Orthopedics

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Treatment of osteoporosis: Recognizing and managing cutaneous adverse reactions and drug-induced hypersensitivity
Osteoporosis International, 11/25/09

Musette P et al. – With early recognition and proper management, including immediate and permanent withdrawal of the culprit agent, accompanied by hospitalization and rehydration and systemic corticosteroids if necessary, the prognosis is good.

• Reviewed cutaneous adverse reactions observed with antiosteoporotic agents, including information from case reports, regulatory documents, and pharmacovigilance

• Cutaneous adverse reactions range from benign reactions including exanthematous or maculopapular eruption (drug rash), photosensitivity, and urticaria to severe and potentially life-threatening reactions, angioedema, drug rash with eosinophilia and systemic symptoms (DRESS), Stevens Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN)
• Review of available evidence shows that cutaneous adverse reactions occur with all commonly used antiosteoporotic agents
• Reports of SJS and TEN for bisphosphonates, and of DRESS and TEN for strontium ranelate
• Severe reactions remain very rare (< 1 in 10,000 cases)

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