Oral fluoroquinolones and risk of fibromyalgia

The Food and Drug Administration (FDA) has recently included a black box warning on fibromyalgia‐like symptoms with fluoroquinolones (FQs) but no large epidemiologic study is to date available. We undertook a case–control study using a random sample of 9 053 240 subjects obtained from the PharMetric...

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Published inBritish journal of clinical pharmacology Vol. 85; no. 1; pp. 236 - 239
Main Authors Ganjizadeh‐Zavareh, Saeed, Sodhi, Mohit, Spangehl, Tori, Carleton, Bruce, Etminan, Mahyar
Format Journal Article
LanguageEnglish
Published England John Wiley and Sons Inc 01.01.2019
Subjects
Adult
Amoxicillin - adverse effects
Anti-Bacterial Agents - adverse effects
antibiotics
Azithromycin - adverse effects
Case-Control Studies
Female
fibromyalgia
Fibromyalgia - chemically induced
Fibromyalgia - epidemiology
fluoroquinolones
Fluoroquinolones - adverse effects
Humans
infectious diseases
Male
Middle Aged
nested case–control study
Risk Factors
Short Report
Short Reports
United States - epidemiology
United States
nested case-control study
fluoroquinolones
fibromyalgia
antibiotics
infectious diseases
Online AccessGet full text
ISSN0306-5251
1365-2125
1365-2125
DOI10.1111/bcp.13765

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Abstract The Food and Drug Administration (FDA) has recently included a black box warning on fibromyalgia‐like symptoms with fluoroquinolones (FQs) but no large epidemiologic study is to date available. We undertook a case–control study using a random sample of 9 053 240 subjects obtained from the PharMetrics Plus health claims database in the United States. Cases received at least two fibromyalgia diagnoses coded by a rheumatologist matched to ten randomly selected controls. After identifying 5148 cases of fibromyalgia and 51 480 controls, the adjusted rate ratio (RR) of fibromyalgia for use of any fluoroquinolones, amoxicillin and azithromycin were 1.63 (95% CI: 1.41–1.87), 1.64 (95% CI: 1.46–1.85) and 1.68 (95% CI, 1.49–1.89), respectively. The adjusted RR for any use of FQ compared to any use of amoxicillin or azithromycin was 0.99 (95% CI: 0.83–1.18) and azithromycin is 0.97 (95%CI: 0.82–1.16), respectively. The risk of fibromyalgia with FQs is similar to that with amoxicillin and azithromycin.
AbstractList The Food and Drug Administration (FDA) has recently included a black box warning on fibromyalgia‐like symptoms with fluoroquinolones (FQs) but no large epidemiologic study is to date available. We undertook a case–control study using a random sample of 9 053 240 subjects obtained from the PharMetrics Plus health claims database in the United States. Cases received at least two fibromyalgia diagnoses coded by a rheumatologist matched to ten randomly selected controls. After identifying 5148 cases of fibromyalgia and 51 480 controls, the adjusted rate ratio (RR) of fibromyalgia for use of any fluoroquinolones, amoxicillin and azithromycin were 1.63 (95% CI: 1.41–1.87), 1.64 (95% CI: 1.46–1.85) and 1.68 (95% CI, 1.49–1.89), respectively. The adjusted RR for any use of FQ compared to any use of amoxicillin or azithromycin was 0.99 (95% CI: 0.83–1.18) and azithromycin is 0.97 (95%CI: 0.82–1.16), respectively. The risk of fibromyalgia with FQs is similar to that with amoxicillin and azithromycin.
The Food and Drug Administration (FDA) has recently included a black box warning on fibromyalgia-like symptoms with fluoroquinolones (FQs) but no large epidemiologic study is to date available. We undertook a case-control study using a random sample of 9 053 240 subjects obtained from the PharMetrics Plus health claims database in the United States. Cases received at least two fibromyalgia diagnoses coded by a rheumatologist matched to ten randomly selected controls. After identifying 5148 cases of fibromyalgia and 51 480 controls, the adjusted rate ratio (RR) of fibromyalgia for use of any fluoroquinolones, amoxicillin and azithromycin were 1.63 (95% CI: 1.41-1.87), 1.64 (95% CI: 1.46-1.85) and 1.68 (95% CI, 1.49-1.89), respectively. The adjusted RR for any use of FQ compared to any use of amoxicillin or azithromycin was 0.99 (95% CI: 0.83-1.18) and azithromycin is 0.97 (95%CI: 0.82-1.16), respectively. The risk of fibromyalgia with FQs is similar to that with amoxicillin and azithromycin.The Food and Drug Administration (FDA) has recently included a black box warning on fibromyalgia-like symptoms with fluoroquinolones (FQs) but no large epidemiologic study is to date available. We undertook a case-control study using a random sample of 9 053 240 subjects obtained from the PharMetrics Plus health claims database in the United States. Cases received at least two fibromyalgia diagnoses coded by a rheumatologist matched to ten randomly selected controls. After identifying 5148 cases of fibromyalgia and 51 480 controls, the adjusted rate ratio (RR) of fibromyalgia for use of any fluoroquinolones, amoxicillin and azithromycin were 1.63 (95% CI: 1.41-1.87), 1.64 (95% CI: 1.46-1.85) and 1.68 (95% CI, 1.49-1.89), respectively. The adjusted RR for any use of FQ compared to any use of amoxicillin or azithromycin was 0.99 (95% CI: 0.83-1.18) and azithromycin is 0.97 (95%CI: 0.82-1.16), respectively. The risk of fibromyalgia with FQs is similar to that with amoxicillin and azithromycin.
Author Etminan, Mahyar
Carleton, Bruce
Spangehl, Tori
Sodhi, Mohit
Ganjizadeh‐Zavareh, Saeed
AuthorAffiliation 5 British Columbia Children's Hospital Research Institute University of British Columbia Vancouver Canada
2 Department of Ophthalmology and Visual Sciences and Pharmacology University of British Columbia Vancouver Canada
6 Pharmaceutical Outcomes Program British Columbia Children's Hospital Vancouver Canada
1 Department of Medicine, Faculty of Medicine University of British Columbia Vancouver Canada
4 Division of Translational Therapeutics, Department of Pediatrics University of British Columbia Vancouver Canada
3 MD Undergraduate Program, Faculty of Medicine University of British Columbia Vancouver Canada
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CitedBy_id crossref_primary_10_1371_journal_pone_0263087
crossref_primary_10_3390_neurosci2030017
crossref_primary_10_1080_08820139_2020_1797778
crossref_primary_10_1080_17476348_2021_1887734
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Keywords nested case-control study
fluoroquinolones
fibromyalgia
antibiotics
infectious diseases
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Snippet The Food and Drug Administration (FDA) has recently included a black box warning on fibromyalgia‐like symptoms with fluoroquinolones (FQs) but no large...
The Food and Drug Administration (FDA) has recently included a black box warning on fibromyalgia-like symptoms with fluoroquinolones (FQs) but no large...
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SubjectTerms Adult
Amoxicillin - adverse effects
Anti-Bacterial Agents - adverse effects
antibiotics
Azithromycin - adverse effects
Case-Control Studies
Female
fibromyalgia
Fibromyalgia - chemically induced
Fibromyalgia - epidemiology
fluoroquinolones
Fluoroquinolones - adverse effects
Humans
infectious diseases
Male
Middle Aged
nested case–control study
Risk Factors
Short Report
Short Reports
United States - epidemiology
Title Oral fluoroquinolones and risk of fibromyalgia
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