ArticleDrug safety2017
Investigating the Additive Interaction of QT-Prolonging Drugs in Older People Using Claims Data.
Article in Drug safety, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Quality of reporting of drug exposure in pharmacoepidemiological studies.Pharmacoepidemiology and drug safety · 2020Pooled it
- Exposure-QTc modeling of bedaquiline, pretomanid, and clofazimine in adults with tuberculosis.Antimicrobial agents and chemotherapy · 2026Article
- A tool for safer prescribing in vulnerable adults: the continuing development of the Medichec app and website.BJPsych bulletin · 2023Review
- The use of a clinical decision support tool to assess the risk of QT drug-drug interactions in community pharmacies.Therapeutic advances in drug safety · 2021Article
- Applying the Infectious Diseases Literature to People who Inject Drugs.Infectious disease clinics of North America · 2020Review
- Comparative risk of cardiac arrhythmias associated with acetylcholinesterase inhibitors used in treatment of dementias - A narrative review.Pharmacology research & perspectives · 2020Review
- Development and validation of a tool to assess the risk of QT drug-drug interactions in clinical practice.BMC medical informatics and decision making · 2020Article
- Adverse Drug Events in Patients with Chronic Kidney Disease Associated with Multiple Drug Interactions and Polypharmacy.Drugs & aging · 2020Observational
- Risk factors for QTc interval prolongation.European journal of clinical pharmacology · 2018Observational
- QTc prolongation during ciprofloxacin and fluconazole combination therapy: prevalence and associated risk factors.British journal of clinical pharmacology · 2018Observational
- Combinations of QTc-prolonging drugs: towards disentangling pharmacokinetic and pharmacodynamic effects in their potentially additive nature.Therapeutic advances in psychopharmacology · 2017Article
- Generating Evidence of Clinical Outcomes of Drug-Drug Interactions.Drug safety · 2017Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDrugs that potentially prolong the QT interval carry the risk of life-threatening Torsades de pointes (TdP) ventricular arrhythmia.
objectiveThe objective of this study was to investigate the potential additive risk for ventricular arrhythmia with concomitant prescriptions of QT-prolonging drugs.
methodsClaims data for persons aged ≥65 years between 2010 and 2012 in Germany were analyzed and all cases hospitalized for ventricular arrhythmia were selected. In a case-crossover analysis, exposure with QT-prolonging drugs according to the Arizona Center for Education and Research on Therapeutics (AZCERT) classification of 'known,' 'conditional,' and 'possible' TdP risk was determined in respective event and control windows preceding hospitalization. Conditional logistic regression was applied to derive odds ratios (ORs).
resultsAmong 6,849,622 health-insured persons, we identified 2572 patients newly hospitalized for ventricular arrhythmia. Drugs with 'known' risk were more frequently prescribed in the event window than in the control window (309 vs. 239; P < 0.001). The number of drugs with an attributed 'known' risk of TdP was significantly associated with hospitalization for ventricular arrhythmia (OR: 2.22; 95% confidence interval [1.51-3.25]; P < 0.001), while increased risk estimates were also obtained upon categorization into one and two or more drugs compared with no drugs for the combined group of drug with 'known' (1.52 [1.16-2.00]) and 'conditional' risk (2.20 [1.42-3.41]). Pairwise comparisons and trend tests based on these classification categories could not demonstrate a significantly increased risk of two or more drugs compared with one drug.
conclusionBeyond suitable single-drug classifications for QT-associated risk estimation, the situation when there is co-prescription of several drugs appears to be complex and may not be extrapolated to all possible multi-drug combinations.
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