Why the study?
Although the association between antipsychotic use and QTc prolongation is confirmed, the relationship has been rarely studied in a practical setting.
What is the prevalence and what are the clinical correlates of QTc prolongation in Asian patients with schizophrenia taking antipsychotics?
What is the prevalence and what are the clinical correlates of QTc prolongation in Asian patients with schizophrenia taking antipsychotics?
QTc prolongation occurs in approximately 1.1% of Asian patients with schizophrenia on antipsychotics, with amisulpride and clozapine use being significant risk factors.
QTc monitoring may be prudent in Asian schizophrenia patients on antipsychotics; leaves open causal inference pending randomized data.
Although the association between antipsychotic use and corrected QT interval (QTc) prolongation has been repeatedly confirmed, the relationship has been rarely studied in a practical setting. Using data from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP-AP) survey, our study aimed to investigate the prevalence and clinical correlates of QTc prolongation in 2553 Asian patients with schizophrenia. After adjusting for the potential effect of confounding factors, the baseline and clinical characteristics of the schizophrenia patients with and without QTc prolongation were compared using analyses of covariance and binary logistic analyses. In addition, a binary logistic analysis model with a forward selection method was used to identify the distinctive clinical correlates of QTc prolongation. QTc prolongation was noted in 1.1% of Asian patients with schizophrenia. Schizophrenia patients were characterized by lower proportions of disorganized speech and negative symptoms; higher use of amisulpride and clozapine; and higher proportions of rigidity, hypercholesterolemia, and sedation than those without QTc prolongation. Finally, a binary logistic mode showed that amisulpride, clozapine, rigidity, and hypercholesterolemia might be the distinctive clinical correlates of QTc prolongation in Asian patients with schizophrenia. These findings indicate the clinical implications that the uses of amisulpride and clozapine and the occurrences of rigidity and hypercholesterolemia may be potential risk factors for QTc prolongation of schizophrenia patients.
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Park et al. (2020) studied this question.
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