دورية أكاديمية
Clofazimine and QT prolongation in the treatment of rifampicin-resistant tuberculosis: Findings of aDSM in Taiwan.
| العنوان: | Clofazimine and QT prolongation in the treatment of rifampicin-resistant tuberculosis: Findings of aDSM in Taiwan. |
|---|---|
| المؤلفون: | Lin CJ; Tao-Yuan General Hospital, Ministry of Health and Welfare, 1492, Zhongshan Road, Taoyuan District, Taoyuan City, 330, Taiwan., Chen JH; Office of Data Science, Taipei Medical University, 301 Yuantong Road, Zhonghe District, New Taipei City, 235, Taiwan., Chien ST; Chest Hospital, Ministry of Health and Welfare, 864 Zhongshan Road, Rende District, Tainan City, 717, Taiwan., Huang YW; Chang-Hua Hospital, Ministry of Health and Welfare, 80 Zhongzheng Road, Section 2, Puxin Township, Changhua County, 513, Taiwan; Institute of Medicine, Chang Shan Medical University, 110 Jianguo North Road, Section 1, Taichung City, 402, Taiwan., Lin CB; Division of Chest Medicine, Department of Internal Medicine, Tzu Chi General Hospital, Tzu Chi University, 707 Chung-Yang Road, Section 3, Hualien, 970, Taiwan; School of Medicine, Tzu Chi University, 701 Zhongyang Road, Section 3, Hualien, 970, Taiwan., Lee JJ; Division of Chest Medicine, Department of Internal Medicine, Tzu Chi General Hospital, Tzu Chi University, 707 Chung-Yang Road, Section 3, Hualien, 970, Taiwan., Lee CH; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, 111 Hsin-Long Road, Section 3, Taipei City, 116, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei City, 110, Taiwan., Yu MC; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, 111 Hsin-Long Road, Section 3, Taipei City, 116, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei City, 110, Taiwan., Chiang CY; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, 111 Hsin-Long Road, Section 3, Taipei City, 116, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei City, 110, Taiwan; International Union Against Tuberculosis and Lung Disease, 2 Rue Jean Lantier, 75001, Paris, France. Electronic address: cychiang@theunion.org. |
| المصدر: | Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi [J Microbiol Immunol Infect] 2024 Aug 08. Date of Electronic Publication: 2024 Aug 08. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: published by Elsevier for the Taiwan Society of Microbiology Country of Publication: England NLM ID: 100956211 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1995-9133 (Electronic) Linking ISSN: 16841182 NLM ISO Abbreviation: J Microbiol Immunol Infect Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Feb. 2010- : Oxford, England : published by Elsevier for the Taiwan Society of Microbiology Original Publication: Taipei, Taiwan : Chinese Society of Microbiology : Chinese Society of Immunology [and] : Infectious Diseases Society of the Republic of China, |
| مستخلص: | Background: Bedaquiline, delamanid and fluoroquinolones are associated with increased QTcF. Whether clofazimine is associated with QTcF prolongation is less clear. Methods: All patients with rifampicin-resistant TB enrolled between May 2017 and Dec 2019 were included. ECGs were performed at baseline, month 1, month 3 and month 6 for patients treated with conventional regimens, and at additional timepoint for patients treated with bedaquiline, delamanid and short regimen. We estimated the maximum increase of QTcF and constructed cox proportional hazards models to assess factors associated with QTcF≥501ms. Results: Among 321 patients, 59 (18.4%) patients had QTcF≥501ms during a mean follow-up of 242 days (median 189, range 4-1091). The median maximum increase of QTcF was 43.4 ms (IQR 31.3-65.9) in patients treated with clofazimine. Treatment with clofazimine was significantly associated with QTcF≥501ms as compared to without clofazimine (adjusted hazards ratio (adjHR) 4.35, 95% confidence interval (CI) 2.01-9.44). Among patients not treated with bedaquiline and delamanid, those treated with clofazimine and a fluoroquinolone (adjHR 3.43, 95% CI 1.61-7.34) and those treated with clofazimine and high dose moxifloxacin (adjHR 6.54, 95% CI 2.43-17.60) had a significantly higher risk of QTcF≥501ms as compared to those treated with a fluoroquinolone without other QTcF prolonging agents. Four (1.6%) patients had documented ventricular tachycardia, in which one was Torsade de pointes. One patient was found to have sudden death during hospitalization. Conclusions: Clofazimine was significantly associated with an increased risk of QTcF prolongation. QTcF≥501ms was potentially associated with fatal event and needed to be managed cautiously. Competing Interests: Declaration of competing interest None declared. (Copyright © 2024. Published by Elsevier B.V.) |
| فهرسة مساهمة: | Keywords: Clofazimine; QTcF prolongation; Torsades de pointes; Ventricular tachycardia |
| تواريخ الأحداث: | Date Created: 20240819 Latest Revision: 20240819 |
| رمز التحديث: | 20240820 |
| DOI: | 10.1016/j.jmii.2024.08.002 |
| PMID: | 39160114 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1995-9133 |
|---|---|
| DOI: | 10.1016/j.jmii.2024.08.002 |