Voriconazole-induced QT prolongation among hemato-oncologic patients: clinical characteristics and risk factors

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Abstract

Purpose: The purpose of this study is to determine the rate of QTcP and associated risk factors in patients treated with voriconazole. Methods: We conducted a retrospective chart review of all patients treated with voriconazole in a large tertiary center between 2009 and 2015, using paired comparison of QTc intervals on and off voriconazole treatment, adjusted for comorbidities, electrolyte abnormalities, and concurrent medications. Results: Fifty-four patients were included, of whom 53 were diagnosed with oncologic/hemato-oncologic disease. Mean QTc during voriconazole therapy (448.0 ± 52.9 msec) was significantly longer compared to QTc off voriconazole (421.8 ± 42.2 msec; p = 0.002). QTcP ≥30 msec and ≥60 msec was demonstrated in 43% (23 patients) and 28% (15 patients), respectively. Multivariate analysis showed that QTcP was significantly associated with baseline QTc ≥ 450 msec (upper QTc quartile) (p < 0.01) and low serum potassium levels (p < 0.01). Contrarily, no significant association was found between mean voriconazole daily and cumulative dose and QTcP. Conclusion: Our findings indicate that hemato-oncologic patients treated with voriconazole are at increased risk for QTcP, especially in the presence of baseline QTc ≥ 450 msec and low serum potassium levels.

Original languageEnglish
Pages (from-to)1181-1185
Number of pages5
JournalEuropean Journal of Clinical Pharmacology
Volume73
Issue number9
DOIs
StatePublished - 1 Sep 2017

Keywords

  • Adverse effects
  • QT prolongation
  • Safety
  • Torsade de pointes
  • Voriconazole

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