Cardiac safety of multidrug-resistant tuberculosis treatment: moving towards individualised monitoring

A heart rate-corrected QT interval (QTc) of 500 ms or more increases the risk of potentially fatal ventricular arrhythmias, including torsade de pointes.2 Despite the frequent, long-term use of QT interval-prolonging drugs, including moxifloxacin, which is used as a positive control in thorough QT s...

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Veröffentlicht in:The Lancet infectious diseases Jg. 21; H. 7; S. 894 - 895
Hauptverfasser: Hewison, Catherine, Guglielmetti, Lorenzo
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Ltd 01.07.2021
Elsevier Limited
New York, NY : Elsevier Science ; The Lancet Pub. Group, 2001
Schlagworte:
Albumins
Antibiotics
Bacteriology
Cardiac arrhythmia
Clinical trials
Drug resistance
Drugs
EKG
Heart rate
HIV
Human immunodeficiency virus
Infectious diseases
Life Sciences
Microbiology and Parasitology
Monitoring
Moxifloxacin
Multidrug resistance
Prolongation
Rifampin
Risk factors
Telemedicine
Torsades de pointes
Tuberculosis
Ventricle
ISSN:1473-3099, 1474-4457, 1474-4457
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Zusammenfassung:A heart rate-corrected QT interval (QTc) of 500 ms or more increases the risk of potentially fatal ventricular arrhythmias, including torsade de pointes.2 Despite the frequent, long-term use of QT interval-prolonging drugs, including moxifloxacin, which is used as a positive control in thorough QT studies,3 ECG monitoring became routine during multidrug or rifampicin-resistant tuberculosis treatment only after the first phase 2 trials showed QT prolongation during treatment with bedaquiline and delamanid. [...]reassuring is the fact that patients with low albumin values do not appear to have clinically-relevant increases in the risk of QT prolongation, an initial concern.9 As expected, owing to bedaquiline's long half-life, QTc interval 4 weeks after treatment stop was reduced by only 25% and 26% in bedaquiline-containing groups, compared with 56% in the delamanid group. [...]these results give us the opportunity of re-establishing the correct priorities.
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ISSN:1473-3099
1474-4457
1474-4457
DOI:10.1016/S1473-3099(20)30836-7