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Rapid response to:


Fluoroquinolone use and risk of aortic aneurysm and dissection: nationwide cohort study

BMJ 2018; 360 doi: (Published 08 March 2018) Cite this as: BMJ 2018;360:k678

Rapid Response:

More research to shed light on pathophysiology is needed.

Following this paper, the MHRA has advised that quinolones should only be used after careful benefit-risk assessment and consideration of other therapeutic options in patients at risk of aortic aneurysm or dissection. However, the considerations made by Dr Stephan Imfeld and Dr Tan Che-Kim are very strong and if and how quinolones may be eventually responsible for the increased risk of dissection remains elusive upon a pathophysiological point of view.

The same applies to their involvement in tendinopathy and tendon rupture, which we know to be far more evident with concurrent corticosteroid exposure.

It is therefore worthwhile considering more in depth those rare events to see what lessons may be learnt from each of them.

Competing interests: No competing interests

29 November 2018
Edoardo Cervoni