.Results: The incidence of tendon disorders were 6.61 and 3.34 per 105 person-years in patients with and without fluoroquinolone exposure, respectively (adjusted hazard ratio, 1.423; 95% confidence interval [1.02,1.87]; p = 0.021). Sensitivity analyses yielded similar results. Patients under 18 and over 60 years with fluoroquinolone exposure; those with chronic kidney disease, diabetes, rheumatologic disease, cardiac disease, lipid disorder, or obesity; and those who concomitantly used statins, aromatase inhibitors, or glucocorticoids, had a significantly higher risk of tendon disorders.Conclusion: The long-term risk of tendon disorders was higher in patients with fluoroquinolone exposure than in those without fluoroquinolone exposure. Clinicians should assess the benefits and risks of fluoroquinolone use in patients at high risk of tendon disorders who require fluoroquinolone administration.https://www.frontiersin.org/articles/10.3389/fphar.2022.814333/fullfluoroquinolonetendinopathytendon rupturestatinglucocorticoidaromatase inhibitor |
| spellingShingle | Chun-Kai Chang Chun-Kai Chang Wu-Chien Chien Wu-Chien Chien Wu-Chien Chien Wan-Fu Hsu Hao-Yu Chiao Chi-Hsiang Chung Chi-Hsiang Chung Chi-Hsiang Chung Yuan-Sheng Tzeng Shao-Wei Huang Kuang-Ling Ou Chih-Chien Wang Shyi-Jou Chen Der-Shiun Wang Der-Shiun Wang Positive Association Between Fluoroquinolone Exposure and Tendon Disorders: A Nationwide Population-Based Cohort Study in Taiwan Frontiers in Pharmacology fluoroquinolone tendinopathy tendon rupture statin glucocorticoid aromatase inhibitor |
| title | Positive Association Between Fluoroquinolone Exposure and Tendon Disorders: A Nationwide Population-Based Cohort Study in Taiwan |
| title_full | Positive Association Between Fluoroquinolone Exposure and Tendon Disorders: A Nationwide Population-Based Cohort Study in Taiwan |
| title_fullStr | Positive Association Between Fluoroquinolone Exposure and Tendon Disorders: A Nationwide Population-Based Cohort Study in Taiwan |
| title_full_unstemmed | Positive Association Between Fluoroquinolone Exposure and Tendon Disorders: A Nationwide Population-Based Cohort Study in Taiwan |
| title_short | Positive Association Between Fluoroquinolone Exposure and Tendon Disorders: A Nationwide Population-Based Cohort Study in Taiwan |
| title_sort | positive association between fluoroquinolone exposure and tendon disorders a nationwide population based cohort study in taiwan |
| topic | fluoroquinolone tendinopathy tendon rupture statin glucocorticoid aromatase inhibitor |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.814333/full |
| work_keys_str_mv | AT chunkaichang positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT chunkaichang positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT wuchienchien positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT wuchienchien positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT wuchienchien positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT wanfuhsu positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT haoyuchiao positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT chihsiangchung positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT chihsiangchung positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT chihsiangchung positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT yuanshengtzeng positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT shaoweihuang positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT kuanglingou positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT chihchienwang positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT shyijouchen positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT dershiunwang positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan AT dershiunwang positiveassociationbetweenfluoroquinoloneexposureandtendondisordersanationwidepopulationbasedcohortstudyintaiwan |