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.
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Gueta, I., Loebstein, R., Markovits, N. et al. Voriconazole-induced QT prolongation among hemato-oncologic patients: clinical characteristics and risk factors. Eur J Clin Pharmacol 73, 1181–1185 (2017). https://doi.org/10.1007/s00228-017-2284-5
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DOI: https://doi.org/10.1007/s00228-017-2284-5