Isavuconazole shortens the QTc interval
Sibylle C Mellinghoff1,2, Matteo Bassetti3, Daniela Dörfel4,5
1Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
Mycoses
|November 28, 2017
Summary
Isavuconazole, an antifungal medication, was found to shorten the QTc interval in most patients treated for invasive fungal infections. This cardiac effect was observed outside of controlled clinical trials, offering new insights into isavuconazole
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- Azole antifungals commonly prolong the QTc interval.
- Isavuconazole is a novel antifungal agent for invasive aspergillosis and mucormycosis.
- Previous clinical trials suggested a potential QTc shortening effect of isavuconazole.
Purpose of the Study:
- To assess the real-world effects of isavuconazole on QTc interval duration.
- To describe changes in QTc interval length during isavuconazole treatment in adult patients.
Main Methods:
- Prospective observational study involving 26 adult patients across 7 hospitals.
- Electrocardiograms (ECGs) were recorded before and during isavuconazole treatment.
- Analysis focused on changes in QTc interval duration.
Main Results:
- Twenty-four out of 26 patients (92%) exhibited QTc interval shortening.
- A mean QTc interval decrease of 7.4% (36.5 ms) was observed during isavuconazole treatment (P = .004).
- One patient showed sustained QTc shortening over 110 days.
Conclusions:
- Isavuconazole demonstrated a QTc shortening effect in a majority of patients in a real-world setting.
- These findings contrast with the known class effect of QTc prolongation by azoles.
- Understanding isavuconazole's cardiac effects is crucial for managing concurrent medications.
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