Assessment of Musculoskeletal Toxicity 5 Years After Therapy With Levofloxacin

作者:Bradley John S*; Kauffman Ralph E; Balis Dainius A; Duffy Ciaran M; Gerbino Peter G; Maldonado Samuel D; Noel Gary J
来源:Pediatrics, 2014, 134(1): E146-E153.
DOI:10.1542/peds.2013-3636

摘要

BACKGROUND: Safety concerns for fluoroquinolones exist from animal studies demonstrating cartilage injury in weight-bearing joints, dependent on dose and duration of therapy. For children treated with levofloxacin or comparator in randomized, prospective, comparative studies for acute otitis media and community-acquired pneumonia, this 5-year follow-up safety study was designed to assess the presence/absence of cartilage injury. %26lt;br%26gt;METHODS: Children enrolled in treatment studies were also enrolled in a 1-year follow-up safety study, which; focused on musculoskeletal adverse events (MSAE). Those with persisting MSAEs, protocol-defined musculoskeletal disorders, or of concern to the Data Safety and Monitoring Committee were requested to enroll in four additional years of follow-up, the subject of this report. %26lt;br%26gt;RESULTS: Of the 2233 subjects participating in the 12-month follow-up study, 124 of 1340 (9%) of the levofloxacin subjects, and 83 of 893 (9%) of the comparator subjects were continued for 5-year posttreatment assessment. From children identified with an MSAE during years 2 through 5 posttreatment, the number that were %26quot;possibly related%26quot; to drug therapy was equal for both arms: 1 of 1340 for levofloxacin and 1 of 893 for comparator. Of all cases of MSAE assessed by the Data Safety and Monitoring Committee at 5 years%26apos; posttreatment, no case was assessed as %26quot;likely related%26quot; to study drug. %26lt;br%26gt;CONCLUSIONS: With no clinically detectable difference between levofloxacin- and comparator-treated children in MSAEs presenting between 1 and 5 years in these safety studies, risks of cartilage injury with levofloxacin appear to be uncommon, are clinically undetectable during 5 years, or are reversible.

  • 出版日期2014-7