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Isavuconazole shortens the QTc interval
Author(s) -
Mellinghoff Sibylle C.,
Bassetti Matteo,
Dörfel Daniela,
Hagel Stefan,
Lehners Nicola,
Plis Andrzej,
Schalk Enrico,
Vena Antonio,
Cornely Oliver A.
Publication year - 2018
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12731
Subject(s) - qt interval , medicine , mucormycosis , aspergillosis , concomitant , clinical trial , torsades de pointes , cardiology , anesthesia , surgery , immunology
Summary Isavuconazole is a novel antifungal drug approved for the treatment of adults with invasive aspergillosis and mucormycosis. While azoles as a class effect are known to prolong QT c interval, clinical trials have shown that isavuconazole administration may cause shortening in a dose‐related manner. Here, we assessed the effects of isavuconazole on the length of QT c interval. The objective of the study was to describe changes in the QT c interval induced by isavuconazole treatment. A total of 26 adult patients from 7 hospitals were included. Patients received isavuconazole for the treatment of invasive fungal infection and, in 1 case, for prophylaxis due to QT c prolongation under fluconazole. Twelve‐channel electrocardiograms (ECGs) were performed before and during treatment. Out of 26 patients, 24 showed shortening of QT c interval. In patients with QT c shortening, QT c during isavuconazole treatment showed a mean decrease of 7.4 ± 5.8% (36.5 ± 38.8 ms, range 7‐202; P = .004), compared to pre‐isavuconazole ECG. One patient with available long‐term follow‐up showed further decrease in QT c on days 55 and 110. Apart from 1 case report, these are the first data outside controlled clinical trials showing QT c shortening. Knowledge about cardiac effects of isavuconazole will serve to better manage the use of concomitant medications.