A Prospective Randomized Pilot Study on the Efficacy of a Dietary Supplementation Regimen of Vitamin E and Selenium for the Prevention of Fluoroquinolone-Induced Tendinopathy
<b>Background</b>: Fluoroquinolone-induced tendinopathy is a clinically significant adverse effect associated with this class of antibiotics, particularly affecting the Achilles tendon. Despite its growing recognition, the precise pathophysiological mechanisms remain incompletely underst...
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MDPI AG
2025-04-01
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| author | Oana-Maria Mișcă Liviu-Coriolan Mișcă Bogdan Huzum Andreea-Adriana Neamţu Simona Cerbu Daniel-Raul Chioibaș Petrișor Zorin Crăiniceanu Andrei Gheorghe Marius Motoc |
| author_facet | Oana-Maria Mișcă Liviu-Coriolan Mișcă Bogdan Huzum Andreea-Adriana Neamţu Simona Cerbu Daniel-Raul Chioibaș Petrișor Zorin Crăiniceanu Andrei Gheorghe Marius Motoc |
| author_sort | Oana-Maria Mișcă |
| collection | DOAJ |
| description | <b>Background</b>: Fluoroquinolone-induced tendinopathy is a clinically significant adverse effect associated with this class of antibiotics, particularly affecting the Achilles tendon. Despite its growing recognition, the precise pathophysiological mechanisms remain incompletely understood, with hypotheses referencing increased matrix metalloproteinase activity, collagen degradation, and oxidative stress. <b>Methods</b>: This prospective randomized pilot study evaluates the potential protective effectiveness of vitamin E and selenium supplementation in mitigating fluoroquinolone-induced tendinopathy. The study was conducted on 25 patients receiving 500 mg/day levofloxacin antibiotherapy, randomly divided into a control group and an experimental group—vitamin E (400 IU/day) and selenium (200 µg/day), oral supplementation for 28 days. Clinical assessment of the pain level through the VAS score and of functionality through the VISA-A score was performed, alongside ultrasound imaging of the Achilles tendon. To assess potential toxicity and ensure adherence to the supplementation protocol, serial biochemical analyses of serum vitamin E and selenium were performed at predetermined intervals. <b>Results</b>: A significant improvement was observed in pain scores (<i>p</i> = 0.0120) and functional outcomes (<i>p</i> = 0.0340) when comparing the control and experimental groups at the three-month follow-up. Ultrasound analysis revealed reduced tendon thickness and neovascularization, supporting structural recovery. Although the incidence of tendinopathy was lower in the interventional group (13.3% vs. 40%), statistical significance was not reached, possibly due to the small sample size. <b>Conclusions</b>: These findings suggest that antioxidant supplementation with vitamin E and selenium may provide a protective effect against fluoroquinolone-induced tendinopathy, warranting further investigation in larger randomized clinical trials. |
| format | Article |
| id | doaj-art-36fa800544c04cbbb72a3d91d2887df1 |
| institution | DOAJ |
| issn | 1424-8247 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
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| series | Pharmaceuticals |
| spelling | doaj-art-36fa800544c04cbbb72a3d91d2887df12025-08-20T03:13:48ZengMDPI AGPharmaceuticals1424-82472025-04-0118457510.3390/ph18040575A Prospective Randomized Pilot Study on the Efficacy of a Dietary Supplementation Regimen of Vitamin E and Selenium for the Prevention of Fluoroquinolone-Induced TendinopathyOana-Maria Mișcă0Liviu-Coriolan Mișcă1Bogdan Huzum2Andreea-Adriana Neamţu3Simona Cerbu4Daniel-Raul Chioibaș5Petrișor Zorin Crăiniceanu6Andrei Gheorghe Marius Motoc7Plastic and Reconstructive Surgery Department—Casa Austria, Pius Brînzeu Clinical County Emergency Hospital Timişoara, Liviu Rebreanu Boulevard, No. 156, 300723 Timișoara, RomaniaDoctoral School Department, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, Eftimie Murgu Square, No. 2, 300041 Timişoara, RomaniaDepartment of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Universității Str., No. 16, 400347 Iasi, RomaniaDepartment of Pathology, Pius Brînzeu Clinical County Emergency Hospital Timişoara, Liviu Rebreanu Boulevard, No. 156, 300723 Timișoara, RomaniaDepartment of Radiology and Medical Imaging, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, Eftimie Murgu Square, No. 