Retroperitoneal fibrosis and betabloking agents: Is there an association?

Hardjit Kharagjitsing, Rike van Eekeren, Eugène P van Puijenbroek, Teun van Gelder, Eric F H van Bommel*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


AIM: Retroperitoneal fibrosis (RPF) is a rare chronic fibro-inflammatory disorder which may be secondary to certain drugs, including beta-blocking agents (BBAs). However, their causative role is unclear. We aimed to investigate this association.

METHODS: Disproportionality analysis was carried out on cases from 1985 to October 4, 2020 in VigiBase®, the WHO pharmacovigilance database. The Bayesian-based IC025 metric and reporting odds ratio were used in order to assess the adverse event signal. We also analysed all published case reports from the literature regarding BBA-associated RPF to assess the value of suggested supportive clinical evidence.

RESULTS: 1.599 individual case safety reports (ICSRs) of RPF were reported to VigiBase®, of which 132 (32%) concerned 16 different single BBA. For 12 of these agents (75%), reporting of RPF was disproportionate, indicating a potential safety signal. Line listing analysis of ICSRs showed no consistent time interval from start of BBA to RPF diagnosis (range 0,7-264 mo). Dechallenge was negative or unknown in the majority of cases (74%). In 18 published cases from the literature, time from start of BBA to RPF diagnosis varied widely (range 3-156 mo). BBA were discontinued 6 mo before (n=1) or at the time of RPF diagnosis (n=17). Most patients (84%) also received RPF specific treatment. Follow-up (FU) duration was short (median 5 mo [range 1-24 mo]) and in most cases (83%) relevant FU data were lacking.

CONCLUSION: Although disproportionality analysis indicated a potential safety signal for RPF associated with BBAs, clinical evidence did not support a cause and effect relationship.

Original languageEnglish
Pages (from-to)2891-2901
Number of pages11
JournalBritish Journal of Clinical Pharmacology
Issue number7
Early online date16-Dec-2020
Publication statusPublished - Jul-2021

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