Frequency, characteristics and risk factors of QT interval prolonging drugs and drug-drug interactions in cancer patients: a multicenter study
Abstract Background Cancer patients may receive a high number of medications with the potential to prolong QT interval and subsequent TdP (torsades de pointes). This study aimed to identify the prevalence of QT prolonging drugs, their TdP risk, QT prolonging drug-drug interactions (QT-DDIs), levels,...
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| Format: | Article |
| Language: | English |
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BMC
2017-12-01
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| Series: | BMC Pharmacology and Toxicology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40360-017-0181-2 |
| _version_ | 1818953273487392768 |
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| author | Qasim Khan Mohammad Ismail Sehrash Khan |
| author_facet | Qasim Khan Mohammad Ismail Sehrash Khan |
| author_sort | Qasim Khan |
| collection | DOAJ |
| description | Abstract Background Cancer patients may receive a high number of medications with the potential to prolong QT interval and subsequent TdP (torsades de pointes). This study aimed to identify the prevalence of QT prolonging drugs, their TdP risk, QT prolonging drug-drug interactions (QT-DDIs), levels, predictors, and TdP risk of drugs involved in QT-DDIs. Methods This multicenter study included cancer patients from three major tertiary care hospitals of Khyber-Pakhtunkhwa, Pakistan. Micromedex DrugReax® was used for identification of QT-DDIs. TdP risks were identified by AZCERT (Arizona Center for Education and Research on Therapeutics) classification. Logistic regression analysis was performed to identify predictors of QT-DDIs. Results Of 555 patients, 51% were females. Mean age was 46.9 ± 15.7 years. Total 28 distinct QT prolonging drugs were identified in 92.6% of the patients. Overall 21.8% patients were presented with QT-DDIs. Of total 288 identified QT-DDIs, all were of major-severity and fair-documentation. According to AZCERT classification, 59.9% of the interacting drugs were included in list-1 (known risk of TdP), 4.7% in list-2 (possible risk of TdP) and 6.8% in list-3 (conditional risk of TdP). Univariate logistic regression analysis showed significant results for various predictors such as, 8–9 prescribed medications (p < 0.001) and ≥10 medications (p < 0.001), 2 QT drugs (p < 0.001) and ≥3 QT drugs (p < 0.001), breast cancer (p = 0.03), gastrointestinal cancer (p = 0.03), 4–5 supportive care drugs (p < 0.001), 6–8 supportive care drugs (p < 0.001) and >8 supportive care drugs (p < 0.001). Conclusions A high prevalence of QT prolonging drugs and QT-DDIs was reported in oncology. Appropriate precautions are needed to prevent harmful consequences of these interactions. |
| first_indexed | 2024-12-20T10:03:39Z |
| format | Article |
| id | doaj.art-3fb5641c390343ab9b4eb42e1ecff038 |
| institution | Directory Open Access Journal |
| issn | 2050-6511 |
| language | English |
| last_indexed | 2024-12-20T10:03:39Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pharmacology and Toxicology |
| spelling | doaj.art-3fb5641c390343ab9b4eb42e1ecff0382022-12-21T19:44:17ZengBMCBMC Pharmacology and Toxicology2050-65112017-12-0118111010.1186/s40360-017-0181-2Frequency, characteristics and risk factors of QT interval prolonging drugs and drug-drug interactions in cancer patients: a multicenter studyQasim Khan0Mohammad Ismail1Sehrash Khan2Department of Pharmacy, University of PeshawarDepartment of Pharmacy, University of PeshawarDepartment of Pharmacy, University of PeshawarAbstract Background Cancer patients may receive a high number of medications with the potential to prolong QT interval and subsequent TdP (torsades de pointes). This study aimed to identify the prevalence of QT prolonging drugs, their TdP risk, QT prolonging drug-drug interactions (QT-DDIs), levels, predictors, and TdP risk of drugs involved in QT-DDIs. Methods This multicenter study included cancer patients from three major tertiary care hospitals of Khyber-Pakhtunkhwa, Pakistan. Micromedex DrugReax® was used for identification of QT-DDIs. TdP risks were identified by AZCERT (Arizona Center for Education and Research on Therapeutics) classification. Logistic regression analysis was performed to identify predictors of QT-DDIs. Results Of 555 patients, 51% were females. Mean age was 46.9 ± 15.7 years. Total 28 distinct QT prolonging drugs were identified in 92.6% of the patients. Overall 21.8% patients were presented with QT-DDIs. Of total 288 identified QT-DDIs, all were of major-severity and fair-documentation. According to AZCERT classification, 59.9% of the interacting drugs were included in list-1 (known risk of TdP), 4.7% in list-2 (possible risk of TdP) and 6.8% in list-3 (conditional risk of TdP). Univariate logistic regression analysis showed significant results for various predictors such as, 8–9 prescribed medications (p < 0.001) and ≥10 medications (p < 0.001), 2 QT drugs (p < 0.001) and ≥3 QT drugs (p < 0.001), breast cancer (p = 0.03), gastrointestinal cancer (p = 0.03), 4–5 supportive care drugs (p < 0.001), 6–8 supportive care drugs (p < 0.001) and >8 supportive care drugs (p < 0.001). Conclusions A high prevalence of QT prolonging drugs and QT-DDIs was reported in oncology. Appropriate precautions are needed to prevent harmful consequences of these interactions.http://link.springer.com/article/10.1186/s40360-017-0181-2QT prolongationQT prolonging drugsQT drug-drug interactionsTorsades de pointesCancerOncology |
| spellingShingle | Qasim Khan Mohammad Ismail Sehrash Khan Frequency, characteristics and risk factors of QT interval prolonging drugs and drug-drug interactions in cancer patients: a multicenter study BMC Pharmacology and Toxicology QT prolongation QT prolonging drugs QT drug-drug interactions Torsades de pointes Cancer Oncology |
| title | Frequency, characteristics and risk factors of QT interval prolonging drugs and drug-drug interactions in cancer patients: a multicenter study |
| title_full | Frequency, characteristics and risk factors of QT interval prolonging drugs and drug-drug interactions in cancer patients: a multicenter study |
| title_fullStr | Frequency, characteristics and risk factors of QT interval prolonging drugs and drug-drug interactions in cancer patients: a multicenter study |
| title_full_unstemmed | Frequency, characteristics and risk factors of QT interval prolonging drugs and drug-drug interactions in cancer patients: a multicenter study |
| title_short | Frequency, characteristics and risk factors of QT interval prolonging drugs and drug-drug interactions in cancer patients: a multicenter study |
| title_sort | frequency characteristics and risk factors of qt interval prolonging drugs and drug drug interactions in cancer patients a multicenter study |
| topic | QT prolongation QT prolonging drugs QT drug-drug interactions Torsades de pointes Cancer Oncology |
| url | http://link.springer.com/article/10.1186/s40360-017-0181-2 |
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