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Bisphosphonate-associated scleritis: a case report and review
Sophia Leung1, Bimal H Ashar, Redonda G Miller
1Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Southern Medical Journal
|August 20, 2005
Summary
Alendronate, a bisphosphonate used for osteoporosis, rarely causes scleritis, an eye inflammation. Discontinuation and treatment resolved symptoms, with recurrence upon reintroduction, suggesting a direct link.
Area of Science:
- Ophthalmology
- Rheumatology
- Pharmacology
Background:
- Osteoporosis management frequently involves bisphosphonates, such as alendronate.
- Aminobisphosphonates are generally considered safe, with a low incidence of adverse effects.
Observation:
- An 86-year-old female developed scleritis in her right eye six weeks after initiating alendronate therapy.
- Scleritis symptoms resolved after discontinuing alendronate and initiating prednisone treatment.
- Recurrence of scleritis was observed upon re-administration of alendronate (rechallenge).
Findings:
- This case suggests a potential causal relationship between alendronate and the development of scleritis.
- Ocular inflammation, including scleritis, is a rare but documented adverse effect of bisphosphonate therapy.
Implications:
- Clinicians should be aware of the potential for bisphosphonates to induce ocular inflammation.
- Further investigation into the mechanism linking bisphosphonates to scleritis is warranted to improve patient safety.
