Wednesday , March 3 2021

ANSM reports the risk of aortic aneurysm



The increased risk of aneurysms and aortic dissection after treatment with fluoroquinolines (ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin, flumequine and ofloxacin) has been clearly identified. "Thus, in patients at risk for aneurysms and aortic dissection, fluoroquinolones should be used only after careful evaluation of the benefit / risk ratio and after considering alternative therapies," said ANSM. .

The aorta is the largest body artery. When damaged, we talk about aneurysms from the aorta. Not supported, patients do not have the opportunity to leave.

"Patients must be informed of the risk of aortic aneurysm and dissection and must be informed of the need for immediate management by a doctor in the emergency department in the event of a sudden attack, intense abdominal pain, chest or back," continued the drug agent.

Treat bacterial infections

Quinolones and fluoroquinolones are systemic antibiotics (injectable or oral) or inhalation. They are used to treat bacterial infections where vital prognosis can be involved.

Predisposing factors for aneurysm and aortic dissection include family history of aneurysms, preexisting aneurysms or aortic dissection, Marfan's syndrome, Ehlers-Danlos vascular syndrome, Takayasu Arteritis, giant cell arteritis (or Horton disease), Behçet's disease, high blood pressure and atherosclerosis .

Many health professionals are involved

Many health professionals are concerned about this new recommendation: general practitioners, cardiologists, internists, infectiologists, pulmonologists, ENTs, pediatricians, gastroenterologists, dermatologists, gynecologists, nephrologists, urologists, resuscitators, geriatricians, radiologists, emergency doctors, pharmacists, pharmacists, pharmacies and hospital pharmacists.

Two studies motivate ANSM decisions

In March and July, two studies motivated ANSM decisions. The first, published at BMJ, comparing the side effects associated with 360 088 fluoroquinolone prescriptions (ciprofloxacin in 78% of cases) with those associated with the prescription of amoxicillin 360 088. As a result, within 60 days after taking antibiotics, the level of aneurysm or aortic dissection increased by 66% with fluoroquinolones.

The second, published at JAMA, also showed that "ciprofloxacin significantly increased the incidence of aortic dissection and rupture in mild and sporadic models of murine aneurysm aneurysms and dissection." In these mice, ciprofloxacin decreases the expression and activity of lysyl oxidase and increases the fragmentation of elastic fibers and cell damage, which can contribute to increased sensitivity to stress-induced aorta destruction. "

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