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Association between oral fluoroquinolones and seizures: a self-controlled case series study

Chui, CSL; Chan, EW; Wong, AYS; Root, A; Douglas, IJ; Wong, ICK; (2016) Association between oral fluoroquinolones and seizures: a self-controlled case series study. Neurology , 86 (18) pp. 1708-1715. 10.1212/WNL.0000000000002633.

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Abstract

Objectives: This study aimed to investigate the association and to estimate the crude absolute risk of seizure among patients exposed to fluoroquinolones (FQ) in Hong Kong and United Kingdom. Methods: A self-controlled case series study (SCCS) was conducted. Data were collected from the Hong Kong Clinical Data Analysis and Reporting System database (CDARS) and the Clinical Practice Research Datalink (CPRD). Patients who were prescribed any oral FQ and had an incident seizure diagnosis from 2001-2013 were included. The risk windows were defined as pre-FQ start, FQ exposed and post-FQ completion. Incident rate ratios (IRR) were estimated in all risk windows and compared with baseline periods. A post-hoc subgroup analysis was conducted to examine the effect of patients with a history of seizure. Results: Increased IRR was found in the pre-FQ start periods and no association was found in the post-FQ completion periods in both databases. The crude absolute risk of an incident seizure in 10,000 oral FQ prescriptions was 0.72 (95% CI 0.47-1.10) in CDARS and 0.40 (95% CI 0.30-0.54) in CPRD. The rate ratio during treatment was not higher than pre-FQ start periods among patients with a history of seizure, therefore, the results did not raise serious concerns. Conclusions: This study does not support a causal association between the use of oral FQ and the subsequent occurrence of seizure. An increased risk prior to the FQ exposure period suggests that the clinical indication for which FQ was prescribed may have contributed to the development of seizure rather than the drug itself.

Type: Article
Title: Association between oral fluoroquinolones and seizures: a self-controlled case series study
DOI: 10.1212/WNL.0000000000002633
Publisher version: http://dx.doi.org/10.1212/WNL.0000000000002633
Language: English
Keywords: Fluoroquinolone, seizure, Hong Kong, United Kingdom, pharmacoepidemiology
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: http://discovery.ucl.ac.uk/id/eprint/1476114
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