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uveitis bisphosphonates

Yiming Tian, Rui Wang, Lianyuan Liu, Chunming Ma, Qiang Lu, Fuzai Yin
BACKGROUND: Zoledronic acid-induced uveitis (ZAIU) is rare but severe, and has been recently considered part of an acute phase reaction. Only 15 cases have been reported since 2005. Here we describe a case with macular edema, which is the first reported case observed after long-term alendronate tolerance. CASE PRESENTATION: A 63-year-old Asian woman received her first intravenous zoledronic acid treatment for the management of postmenopausal osteoporosis as a more convenient substitute for oral alendronate...
2016: BMC Musculoskeletal Disorders
Elena Generali, Luca Cantarini, Carlo Selmi
Eye involvement represents a common finding in patients with systemic autoimmune diseases, particularly rheumatoid arthritis, Sjogren syndrome, seronegative spondyloarthropathy, and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. The eye is a privileged immune site but commensal bacteria are found on the ocular surface. The eye injury may be inflammatory, vascular or infectious, as well as iatrogenic, as in the case of hydroxychloroquine, chloroquine, corticosteroids, and bisphosphonates. Manifestations may affect different components of the eye, with episcleritis involving the episclera, a thin layer of tissue covering the sclera; scleritis being an inflammation of the sclera potentially leading to blindness; keratitis, referring to corneal inflammation frequently associated with scleritis; and uveitis as the inflammation of the uvea, including the iris, ciliary body, and choroid, subdivided into anterior, posterior, or panuveitis...
December 2015: Clinical Reviews in Allergy & Immunology
Pascal Sève, Laurent Kodjikian, Léopold Adélaïde, Yvan Jamilloux
Rheumatologists may need to establish the etiological diagnosis and handle the therapeutic management of adults with uveitis. To date, no diagnostic strategy for uveitis has been validated by prospective studies. Investigations are selected based on the clinical features and on the anatomic location of the ocular abnormalities. Infections such as syphilis, Lyme disease, tuberculosis, and Whipple's disease may cause uveitis, with concomitant joint inflammation in a few cases. In patients with a known history of chronic inflammatory joint disease, causes of uveitis include bisphosphonate therapy and immunodepression-related infections (e...
October 2015: Joint, Bone, Spine: Revue du Rhumatisme
Angela Notarnicola, Giuseppe Maccagnano, Alessio Casalino, Lorenzo Moretti, Andrea Piazzolla, Biagio Moretti
INTRODUCTION: The most common adverse effects associated with bisphosphonates are renal toxicity, acute-phase reactions, gastrointestinal toxicity, osteonecrosis of the jaw, transitory fever and uveitis. We report a unique adverse case of vasculitis induced by clodronate. CASE PRESENTATION: A 61-year-old Caucasian woman developed bilateral renal ischemia after kyphoplasty and clodronate treatment for lumbar vertebral fracture. Tests revealed a vasculitis due to clodronate treatment...
2014: Journal of Medical Case Reports
Ramana S Moorthy, Nikolas J S London, Sunir J Garg, Emmett T Cunningham
PURPOSE OF REVIEW: Although more than 50% of all uveitis cases have no identifiable cause, certain medications can cause ocular inflammation and are often overlooked. Drug-induced ocular inflammation has increased in frequency with the advent of new bisphosphonates, antitumor necrosis factor biologic agents, and intravitreal triamcinolone and antivascular endothelial growth factor medications. Identification of these inciting drugs will simplify work-up and management of patients with uveitis and improve visual outcomes...
November 2013: Current Opinion in Ophthalmology
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May 2013: Prescrire International
Chris Or, Jing Cui, Joanne Matsubara, Farzin Forooghian
AIM: Bisphosphonates have been shown to induce ocular inflammatory diseases such as uveitis and scleritis, while being protective against angiogenic diseases like neovascular age-related macular degeneration (AMD). Therefore, we studied the effects of bisphosphonates on primary culture of human fetal retinal pigment epithelium (hRPE), a cell type known to secrete both inflammatory and angiogenic factors. Alendronate and etidronate were selected for this experiment as they are members of the two structurally different classes of bisphosphonates...
