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Increased long QT and torsade de pointes reporting on tamoxifen compared with aromatase inhibitors

dc.rights.licenseopenen_US
dc.contributor.authorGROUTHIER, V.
dc.contributor.authorLEBRUN-VIGNES, B.
dc.contributor.authorGLAZER, A. M.
dc.contributor.authorTOURAINE, P.
dc.contributor.authorFUNCK-BRENTANO, C.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorPARIENTE, Antoine
dc.contributor.authorCOURTILLOT, C.
dc.contributor.authorBACHELOT, A.
dc.contributor.authorRODEN, D. M.
dc.contributor.authorMOSLEHI, J. J.
dc.contributor.authorSALEM, J. E.
dc.date.accessioned2020-11-10T15:56:54Z
dc.date.available2020-11-10T15:56:54Z
dc.date.issued2018-11
dc.identifier.issn1355-6037en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/12220
dc.description.abstractEnOBJECTIVE: A prolonged QTc (LQT) is a surrogate for the risk of torsade de pointes (TdP). QTc interval duration is influenced by sex hormones: oestradiol prolongs and testosterone shortens QTc. Drugs used in the treatment of breast cancer have divergent effects on hormonal status. METHODS: We performed a disproportionality analysis using the European database of suspected adverse drug reaction (ADR) reports to evaluate the reporting OR (ROR chi(2)) of LQT, TdP and ventricular arrhythmias associated with selective oestrogen receptor modulators (SERMs: tamoxifen and toremifene) as opposed to aromatase inhibitors (AIs: anastrozole, exemestane and letrozole). When the proportion of an ADR is greater in patients exposed to a drug (SERMs) compared with patients exposed to control drug (AIs), this suggests an association between the specific drug and the reaction and is a potential signal for safety. Clinical and demographic characterisation of patients with SERMs-induced LQT and ventricular arrhythmias was performed. RESULTS: SERMs were associated with higher proportion of LQT reports versus AIs (26/8318 vs 11/14851, ROR: 4.2 (2.11-8.55), p<0.001). SERMs were also associated with higher proportion of TdP and ventricular arrhythmia reports versus AIs (6/8318 vs 2/14851, ROR: 5.4 (1.29-26.15), p:0.02; 16/8318 vs 12/14851, ROR: 2.38 (1.15-4.94), p:0.02, respectively). Mortality was 38% in patients presenting ventricular arrhythmias associated with SERMs. CONCLUSIONS: SERMs are associated with more reports of drug-induced LQT, TdP and ventricular arrhythmias compared with AIs. This finding is consistent with oestradiol-like properties of SERMs on the heart as opposed to effects of oestrogen deprivation and testosterone increase induced by AIs. TRIAL REGISTRATION NUMBER: NCT03259711.
dc.language.isoENen_US
dc.subject.enPharmacoEpi-Drugs
dc.subject.enCIC1401
dc.title.enIncreased long QT and torsade de pointes reporting on tamoxifen compared with aromatase inhibitors
dc.title.alternativeHearten_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1136/heartjnl-2017-312934en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed29720397en_US
bordeaux.journalHeart (British Cardiac Society)en_US
bordeaux.page1859-1863en_US
bordeaux.volume104en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue22en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamPharmacoEpi-Drugsen_US
bordeaux.teamCIC1401en_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
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