Background and Purpose—Fluoroquinolone use is associated with an increased risk of aortic aneurysm and dissection. We investigated this risk of arterial wall injury on intracranial arteries, given the similar pathophysiological mechanisms for aneurysm and dissection in both types of arteries.Methods—A case-time-control study was conducted using French National Insurance databases covering >60 million inhabitants. Cases were aged ≥18 years with first ruptured intracranial aneurysm and dissection between 2010 and 2015. For each case, fluoroquinolone use was compared between the exposure-risk window (day 30–day 1 before the outcome) and matched control windows (day 120–day 91, day 150–day 121, and day 180–day 151) and adjusted for time-varying confounders; potential time-trend for exposure was controlled using an age- and sex-matched reference group. Amoxicillin use was studied similarly for indication bias controlling. The potential excess of risk conveyed by fluoroquinolones was assessed by the ratio of OR for fluoroquinolones to that for amoxicillin.Results—Of the 7443 identified cases, 75 had been exposed to fluoroquinolones in the prior 180 days, including 16 in the 30-day at-risk window (385/97 cases exposed to amoxicillin, respectively). The adjusted OR for fluoroquinolones was 1.26 (95%CI, 0.65–2.41) and that for amoxicillin of 1.36 (95% CI, 1.05–1.78). Ratio of OR for fluoroquinolones to that for amoxicillin was estimated at 0.92 (95% CI, 0.46–1.86). Result was similar when extending outcome definition to unruptured events (ratio of OR for fluoroquinolones to that for amoxicillin, 0.97 [95% CI, 0.61–1.53]).Conclusions—This study did not evidence an excess of risk of intracranial aneurysm or dissection with fluoroquinolone use.

中文翻译：

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颅内动脉瘤和夹层的风险以及氟喹诺酮类药物的使用：一项病例时间对照研究。

背景和目的-使用氟喹诺酮会增加主动脉瘤和夹层动脉瘤的风险。考虑到两种动脉瘤的动脉瘤和解剖相似的病理生理机制，我们调查了颅内动脉的这种动脉壁损伤风险。方法－使用法国国家保险数据库进行了病例-时间-对照研究，覆盖超过6000万居民。年龄≥18岁的病例在2010年至2015年之间首次颅内动脉瘤破裂和解剖。对于每例病例，比较了暴露风险窗（结果前30天至第1天）和对照窗（120天至120天）之间的氟喹诺酮使用情况。第91天，150天至121天以及180天至151天），并针对时变的混杂因素进行了调整；使用年龄和性别相匹配的参照组来控制潜在的暴露时间趋势。对阿莫西林的使用进行了类似的研究，以控制适应症。通过氟喹诺酮类药物与阿莫西林的OR之比来评估氟喹诺酮类药物可能带来的潜在风险。结果—在7443例确诊病例中，有75例在前180天内曾接触过氟喹诺酮类药物，其中30天内为16例。风险窗口（分别有385/97例暴露于阿莫西林的情况）。氟喹诺酮类药物的校正OR为1.26（95％CI，0.65–2.41），阿莫西林的校正OR为1.36（95％CI，1.05–1.78）。氟喹诺酮类药物与阿莫西林的OR比率估计为0.92（95％CI，0.46-1.86）。将结果定义扩展到未破裂事件时，结果相似（氟喹诺酮类药物与阿莫西林的OR比率为0。