ArticleEuropean heart journal2021
Anticancer drug-induced life-threatening ventricular arrhythmias: a World Health Organization pharmacovigilance study.
Article in European heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03530215 (Evaluation of Reporting of Cardio-vascular Adverse Events With Antineoplastic and Immunomodulating Agents), which is not on this map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Evaluation of Reporting of Cardio-vascular Adverse Events With Antineoplastic and Immunomodulating Agents (EROCA)
Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 75 citations in OpenAlex.
- An Awareness of Pharmacovigilance Among Healthcare Professionals Due to an Underreporting of Adverse Drug Reactions Issue: A Systematic Review of the Current State, Obstacles, and Strategy.Current drug safety · 2024Pooled it
- Regulatory challenges and current policy for cardiotoxicity detection in oncology drug development.Journal of thrombosis and thrombolysis · 2026Review
- The intersection of colorectal cancer and cardiovascular disease: shared mechanisms and clinical implications.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Prescribed drugs and comorbidities as risk factors for Torsades de Pointes arrhythmia: a Swedish population-based cohort study.European journal of clinical pharmacology · 2026Article
- Validation of a novel semi-automated ECG quantification tool, applied to a cardio-oncology : Semi-automated ECG Tool applied to cardio-oncology.Cardio-oncology (London, England) · 2025Article
- Cancer-Induced Cardiac Dysfunction: Mechanisms, Diagnostics, and Emerging Therapeutics in the Era of Onco-Cardiology.Cancers · 2025Review
- Epigenetic Mechanisms in Heart Diseases.Reviews in cardiovascular medicine · 2025Review
- Transgender-Affirming Hormone Therapies, QT Prolongation, and Cardiac Repolarization.JAMA network open · 2025Article
- Revolutionising Cardio-Oncology Care with Precision Genomics.International journal of molecular sciences · 2025Review
- Global burden of vaccine-associated kidney injury using an international pharmacovigilance database.Scientific reports · 2025Article
- The role and mechanism of epigenetics in anticancer drug-induced cardiotoxicity.Basic research in cardiology · 2025Review
- Global burden of anticancer drug-induced acute kidney injury and tubulointerstitial nephritis from 1967 to 2023.Scientific reports · 2024Article
- Cardiovascular events reported in patients with B-cell malignancies treated with zanubrutinib.Blood advances · 2024Article
- Chronic Lymphocytic Leukemia: Management of Adverse Events in the Era of Targeted Agents.Cancers · 2024Review
- Article
- Cardiovascular disease burden in patients with urological cancers: The new discipline of uro-cardio-oncology.Cancer innovation · 2024Review
- Immune Checkpoint Inhibitor Use During Pregnancy and Outcomes in Pregnant Individuals and Newborns.JAMA network open · 2024Article
- Case report: Phosphoinositide 3-kinase inhibitor with fulvestrant in a patient with ER+/HER2- metastatic breast carcinoma induced fatal arrhythmias: a preventable event?Frontiers in oncology · 2024Article
- Advancements in understanding cardiotoxicity of EGFR- TKIs in non-small cell lung cancer treatment and beyond.Frontiers in pharmacology · 2024Review
- Epidemiology, clinical characteristics and potential mechanism of ibrutinib-induced ventricular arrhythmias.Frontiers in pharmacology · 2024Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
aimsWith the explosion of anticancer drugs, an emerging concern is the risk for drug-induced sudden death (SD) via ventricular arrhythmias (VA). METHODS AND
resultsWe used the international pharmacovigilance database VigiBase (n = 18 441 659 reports) to compare drug-induced long QT (diLQT, n = 18 123) and VA (n = 29 193) including torsade de pointes (TdP, n = 8163) reporting for 663 anticancer drugs vs. all other drugs until 01/01/2019. The analysis used the 95% lower-end credibility interval of the information component (IC025), an indicator for disproportionate Bayesian reporting; significant when IC025 >0. There were 2301 reports (13.8% fatal) for 40 anticancer drugs significantly associated with diLQT (with 27 also associated with VA or SD) and 9 drugs associated with VA without diLQT. Half of these (46.9%, 23/49) were associated with SD. Most (41%, 20/49) were kinase inhibitors, 8% (4/49) were hormonal therapies, 6% (3/49) were immunotherapies, 24% (12/49) were cytotoxics, and 20% (10/49) were miscellaneous. In VigiBase, reports of diLQT, TdP, or VA increased from 580 in the period 1967-83 to 15 070 in 2014-18 with the proportion related to anticancer drugs increasing from 0.9% (5/580) to 14.0% (2115/15 070) (P < 0.0001). Concordance between these VigiBase signals and data concerning diLQT and VA/TdP identified in CredibleMeds or US Food and Drug Administration (FDA) labels was moderate (κ = 0.47 and 0.40, P < 0.0001). Twenty-three drugs represent new signals, while 24 flagged by CredibleMeds or FDA had no signal in VigiBase. A three-level SD risk stratification relying on isolated long QT (low risk), associated with VA without SD (moderate risk), and VA with SD (high risk) is proposed.
conclusionThis list of liable anticancer drugs may prove useful for physicians and regulatory authorities to re-evaluate cardiac monitoring requirements. CLINICAL
trial registrationNCT03530215.
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