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QT Interval Prolongation in the Pediatric Oncologic Population on Methadone
Jenna A Piccininni1, James S Killinger2,3,4, Hoda T Hammad5
1Division of Pediatric Cardiology, NewYork Presbyterian/Columbia University Medical Center, Morgan Stanley Children's Hospital of New York.
Journal of Pediatric Hematology/Oncology
|March 5, 2019
Summary
Methadone use can prolong the QTc interval in pediatric cancer patients. Longer baseline QTc and concurrent QTc-prolonging medications identify at-risk children needing closer monitoring.
Area of Science:
- Pediatric Oncology
- Clinical Pharmacology
- Cardiology
Background:
- Methadone is frequently prescribed for pain management in pediatric oncology.
- QTc interval prolongation is a known side effect of methadone in adults, but data in children is lacking.
- Current guidelines lack consensus on QTc monitoring frequency for methadone in pediatric patients.
Purpose of the Study:
- To determine the incidence of QTc interval prolongation in pediatric oncology patients receiving methadone.
- To identify risk factors associated with methadone-induced QTc prolongation in this population.
- To inform monitoring strategies for pediatric patients on methadone.
Main Methods:
- Retrospective chart review of pediatric oncology patients prescribed methadone.
- Analysis of baseline QTc intervals and concurrent medication use.
- Assessment of QTc interval changes during methadone therapy.
Main Results:
- 18% of pediatric oncology patients developed QTc interval prolongation.
- Patients with prolonged QTc intervals had significantly longer baseline QTc.
- Concomitant use of multiple QTc-prolonging medications was more frequent in patients with QTc prolongation.
Conclusions:
- Methadone is associated with QTc interval prolongation in pediatric oncology patients.
- Baseline QTc interval and concurrent QTc-prolonging medications are key risk factors.
- These factors may aid in risk stratification for tailored QTc monitoring.
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