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Cancer drug may cause scleritis, study finds
PORTLAND, Ore. — Vision-threatening side effects of pamidronate disodium and a similar drug may require discontinuing the drug in some patients, according to a case series reported here.
The report directly linked the use of pamidronate disodium, a cancer drug approved in the United States for the treatment of osteolytic bone metastases of breast cancer, to the induction of scleritis. A similar drug, alendronate sodium, has also been associated with scleritis in a previous report.
Frederick W. Fraunfelder, MD, and others here at the Casey Eye Institute looked at case reports from the National Registry of Drug-Induced Ocular Side Effects, the Food and Drug Administration and the World Health Organization to determine what, if any, ocular side effects were associated with pamidronate. The intravenous bisphosphate has been reported to cause anterior uveitis and nonspecific conjunctivitis.
Seventeen cases of unilateral scleritis and one case of bilateral scleritis occurred within 6 hours to 2 days after intravenous pamidronate disodium. Six patients tested positive again after a second administration of the drug. Sixteen of the 17 cases were anterior scleritis. Dosage ranged from 30 mg to 90 mg. In 14 cases, the diagnosis was made within 48 hours of dosing.
Other ocular side effects included blurred vision, nonspecific conjunctivitis, ocular pain, bilateral anterior uveitis and episcleritis.
The study authors are seeking other reports of scleritis caused by drugs. They can be contacted online at www.eyedrugregistry.com.
The study is published in the February issue of American Journal of Ophthalmology.