Trial reportJournal of palliative medicine2010
The effect of oral methadone on the QTc interval in advanced cancer patients: a prospective pilot study.
Trial report in Journal of palliative medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- 2017 HIVMA of IDSA Clinical Practice Guideline for the Management of Chronic Pain in Patients Living With HIV.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Guideline
- Adult cancer pain.Journal of the National Comprehensive Cancer Network : JNCCN · 2013Guideline
- Efficacy and Safety of Methadone as a Second-Line Opioid for Cancer Pain in an Outpatient Clinic: A Prospective Open-Label Study.The oncologist · 2016Trial
- Effects of disulfiram on QTc interval in non-opioid-dependent and methadone-treated cocaine-dependent patients.Journal of addiction medicineTrial
- Efficacy and safety of combining low-dose methadone with ongoing opioid treatment for uncontrolled cancer pain: an open-label single-arm study.The oncologist · 2025Observational
- The effect of oral methadone on the QTc interval in cancer pain patients.Pain management · 2025Article
- A case with a trend of QT interval prolongation due to the introduction of methadone to a pancreatic cancer patient on levofloxacin.Journal of pharmaceutical health care and sciences · 2024Article
- Prevention, diagnosis, and treatment of opioid use disorder under the supervision of opioid stewardship programs: it's time to act now.The Korean journal of pain · 2022Review
- Integrating in vitro data and physiologically based kinetic modeling-facilitated reverse dosimetry to predict human cardiotoxicity of methadone.Archives of toxicology · 2020Article
- How to Use Methadone in an Era of an Opioid Epidemic.Current treatment options in oncology · 2020Review
- QT Interval Prolongation in the Pediatric Oncologic Population on Methadone.Journal of pediatric hematology/oncology · 2020Article
- Review
- Practical Pharmacology of Methadone: A Long-acting Opioid.Indian journal of palliative care · 2018Review
- Challenges of Using Methadone in the Indian Pain and Palliative Care Practice.Indian journal of palliative care · 2018Review
- Histopathological study of liver tissue due to methadone consumption and its effect on liver enzymes and inflammatory indices in rat.Drug design, development and therapy · 2018Article
- Overall Survival among Cancer Patients Undergoing Opioid Rotation to Methadone Compared to Other Opioids.Journal of palliative medicine · 2017Article
- Chronic opioid therapy in long-term cancer survivors.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2017Review
- The Impact of Opioids on Cardiac Electrophysiology.Current cardiology reviews · 2016Review
- Evaluation of Methadone-Induced QTc Prolongation in a Veteran Population.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2015Article
- Palliative care research: lessons learned by our team over the last 25 years.Palliative medicine · 2013Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundRecent reports suggest that high doses of methadone may prolong QTc interval and occasionally cause torsades de pointes; however, few of these studies involved the palliative care population.
objectiveThe purpose of this study was to determine the effect of initiation of methadone on QTc interval in patients with cancer pain seen at the palliative care setting.
methodsWe enrolled 100 patients with cancer in this prospective study. Patients were followed clinically and electrocardiographically for QTc changes at baseline, 2, 4, and 8 weeks. Contributing factors for QTc prolongation such as medications, cardiovascular diseases, and electrolytes disturbances were documented. QTc prolongation was defined as greater than 430 ms in males and greater than 450 ms in females, and significant QTc prolongation was defined as QTc interval greater than 25% increase from baseline or 500 ms or more.
resultsElectrocardiographic (ECG) assessments were available for 100, 64, 41, and 27 patients at baseline, 2-, 4-, and 8-week follow-up, respectively. At baseline prior to initiation of methadone, 28 (28%) patients had QTc prolongation. Clinically significant increase in QTc occurred in only 1 of 64 (1.6%) patients at week 2, and none at weeks 4 and 8. There was no clinical evidence of torsades de pointes, ventricular fibrillation, or sudden death. QTc prolongation was more frequent among patients with increased baseline QTc interval.
conclusionsBaseline QTc prolongation was common, whereas significant QTc interval 500 ms or more after methadone initiation rarely occurred, with no evidence of clinically significant arrhythmias. This study supports the safety of methadone use for pain control in patients with advanced cancer in the palliative care setting.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.