QT Interval, Antipsychotics and Correlates Among Patients with Schizophrenia: Cross-Sectional Data from the Multicentric Real-World FACE-SZ.

IF 4 2区医学 Q1 PHARMACOLOGY & PHARMACY

Drug Safety Pub Date : 2025-03-15 DOI:10.1007/s40264-025-01526-9

Mona Gerentes, Mohamed Lajnef, Andrei Szöke, Bruno Aouizerate, Fabrice Berna, Maud Cléry, Isabelle Chéreau, Nathalie Coulon, Julia Clauss-Kobayashi, Eric Fakra, Jean-Michel Dorey, Caroline Dubertret, Guillaume Fond, Ophélia Godin, Tudi Goze, Christophe Lançon, Marion Leboyer, Sylvain Leignier, Pierre-Michel Llorca, Jasmina Mallet, David Misdrahi, Nicolas Oriol, Romain Rey, Paul Roux, Benoit Schorr, Mathieu Urbach, Etienne Véry, Franck Schürhoff, Baptiste Pignon

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引用次数: 0

Abstract

Background: The life expectancy of patients with schizophrenia is reduced, partly due to cardiovascular diseases. Antipsychotics are associated with QT interval prolongation, which is a risk factor for arrhythmia and cardiac arrest. The differences between antipsychotic with regard to QT interval prolongation are not well understood.

Objective: The aim was to compare the QT values associated with different antipsychotics within a real-world population of subjects with clinically stable forms of schizophrenia.

Methods: The FACE-SZ cohort comprises subjects with psychotic disorders, referred to schizophrenia expert cents. QT interval was measured, as well as all treatments (psychotropic and others). The following maintenance treatment for schizophrenia was analysed cross-sectionally: aripiprazole, clozapine, haloperidol, amisulpride, olanzapine, quetiapine, risperidone. Age, sex, smoking status, body mass index, blood potassium levels, and the co-prescription of another QT-prolonging treatment were used as adjustment factors in multivariable linear regression analyses.

Results: Among 792 patients, the mean corrected QT (QTc) interval in the sample of patients under monotherapy was 407 ms. The mean age was 31.7 years, and the majority were male (73.3 %). In comparison to the rest of the sample, clozapine was associated with a longer QTc interval (β = 0.012, 95% CI [0.006-0.018]), while aripiprazole was significantly associated with a shorter QTc interval (β = - 0.010, 95% CI [- 0.016 to - 0.005]). Other antipsychotics were not associated with significant variations of the QTc.

Conclusions: The prescription of antipsychotics should always be accompanied by close monitoring of the QTc interval to prevent the risk of severe cardiac arrhythmia, particularly concerning clozapine.

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精神分裂症患者的QT间期、抗精神病药物和相关因素：来自多中心真实世界FACE-SZ的横断面数据。

背景：精神分裂症患者的预期寿命降低，部分原因是心血管疾病。抗精神病药物与QT间期延长有关，QT间期延长是心律失常和心脏骤停的危险因素。抗精神病药在QT间期延长方面的差异尚不清楚。目的：目的是比较现实世界中具有临床稳定形式精神分裂症的受试者群体中与不同抗精神病药物相关的QT值。方法：FACE-SZ队列包括精神障碍患者，指精神分裂症专家。测量QT间期，以及所有治疗（精神药物和其他）。对精神分裂症患者的下列维持治疗进行横断面分析：阿立哌唑、氯氮平、氟哌啶醇、氨硫pride、奥氮平、喹硫平、利培酮。在多变量线性回归分析中，以年龄、性别、吸烟状况、体重指数、血钾水平和联合使用另一种延长qt治疗作为调整因素。结果：792例患者中，单药治疗组校正QT间期（QTc）平均为407 ms。平均年龄31.7岁，以男性居多（73.3%）。与其他样本相比，氯氮平与较长的QTc间隔相关（β = 0.012, 95% CI[0.006-0.018]），而阿立哌唑与较短的QTc间隔相关（β = - 0.010, 95% CI[- 0.016至- 0.005]）。其他抗精神病药物与QTc的显著变化无关。结论：在使用抗精神病药物时应密切监测QTc间期，以预防严重心律失常的发生，尤其是氯氮平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Safety 医学-毒理学

CiteScore

7.60

自引率

7.10%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.