A systematic literature review was conducted to provide a detailed picture of some of the medications for which there is published evidence of orbital inflammatory disease (OID)–related adverse events.
Study Design
Ninety-six peer-reviewed publications published before June 2023 met inclusion criteria; exclusion criteria included papers involving patients with actual eye/optic nerve involvement (e.g., scleritis) or medication-associated thyroid eye disease.
Outcomes
The authors defined OID as clinical or radiologic evidence of myositis, dacryoadenitis, and/or orbital fat inflammation. Drugs and drug classes with reported OID-related adverse events in the clinical literature include bisphosphonates, statins, immune checkpoint inhibitors, Janus kinase 2 inhibitors, tumor necrosis factor-alpha inhibitors, interferon alpha-2b, ribavirin, and hyaluronidase. There is also temporal evidence for a relationship between OID and vaccines against the coronavirus and the influenza and varicella zoster (shingles) viruses.
Limitations
Only English-language publications were considered, and many of the reviewed articles were case series and individual case reports. The authors also noted the difficulties they had in collecting dechallenge and rechallenge data.
Clinical Significance
Medication-associated OID should be included in the differential diagnosis for OID, especially in patients with a prior history of nonspecific orbital inflammation. If medications are suspected as the cause, consider suspending or ceasing the patients’ use of these agents.
Financial Disclosures: Dr. Nikisha Richards discloses financial relationships with Genentech and Horizon Therapeutics (Consultant/Advisor).