2, 300041 Timisoara, RomaniaDepartment IX of Surgery, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, Eftimie Murgu Square, No. 2, 300041 Timișoara, RomaniaPlastic and Reconstructive Surgery Department—Casa Austria, Pius Brînzeu Clinical County Emergency Hospital Timişoara, Liviu Rebreanu Boulevard, No. 156, 300723 Timișoara, RomaniaDepartment of Anatomy and Embryology, “Victor Babeș” University of Medicine and Pharmacy of Timișoara, Eftimie Murgu Square, No. 2, 300041 Timișoara, Romania<b>Background</b>: Fluoroquinolone-induced tendinopathy is a clinically significant adverse effect associated with this class of antibiotics, particularly affecting the Achilles tendon. Despite its growing recognition, the precise pathophysiological mechanisms remain incompletely understood, with hypotheses referencing increased matrix metalloproteinase activity, collagen degradation, and oxidative stress. <b>Methods</b>: This prospective randomized pilot study evaluates the potential protective effectiveness of vitamin E and selenium supplementation in mitigating fluoroquinolone-induced tendinopathy. The study was conducted on 25 patients receiving 500 mg/day levofloxacin antibiotherapy, randomly divided into a control group and an experimental group—vitamin E (400 IU/day) and selenium (200 µg/day), oral supplementation for 28 days. Clinical assessment of the pain level through the VAS score and of functionality through the VISA-A score was performed, alongside ultrasound imaging of the Achilles tendon. To assess potential toxicity and ensure adherence to the supplementation protocol, serial biochemical analyses of serum vitamin E and selenium were performed at predetermined intervals. <b>Results</b>: A significant improvement was observed in pain scores (<i>p</i> = 0.0120) and functional outcomes (<i>p</i> = 0.0340) when comparing the control and experimental groups at the three-month follow-up. Ultrasound analysis revealed reduced tendon thickness and neovascularization, supporting structural recovery. Although the incidence of tendinopathy was lower in the interventional group (13.3% vs. 40%), statistical significance was not reached, possibly due to the small sample size. <b>Conclusions</b>: These findings suggest that antioxidant supplementation with vitamin E and selenium may provide a protective effect against fluoroquinolone-induced tendinopathy, warranting further investigation in larger randomized clinical trials.https://www.mdpi.com/1424-8247/18/4/575tendinopathyfluoroquinolonelevofloxacinvitamin EseleniumAchilles tendon thickness |
| spellingShingle | Oana-Maria Mișcă Liviu-Coriolan Mișcă Bogdan Huzum Andreea-Adriana Neamţu Simona Cerbu Daniel-Raul Chioibaș Petrișor Zorin Crăiniceanu Andrei Gheorghe Marius Motoc A Prospective Randomized Pilot Study on the Efficacy of a Dietary Supplementation Regimen of Vitamin E and Selenium for the Prevention of Fluoroquinolone-Induced Tendinopathy Pharmaceuticals tendinopathy fluoroquinolone levofloxacin vitamin E selenium Achilles tendon thickness |
| title | A Prospective Randomized Pilot Study on the Efficacy of a Dietary Supplementation Regimen of Vitamin E and Selenium for the Prevention of Fluoroquinolone-Induced Tendinopathy |
| title_full | A Prospective Randomized Pilot Study on the Efficacy of a Dietary Supplementation Regimen of Vitamin E and Selenium for the Prevention of Fluoroquinolone-Induced Tendinopathy |
| title_fullStr | A Prospective Randomized Pilot Study on the Efficacy of a Dietary Supplementation Regimen of Vitamin E and Selenium for the Prevention of Fluoroquinolone-Induced Tendinopathy |
| title_full_unstemmed | A Prospective Randomized Pilot Study on the Efficacy of a Dietary Supplementation Regimen of Vitamin E and Selenium for the Prevention of Fluoroquinolone-Induced Tendinopathy |
| title_short | A Prospective Randomized Pilot Study on the Efficacy of a Dietary Supplementation Regimen of Vitamin E and Selenium for the Prevention of Fluoroquinolone-Induced Tendinopathy |
| title_sort | prospective randomized pilot study on the efficacy of a dietary supplementation regimen of vitamin e and selenium for the prevention of fluoroquinolone induced tendinopathy |
| topic | tendinopathy fluoroquinolone levofloxacin vitamin E selenium Achilles tendon thickness |
| url | https://www.mdpi.com/1424-8247/18/4/575 |
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