TY - JOUR
T1 - Voriconazole-induced QT prolongation among hemato-oncologic patients
T2 - clinical characteristics and risk factors
AU - Gueta, I.
AU - Loebstein, R.
AU - Markovits, N.
AU - Kamari, Y.
AU - Halkin, H.
AU - Livni, G.
AU - Yarden-Bilavsky, H.
N1 - Publisher Copyright:
© 2017, Springer-Verlag GmbH Germany.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - 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.
AB - 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.
KW - Adverse effects
KW - QT prolongation
KW - Safety
KW - Torsade de pointes
KW - Voriconazole
UR - http://www.scopus.com/inward/record.url?scp=85020496161&partnerID=8YFLogxK
U2 - 10.1007/s00228-017-2284-5
DO - 10.1007/s00228-017-2284-5
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AN - SCOPUS:85020496161
SN - 0031-6970
VL - 73
SP - 1181
EP - 1185
JO - European Journal of Clinical Pharmacology
JF - European Journal of Clinical Pharmacology
IS - 9
ER -