VASCERN HTAD-WG Consensus statement on Fluoroquinolone use in HTAD.

The Heritable Thoracic Aortic Diseases Working Group (HTAD WG) has issued the following consensus statement on the use of fluoroquinolones in patients with Heritable Thoracic Aortic Diseases (HTAD):

“In patients with HTAD, Fluoroquinolones should be used with caution because of a possible risk for exacerbation of aortic disease.  The use of alternatives is preferred while awaiting further evidence.”

Fluoroquinolones (FQ) are a group of antibiotics used to treat a wide variety of infections. FQ have recently been associated with an increased risk of aortic aneurysm or dissection in a number of human and animal studies.  Patients with HTAD, such as Marfan syndrome, have an increased risk for aortic aneurysm or dissection due to pathogenic variants in one of the genes involved in the production and regulation of the connective tissue’s key components (e.g. collagen, fibrillin and elastin).

Known adverse effects of FQ include an increased risk of tendon damage and experimental studies have suggested that this damage may be due to an increase in collagen breakdown caused by these antibiotics. As the aorta is equally rich in collagen, it has been hypothesized that FQ could also increase the risk of aortic disease.

Until further research has been conducted into the effects of fluoroquinolones on aortic tissue, doctors treating HTAD patients and HTAD patients themselves should be aware of this consensus statement that was extensively examined and agreed upon by all members of the VASCERN HTAD-WG. 

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