Uveitis Associated With Bisphosphonate Treatment Is Infrequent

Uveitis associated with the use of bisphosphonates is a rare occurrence, according to study results presented at the American Society for Bone and Mineral Research (ASBMR) 2020 Annual Meeting, held virtually from September 11 to 15, 2020.

Bisphosphonates are typically used as first-line treatment for osteoporosis and other bone diseases. Although eye inflammation is an uncommon side effect with bisphosphonate use, it can be suspected in patients with pain, photophobia, or red eye after bisphosphonate treatment.

Six patients with ocular inflammation associated with bisphosphonate use aged 50 to 86 years were included in the study. Of the total cohort, 4 patients received intravenous bisphosphonates for osteoporosis, and 2 for oncologic disease. Overall, 5 patients developed an inflammatory reaction after the first infusion of zoledronate; the other patient developed an inflammatory reaction after a pamidronate infusion. The presentation time of the adverse effects varied between 12 hours and 7 days after administration.

Of the 6 patients, anterior uveitis was diagnosed in 5 and posterior scleritis associated with optic perineuritis in the other. Engagement was monocular in all patients. An adverse ocular reaction was not observed in 3 patients who had received previous oral bisphosphonates; however, a new episode of uveitis was seen in 1 patient who received a second zoledronate treatment.

Use of topical corticosteroids was effective in the 5 patients who presented with anterior uveitis. However, systemic corticotherapy and hospitalization for pain management were required for the patient who presented with posterior scleritis and perineuritis. In all patients, ocular inflammation resolved within 4 weeks.

Overall, eye inflammation was found to be uncommon with use of bisphosphonates. Use of local and systemic corticotherapy was able to resolve eye inflammation in the all patients.

“Early intervention is essential to improve pain and reduce the risk [for] complications. Multidisciplinary work is necessary for a proper diagnosis and treatment,” the researchers concluded.

Reference

González VR, Diehl M, Buttazzoni M, Kitaigrodsky A, García MM, Galich AM. Eye inflammation associated with bisphosphonate treatment. Presented at: ASBMR 2020 Virtual Annual Meeting; September 11-15, 2020; Poster #P-202.