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Reynard P, Thai-Van H. Drug-induced hearing loss: Listening to the latest advances. Therapie 2024; 79:283-295. [PMID: 37957052 DOI: 10.1016/j.therap.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/14/2023] [Indexed: 11/15/2023]
Abstract
Sensorineural hearing loss (SNHL) is the most common type of hearing loss. Causes include degenerative changes in the sensory hair cells, their synapses and/or the cochlear nerve. As human inner ear hair cells have no capacity for regeneration, their destruction is irreversible and leads to permanent hearing loss. SNHL can be genetically inherited or acquired through ageing, exposure to noise or ototoxic drugs. Ototoxicity generally refers to damage to the structures and functions of the inner ear following exposure to specific drugs. Ototoxicity can be multifactorial, causing damage to cochlear hair cells or cells with homeostatic functions that modulate cochlear hair cell function. Clinical strategies to limit ototoxicity include identifying patients at risk, monitoring drug concentrations, performing serial hearing assessments and switching to less ototoxic therapy. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the PubMed® database. The search terms "ototoxicity", "hearing loss" and "drugs" were combined. We included studies published between September 2013 and June 2023, and focused on medicines and drugs used in hospitals. The review highlighted a number of articles reporting the main drug classes potentially involved: namely, immunosuppressants, antimalarials, vaccines, antibiotics, antineoplastic agents, diuretics, nonsteroidal anti-inflammatory drugs and analgesics. The presumed ototoxic mechanisms were described, together with the therapeutic and preventive options developed over the last ten years.
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Affiliation(s)
- Pierre Reynard
- Service d'audiologie & explorations oto-neurologiques, hospices civils de Lyon, hôpital Edouard-Herriot & hôpital Femme Mère-Enfant, 69000 Lyon, France; Institut Pasteur, Institut de l'Audition, Center for Research and Innovation in Human Audiology, 75000 Paris, France; Université Claude Bernard Lyon 1, 69622 Villeurbanne, France
| | - Hung Thai-Van
- Service d'audiologie & explorations oto-neurologiques, hospices civils de Lyon, hôpital Edouard-Herriot & hôpital Femme Mère-Enfant, 69000 Lyon, France; Institut Pasteur, Institut de l'Audition, Center for Research and Innovation in Human Audiology, 75000 Paris, France; Université Claude Bernard Lyon 1, 69622 Villeurbanne, France.
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Favrelière S, Delaunay P, Lebreton JP, Rouby F, Atzenhoffer M, Lafay-Chebassier C, Pérault-Pochat MC. Drug-induced hearing loss: a case/non-case study in the French pharmacovigilance database. Fundam Clin Pharmacol 2020; 34:397-407. [PMID: 31912913 DOI: 10.1111/fcp.12533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 12/06/2019] [Accepted: 01/06/2020] [Indexed: 11/29/2022]
Abstract
Hearing loss is defined as a decrease in the ability to perceive sounds which can occur suddenly or gradually and affects one ear or both. It is related to various etiologies, in particular drugs. The identification of all drugs that could be associated with hearing loss is essential for the patients' life quality. The objective of our study was to identify signals of hearing loss involving drugs approved in the last 20 years. The occurrence in association with drugs known for their ototoxicity was also analyzed. We used a case/non-case method in the French Pharmacovigilance Database (FPVD). The cases were reports of hearing loss in the FPVD between January 2007 and August 2017. Non-cases were all reports over the same period. We calculated the reporting odds ratio (ROR) with 95% confidence intervals. Among the 555 reports of hearing loss, significant RORs were found for 68 drugs. The main therapeutic classes implicated were antineoplastic agents (n = 240), systemic anti-infective agents (n = 182), immunosuppressants (n = 42) loop diuretics (n = 26), and salicylate analgesics (n = 26). We found signals of hearing loss with azacitidine, vaccines and nevirapine, immunosuppressants such as leflunomide, and biotherapies such as panitumumab and vandetanib. Prescribers should be informed about the potential associations with all these drugs. The role of the pathology itself and the known ototoxic drugs that can be associated do not allow to conclude definitively. Audiograms for the early detection of hearing loss induced by drugs known to be ototoxic are rarely carried out. Preventive treatments exist and must be considered.
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Affiliation(s)
- Sylvie Favrelière
- Department of Clinical Pharmacology and Pharmacovigilance, University Hospital of Poitiers, 2 rue de la Milètrie, BP 577, 86021, Poitiers Cedex, France
| | - Paul Delaunay
- Department of Clinical Pharmacology and Pharmacovigilance, University Hospital of Poitiers, 2 rue de la Milètrie, BP 577, 86021, Poitiers Cedex, France
| | - Jean-Pascal Lebreton
- Department of Otorhinolaryngology - Head & Neck Surgery, University Hospital of Poitiers, 2, rue de la Milètrie, BP 577, 86021, Poitiers Cedex, France
| | - Franck Rouby
- Department of Clinical Pharmacology and Pharmacovigilance, University Hospital of Marseille, 270 Boulevard Sainte Marguerite, 13009, Marseille, France
| | - Martine Atzenhoffer
- Department of Clinical Pharmacology and Pharmacovigilance, Hospices civils de Lyon, 69424, Lyon, France
| | - Claire Lafay-Chebassier
- Department of Clinical Pharmacology and Pharmacovigilance, University Hospital of Poitiers, 2 rue de la Milètrie, BP 577, 86021, Poitiers Cedex, France.,INSERM, U1084, Laboratoire de Neurosciences Expérimentales et Cliniques - LNEC, Université de Poitiers, Batiment B36, 1 rue Georges Bonnet, BP633, 86022, Poitiers Cedex, France
| | - Marie Christine Pérault-Pochat
- Department of Clinical Pharmacology and Pharmacovigilance, University Hospital of Poitiers, 2 rue de la Milètrie, BP 577, 86021, Poitiers Cedex, France.,INSERM, U1084, Laboratoire de Neurosciences Expérimentales et Cliniques - LNEC, Université de Poitiers, Batiment B36, 1 rue Georges Bonnet, BP633, 86022, Poitiers Cedex, France
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