Osteoarticular side effects of BCG therapy

Clavel, Gaëlle; Grados, Franck; Lefauveau, Pascal; Fardellone, Patrice

doi:10.1016/j.jbspin.2004.12.003

Cited by 45 publications

(33 citation statements)

References 45 publications

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“…As shown in our recent report, the frequency of iB-CG-induced ReA in the Japanese population was 2.0% [9], greater than the 0.5-1% reported in the Western countries [4][5][6][7]. Recently, it has been reported that the time to revisit the concept of ReA is coming [1].…”

Section: Brief Reportmentioning

confidence: 63%

“…Intravesical instillation of Bacillus Calmette-Guerin (iBCG) is used as an effective immunotherapy of bladder cancer [3]. In contrast to the clinical efficacy, ReA could develop as adverse event and the frequencies are known as about 0.5 to 1% in Western countries [4][5][6][7]. We recently reported about the clinical characteristics and the frequency 2.0% of iBCG-induced ReA in patients with bladder cancer in Japan [8,9].…”

Section: Brief Reportmentioning

confidence: 99%

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Trend of Frequency and Outcome of Reactive Arthritis in Japanese Patients with Bladder Cancer following Intravesical BCG Therapy over the Last 20 Years

Taniguchi¹,

Nishikawa²,

Yoshinaga³

et al. 2018

J Rheum Dis Treat

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Reactive arthritis (ReA) is a sterile arthritis occurring in a genetically predisposed individual, secondary to an extra-articular infection, usually of the gastrointestinal or genitourinary tract. Intravesical instillation of Bacillus Calmette-Guerin (iBCG) is used as an effective immunotherapy of bladder cancer. Despite of the clinical efficacy, ReA could develop as adverse event and the frequencies are known as about 0.5 to 1% in Western countries and 2.0% in Japan. However, the trend of frequency and outcome of iBCG-induced ReA in Japanese patients have not been assessed in multi-centre studies. Herein, Japanese patients who received iBCG (n = 555) for bladder cancer from March 1997 to February 2017 were retrospectively assessed. Of the 555 cases, ReA was revealed in 11/555 (2.0%). Although the protocol of iBCG therapy was not statistically different over the 20 years, but a half dose of iBCG was used in 2007 to 2017 more than in 1997 to 2007. Despite the increase of the use of half dose of iBCG in 2007 to 2017, the overall frequency of iBCG-induced ReA was not significantly different between from 1997 to 2007 and from 2007 to 2017 (2.1% and 1.9%, respectively). This suggests that the development of iBCG-induced ReA was dose-independent. Furthermore, all iBCG-induced ReA, even if revealing sacroiliitis, did not progress to chronic peripheral arthritis type and spondyloarthritis over the last 20 years.

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Section: Brief Reportmentioning

confidence: 63%

Section: Brief Reportmentioning

confidence: 99%

Trend of Frequency and Outcome of Reactive Arthritis in Japanese Patients with Bladder Cancer following Intravesical BCG Therapy over the Last 20 Years

Taniguchi¹,

Nishikawa²,

Yoshinaga³

et al. 2018

J Rheum Dis Treat

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“…Even so, joint fluid analysis is imperative in order to rule out septic arthritis. 7 In the majority of cases, knee, ankle, and wrist involvement has also been reported anywhere from a few days to five months after the first instillation, and further instillations aggravate the arthritis. This is also accompanied by fever and/or HLA-B27 positivity in over half of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, spinal pain has been reported in 19% of the patients with reactive arthritis and 14% have had sacroiliac involvement. 7 Tinazzi et al 8 conducted a systematic review of patients with arthralgia and arthritis following BCG immunotherapy and identified 61 cases of musculoskeletal complications related to intravesical BCG instillation. These included pain and arthritis in 64%, Reiter's syndrome in 24%, arthritis and fever in 4%, peripheral arthritis in patients with ankylosing spondylitis (AS) in 4%, psoriatic arthritis (PsA) in 2%, and Sjögrens syndrome in 2%.…”

Section: Discussionmentioning

confidence: 99%

Reactive Arthritis Following Intravesical Instillation of Bacillus Calmette-Guerin

et al. 2014

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Reactive arthritis is a seronegative, HLA-B27-linked spondyloarthropathy which occurs as a result of a pathogen, often of gastrointestinal or genitourinary origin, and triggers a cell-mediated immune response. In this article, we present a 64-yearold male case who developed reactive arthritis with fever and asymmetric oligoarthritis following treatment with intravesical Bacillus Calmette-Guerin (BCG) for bladder carcinoma.

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“…A recent series reported 8 cases of osteomyelitis after BCG therapy. 26 Of these, 5 involved the vertebrae, 2 involved prostheses (1 knee and 1 hip), and 1 was monoarticular. BCG osteomyelitis is more difficult to diagnose because it presents late.…”

Section: Orthopedic Complicationsmentioning

confidence: 99%

Complications of Intravesical Bacillus Calmette-Guérin

Macleod

Ngo

Gonzalgo

2014

CUAJ

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Intravesical Bacillus Calmette-Guérin (BCG) is an important treatment for the management of non-muscle invasive bladder cancer because of its proven efficacy and favourable safety profile. The most common complications associated with BCG treatment are relatively minor. They include urinary frequency, cystitis, fever, and hematuria. Although serious complications are rare, patients can develop severe, life-threatening sepsis with disseminated mycobacterial infection. We report a rare case of periurethral diverticulum formation after intravesical BCG and review the literature on the potential complications of this treatment modality.

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Osteoarticular side effects of BCG therapy

Cited by 45 publications

References 45 publications

Trend of Frequency and Outcome of Reactive Arthritis in Japanese Patients with Bladder Cancer following Intravesical BCG Therapy over the Last 20 Years

Trend of Frequency and Outcome of Reactive Arthritis in Japanese Patients with Bladder Cancer following Intravesical BCG Therapy over the Last 20 Years

Reactive Arthritis Following Intravesical Instillation of Bacillus Calmette-Guerin

Complications of Intravesical Bacillus Calmette-Guérin

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