Impact of Substantial Weight Loss on Digoxin Intoxication During Long-term Therapy

Area of Science:

• Pharmacology
• Clinical Medicine
• Patient Safety

Background:

• Digoxin safety is well-studied, but the role of body weight loss and evolving risk factors for digoxin intoxication in long-term users remains unclear.
• Understanding these factors is crucial for preventing adverse events in patients on chronic digoxin therapy.

Purpose of the Study:

• To investigate how risk factors for digoxin intoxication, including significant body weight loss, change during the course of long-term digoxin treatment.
• To identify specific clinical features associated with digoxin intoxication at different treatment stages.

Main Methods:

• A retrospective study analyzed adult patients prescribed digoxin between 2010 and 2021.
• Multivariate logistic regression identified clinical predictors of digoxin intoxication over time.

Main Results:

• Of 329 patients, 36 (11%) developed digoxin intoxication.
• Early intoxication (<6 months) was linked to diuretics, cancer, and eGFR reduction.
• Later intoxication (>6 months) was associated with >6% weight loss and eGFR reduction.

Conclusions:

• Risk factors for digoxin intoxication transition during treatment.
• Concomitant diuretics and cancer are early risks; substantial weight loss is a later risk.
• Impaired renal function is a consistent risk factor throughout treatment.