Cutaneous side effects of antiosteoporosis treatments

[en] Cutaneous adverse reactions are reported for many therapeutic agents and, in general, are observed in between 0% and 8% of treated patients depending on the drug. Antiosteoporotic agents are considered to be safe in terms of cutaneous effects, however there have been a number of case reports of cutaneous adverse reactions which warrant consideration. This was the subject of a working group meeting of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis in April 2009, which focused on the impact of cutaneous adverse reactions and drug-induced hypersensitivity in the management of postmenopausal osteoporosis. This position paper was drafted following these discussions and includes a flowchart for their recognition. Cutaneous adverse reactions observed with antiosteoporotic agents were reviewed and included information from case reports, regulatory documents and pharmacovigilance. These reactions ranged from benign effects including exanthematous or maculopapular eruption (drug rash), photosensitivity and urticaria, to the severe and potentially life-threatening reactions of angioedema, drug rash with eosinophilia and systemic symptoms (DRESS), Stevens Johnson syndrome and toxic epidermal necrolysis. A review of the available evidence demonstrates that cutaneous adverse reactions occur with all commonly used antiosteoporotic treatments. Notably, there are reports of Stevens Johnson syndrome and toxic epidermal necrolysis for bisphosphonates, and of DRESS and toxic epidermal necrolysis for strontium ranelate. These severe reactions remain very rare (<1 in 10,000 cases). In general, with proper management and early recognition, including immediate and permanent withdrawal of the culprit agent, accompanied by hospitalization, rehydration and systemic corticosteroids if necessary, the prognosis is positive. © The Author(s), 2011.

Disciplines :

General & internal medicine

Author, co-author :

Musette, P.; Department of Dermatology, Rouen University Hospital, 76038 Rouen, France

Kaufman, J.-M.; Department of Internal Medicine, Gent University Hospital, B-9000 Gent, Belgium

Rizzoli, R.; Department of Rehabilitation and Geriatrix - Service of Bone Diseases, Geneva University Hospital, 1211 Geneva 14, Switzerland

Cacoub, P.; Department of Internal Medicine, AP-HP, Hôpital Pitié Salpétrière and Université Pierre et Marie Curie, 75013 Paris, France

Brandi, M. L.; Department of Internal Medicine, University of Florence, 50139 Florence, Italy

REGINSTER, Jean-Yves ; Centre Hospitalier Universitaire de Liège - CHU > Médecine de l'appareil locomoteur

Language :

English

Title :

Cutaneous side effects of antiosteoporosis treatments

Publication date :

2011

Journal title :

Therapeutic Advances in Musculoskeletal Disease

ISSN :

1759-720X

eISSN :

1759-7218

Publisher :

SAGE Publications, New York, United States - New York

Volume :

Issue :

Pages :

31-41

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 18 October 2013

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