Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
June 26, 2006Archives of Internal MedicineOpen Access

Drug-Induced Long QT Syndrome in Injection Drug Users Receiving Methadone

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Does methadone maintenance treatment increase the risk of QTc prolongation in hospitalized injection drug users?

Population

247 active or former intravenous drug users hospitalized over a 5-year period in a tertiary care hospital

Comparison

Methadone maintenance treatment vs Injection drug users not receiving methadone

Design

Cohort

Authors

GEGeorg EhretGeneral / Preventive / LipidsCVCathy VoideHôpital du ValaisMGMarianne Gex‐FabryUniversity of Geneva

Discussion

Loading...

Member takes

Implication

Methadone maintenance was associated with QTc prolongation; leaves open whether ECG screening reduces arrhythmic events in observational data.

Key Points

  • To determine the prevalence, dose dependence, and clinical cofactors of QT interval prolongation among hospitalized injection drug users receiving methadone maintenance therapy.
  • Retrospective comparative analysis conducted over a 5-year period in a tertiary care hospital.
  • Evaluated 167 hospitalized active or former intravenous drug users receiving methadone versus 80 control injection drug users not on methadone across 15 clinical and pharmacological variables.
  • Severe QTc prolongation (≥0.50 s^1/2) occurred in 16.2% of methadone patients compared with 0% of controls, with 3.6% (n=6) of methadone patients developing torsades de pointes.
  • QTc duration weakly correlated with daily methadone dose (Spearman rank correlation coefficient 0.20, P<.01), with methadone dose, CYP3A4 inhibitors, hypokalemia, and altered liver function together accounting for 31.8% of QTc variability.

Structured PICO

Does methadone maintenance treatment increase the risk of QTc prolongation in hospitalized injection drug users?

P
Population
247 active or former intravenous drug users hospitalized over a 5-year period in a tertiary care hospital
I
Intervention
Methadone maintenance treatment
C
Comparator
Injection drug users not receiving methadone
O
Outcome
Prevalence of QTc prolongation to 0.50 second or longersafety

Methadone maintenance treatment is associated with a significantly increased risk of QTc prolongation and torsades de pointes in hospitalized injection drug users, influenced by dose, CYP3A4 inhibitors, hypokalemia, and liver function.

Cite This Study

Ehret et al. (2006) studied this question.

synapsesocial.com/papers/6a788a212e130d02afed330ahttps://doi.org/10.1001/archinte.166.12.1280
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1QTc Interval Prolongation in Patients on Long-Term Methadone Maintenance Therapy2004 · 117 citations
  2. 2QT prolongation and torsades de pointes among methadone users: reports to the FDA spontaneous reporting system2005 · 224 citations
  3. 3QT Interval Prolongation in Patients on Methadone With Concomitant Drugs2004 · 53 citations
  4. 4Effects of Buprenorphine on Cardiac Repolarization in a Patient with Methadone‐Related Torsade de Pointes2005 · 63 citations
  5. 5Relations of QTc prolongation on the electrocardiogram to torsades de pointes: Definitions and mechanisms1993 · 83 citations