Fluoroquinolone and aortic anuerysms

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From a recent long term survey in pub med

Our objective was to evaluate the association between fluoroquinolone use and aortic dissection or aortic aneurysm in a systematic review and meta-analysis.

Evidence from a small number of studies suggests that exposure to fluoroquinolones is consistently associated with a small but significantly increased risk of aortic dissection and aortic aneurysm.

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  • Posted

    Hi Derek,

    Thanks for posting this.  The study is known to me, it was published in Oct 2015 in the BMJ. Unfortunately, when the European Medical Agency (EMA - which our MHRA still refer to) looked into the link between Fluoroquinolones and aortic aneurysms in 2016, they decided that there wasn't sufficient evidence so no warnings were needed.

    The EMA are currently reviewing the evidence about persistent and delayed severe side effects of FQs and should be announcing their conclusions in late February.  They originally said they would have a result by last July so I'm kind of hoping that the unexpected wealth of evidence they were presented with by various groups around Europe has caused this delay.  Our UK group sent in a 40 page report along with 50 case histories for them to get their teeth into!

    A connection with aortic aneurysm shouldn't come as a surprise to anyone as the aorta and other blood vessels are comprised mainly of collagen while FQs are specialists at causing damage to all types of collagen - hence the tendon and muscle issues more closely associated with them. 

    Is this a problem you suffer with?  I'm afraid I can't offer any cure but if it is at least you know you're not alone!

    Best wishes for 2018.


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    • Posted

      Hi Miriam,  

                  Thank you for that interesting report. I’ll print out your reply for my GP, Urologist and Cardiologist who have all prescribed Fluoroquinolones for me over the years. 

      Yes an aortic aneurysm is yet another of my problems. It was noticed in 2004  when I had a scan for something else. It was only 3.1 cm and they checked it every year when I was welcomed with 'Here comes the man with the little one" It made travel insurance a problem as they work from a tick list and size does not matter to them.

      It has been very slow growing and was 3.6cm in 2015. However when I wanted treatment from an osteopath she thought it would be dangerous to treat me. I checked with the vascular surgeon and he said it was not a problem. I went to another osteopath for treatment and last year it showed as being 4.0cm and this year 4.2cm. I'll have another word with the vascular surgeon and see if he is aware of this. 

      Another drug that I had problems with was Amiodarone where there have been mainly uninvestigated reports of rupture aneurysms when it has been prescribed.  


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    • Posted

      I don't know which you had first - a Quin or the aneurysm.  If the Quin was first it may have helped the aneurysm to start, or,  if it had already started, the Quins you took can't have helped!  In fact you probably shouldn't have been prescribed them at all.

      Oh well, we live and learn!  I'd never heard of Amiodarone but I've just had a quick read about it and it doesn't sound very nice either.

      If I come across anything else about Quins and aortic aneurysm I'll message you with the link.

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    • Posted

      I had the aortic aneurysm first.

      I have created a google alert for Quins and aortic aneurysm so anything about it will come to me.

      When I go to http://patient.info/forums/discuss/fluoroquinolone-toxicity-syndrome-427305

      I now get this page cannot be displayed. It has happened a few times on other subjects that have developed into long discussions. The moderator has made suggestions that did not help. A few other have had the same problem in prostate discussions. 

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    • Posted

      Hi Derek, that's odd about the page.  I just clicked on the link in your message and it took me straight there - plus the links given in it all work (which is always a bonus!).  Are you looking on a phone or tablet?  You may be right in that the discussion is too long for a smaller device to handle.  I'm on my laptop so have never come across this before.

      I've sent the link to many people, as you're probably aware!  I just sent it to a new guy this morning, so it will be interesting to see if he says it doesn't open for him.  I can perhaps ask the moderator to repost the information in a new pinned post so that it's no longer weighed down with the baggage of the discussion.  It's a new guy who's taken over from the original moderator who posted it but I can see what I can do.


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