August 2013: British Journal of Ophthalmology
C Böni, H Kordic, K Chaloupka
BACKGROUND: Drug-induced cases of orbital inflammation and uveitis are rare.We present a bisphosphonate-induced case of unilateral orbital inflammation and bilateral anterior uveitis. PATIENTS AND METHODS: A 75-year-old female presents because of pain and swelling around her left eye with an onset 2 days after an intravenous zoledronic acid therapy for osteoporosis. Examination reveals reduced visual acuity of 0.2, proptosis of 4 mm, marked conjunctival chemosis and hyperemia, ophthalmoplegia and choroidal folds in the left eye and a bilateral anterior uveitis...
April 2013: Klinische Monatsblätter Für Augenheilkunde
Mario Albani-Campanario, Gerardo Buendía-Díaz, María de Lourdes Flores-Islas, Carlos Maquita-Nakano, Josefina Ochoa-Cervantes
There are several treatment options for postmenopausic patients suffering from ostopenia or osteoporosis; one of them being inhibition of bone resorption using bisphosphonates. The most common side effects of these drugs are of gastrointestinal nature. There are, of course, other side effects that could jeopardize the function and integrity of other organs or systems. A case of a 58-year-old patient presenting zoledronic-acid induced uveitis symptoms is reported. The importance of this paper lies in that this complication is rather exceptional, in particular if associated with the biphosphonate in question...
May 2012: Ginecología y Obstetricia de México
Dipika V Patel, Anne Horne, Meaghan House, Ian R Reid, Charles N J McGhee
PURPOSE: To investigate the incidence of significant adverse ocular side effects after intravenous zoledronate infusion for osteopenia. DESIGN: Data analysis of a large, prospective, randomized, double-blind, placebo-controlled clinical trial. PARTICIPANTS: Postmenopausal women (n = 2001) with osteopenia randomized to placebo or zoledronate infusion. INTERVENTION: Intravenous infusion of zoledronate 5 mg or placebo. MAIN OUTCOME MEASURES: Adverse ocular events...
April 2013: Ophthalmology
Michael Pazianas, Emma M Clark, Pia A Eiken, Kim Brixen, Bo Abrahamsen
Ocular inflammatory reactions have been described in patients on bisphosphonate treatment. We estimated the incidence rate of ocular inflammation at 3 and 12 months in patients treated for osteoporosis using a register-based cohort linked to prescription data (hospitals and private practice) and hospital data. From January 1, 1997 to December 31, 2007, a total of 88,202 patients beginning osteoporosis therapy were identified. Of those patients, 82,404 (93%) began oral bisphosphonates and 5798 (7%) nonbisphosphonates...
March 2013: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Jared D Peterson, Edward H Bedrossian
Bisphosphonates are becoming more widespread as indications for them broaden. Several ocular side effects due to bisphosphonates have been described, among the most potentially serious of which is orbital inflammation. Thirteen case reports of this side effect exist in the literature, with an additional case reported here. The most common presenting signs are lid edema, conjunctival hyperemia, and chemosis, while common symptomatology includes pain, diplopia, and blurry vision. A concomitant anterior uveitis is present in 30% of cases, and some degree of bilaterality is also seen in 30% of cases...
April 2012: Orbit
Mahyar Etminan, Farzin Forooghian, David Maberley
BACKGROUND: There have been several published reports of inflammatory ocular adverse events, mainly uveitis and scleritis, among patients taking oral bisphosphonates. We examined the risk of these adverse events in a pharmacoepidemiologic cohort study. METHODS: We conducted a retrospective cohort study involving residents of British Columbia who had visited an ophthalmologist from 2000 to 2007. Within the cohort, we identified all people who were first-time users of oral bisphosphonates and who were followed to the first inflammatory ocular adverse event, death, termination of insurance or the end of the study period...
May 15, 2012: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Alvin Eisner, Shiuh-Wen Luoh
This review concerns the effects on vision and the eye of medications prescribed at three phases of treatment for women with early-stage breast cancer (BC): (1) adjuvant cytotoxic chemotherapy, (2) adjuvant endocrine therapy, and (3) symptomatic relief. The most common side effects of cytotoxic chemotherapy are epiphora and ocular surface irritation, which can be caused by any of several different regimens. Most notably, the taxane docetaxel can lead to epiphora by inducing canalicular stenosis. The selective-estrogen-receptor-modulator (SERM) tamoxifen, long the gold-standard adjuvant-endocrine-therapy for women with hormone-receptor-positive BC, increases the risk of posterior subcapsular cataract...
