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.