In:
Respiration, S. Karger AG, Vol. 99, No. 2 ( 2020), p. 125-131
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Joint pain is frequently observed in patients on antituberculous treatment, and pyrazinamide is known to be associated with joint pain in patients receiving antituberculous treatment. Fluoroquinolone-associated joint pain and tendon injury have been reported in long-term corticosteroid and transplant recipients, but data are lacking in patients with tuberculosis. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 The objective of this study was to examine the incidence of joint pain manifested during administration of antituberculous therapy and their association with fluoroquinolones. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Patients diagnosed with tuberculosis attending the outpatient clinic over a period of 1 year were reviewed and divided into 3 groups: group A receiving pyrazinamide, group B receiving a fluoroquinolone, and group C receiving both pyrazinamide and a fluoroquinolone. Latency to onset of joint pain was noted in all 3 groups. Joint pain was initially managed with analgesics, and associated hyperuricemia was treated with allopurinol/febuxostat. Causative drugs were stopped in case of intolerable joint pain. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 260 patients (47% females, aged 38 ± 18 years; mean ± SD) were included [group A ( 〈 i 〉 n 〈 /i 〉 = 140), group B ( 〈 i 〉 n 〈 /i 〉 = 81), and group C ( 〈 i 〉 n 〈 /i 〉 = 39)]. Overall, 76/260 (29%) patients developed joint pain: group A – 24/140 patients (17%), group B – 32/81 patients (40%), and group C – 20/39 patients (51%). The median latency to the onset of joint pain was 83 days (interquartile range, IQR 40–167): 55 days (IQR 32–66) in group A, 138 days (IQR 74–278) in group B, and 88 days (IQR 34–183) in group C. Hyperuricemia was present in 12/24 (50%) patients in group A and 11/20 (55%) patients in group C. Pyrazinamide was stopped in 7/140 (5%) patients in group A, fluoroquinolones in 6/81 (7%) patients in group B, and both pyrazinamide and fluoroquinolones were stopped in 5/39 (13%) patients in group C because of intolerable joint pain. Major joints affected were knees and ankles. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 There is a high incidence of joint pain in patients receiving antituberculous treatment, which is higher when fluoroquinolones or the pyrazinamide-fluoroquinolone combination are administered as compared to pyrazinamide alone.
Type of Medium:
Online Resource
ISSN:
0025-7931
,
1423-0356
Language:
English
Publisher:
S. Karger AG
Publication Date:
2020
detail.hit.zdb_id:
1464419-8
detail.hit.zdb_id:
206674-9