October 2011: Current Eye Research
Luca Dalle Carbonare, Mirko Zanatta, Adriano Gasparetto, Maria Teresa Valenti
Bisphosphonates (BPs) are widely used in the treatment of postmenopausal osteoporosis and other metabolic bone diseases. They bind strongly to bone matrix and reduce bone loss through inhibition of osteoclast activity. They are classified as nitrogen- and non-nitrogen-containing bisphosphonates (NBPs and NNBPs, respectively). The former inhibit farnesyl diphosphate synthase while the latter induce the production of toxic analogs of adenosine triphosphate. These mechanisms of action are associated with different antifracture efficacy, and NBPs show the most powerful action...
2010: Drug, Healthcare and Patient Safety
Yar Li Tan, Joanne Sims, Soon Phaik Chee
BACKGROUND/AIMS: To highlight the potential ocular side effects of bisphosphonate therapy and the importance of a proper drug history in patients who present with uveitis. METHODS: We report 2 cases of bilateral uveitis secondary to bisphosphonate therapy. Both patients were on nitrogen-containing bisphosphonates when they developed symptoms of bilateral anterior uveitis. A uveitis screen done in both cases was normal. RESULTS: The uveitis in both patients resolved after discontinuation of the bisphosphonates, and there has been no recurrence of symptoms during the duration of the follow-up of 6 and 5 months, respectively...
2009: Ophthalmologica. Journal International D'ophtalmologie
Constantin A Dasanu, Doru T Alexandrescu
Bisphosphonates are associated with an important number of inflammatory ocular side-effects including but not limited to conjunctivitis, episcleritis, scleritis, uveitis, and optic neuritis. The intravenous bisphosphonates appear to be linked with more severe ocular inflammation than the orally administered ones. These eye complications tend to resolve with the bisphosphonate discontinuation and can re-occur with its re-challenge. We present here the first case of an acute retinal pigment epithelial detachment associated with pamidronate infusion in a 59-year-old patient with metastatic prostate cancer...
June 2009: Journal of Oncology Pharmacy Practice
Dustin D French, Curtis E Margo
PURPOSE: Uveitis and scleritis are the most serious ocular side effects of bisphosphonate therapy. The purpose of this study was to determine the 6-month rates of uveitis/scleritis following dispensing of bisphosphonates in a large veteran cohort. METHODS: Two national databases (clinical and pharmacy) for fiscal year (FY) 2006 were linked to identify new diagnoses of uveitis/scleritis following the initial dispensing of bisphosphonate drugs. New diagnoses in FY 2006 were identified using International Classification of Diseases, Version 9, Clinical Modification (ICD-9-CM), in a cohort of veterans without a previous diagnosis of uveitis or scleritis using a look-back period to FY 2005...
June 2008: Retina
Saadettin Kilickap, Yasemin Ozdamar, M Kadri Altundag, Omer Dizdar
BACKGROUND: Bisphosphonates prevent bone loss by binding on active sites of bone remodeling and inhibiting osteoclast-mediated bone resorption. Zoledronic acid is recommended for patients with bone metastases from breast, prostate, and lung cancers. OBJECTIVE: To report a case of anterior uveitis after the infusion of zoledronic acid. CASE SUMMARY: A breast cancer patient with bone metastasis was admitted with pain, visual loss, hyperemia, and periorbital swelling in her right eye 24 h after the first dose of zoledronic acid...
2008: Medical Oncology
Ricardo M Santaella, Frederick W Fraunfelder
This article reviews several retrospective case series and reported adverse events regarding common ocular adverse effects related to systemic therapy. It is not intended as a comprehensive summary of these well described adverse drug reactions, nor is it intended to cover the complete spectrum of all ocular adverse effects of systemic therapy. Many systemic drugs may produce ocular toxicity, including bisphosphonates, topiramate, vigabatrin, isotretinoin and other retinoids, amiodarone, ethambutol, chloroquine and hydroxychloroquine, tamoxifen, quetiapine, cyclo-oxygenase (COX)-2 inhibitors, erectile dysfunction agents and some herbal medications...
2007: Drugs
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