Congratulations to Matt Burman on his latest paper as part of the European collective TBNet.
The study explored second line drugs used to treat multidrug-resistant (MDR)- tuberculosis (TB) and their effect on QT interval. Fluoroquinolones and, possibly, clofazimine can prolong the QTc, as do bedaquiline and delamanid. A QTc >500 ms is considered a risk factor for ventricular arrhythmias, such as torsades de pointes. In smaller cohorts, no cases of fatal arrhythmia have been reported in association with new TB drugs; deaths in bedaquiline/delamanid registration trials were not linked to prolonged QTc nor arrhythmias.
The objective of the study was to evaluate the clinical impact of QTc prolongation and the number of cardiac events in patients receiving bedaquiline/delamanid for MDR-TB treatment in TBnet treatment centres within the WHO Europe region.
QTc interval monitoring was regularly performed by physicians treating patients with bedaquiline and/or delamanid in WHO Europe region. Reassuringly the frequency of clinically relevant cardiac events associated with the use of these drugs was low. Among 1044 patients treated with bedaquiline and 220 patients treated with delamanid as part of a MDR-TB treatment regimen, not a single case of fatal cardiac event was observed.
Read more in the full paper: Guglielmetti, L., Tiberi, S., Burman, M., Kunst, H., Wejse, C., Togonidze, T., … & Lange, C. (2018). QT prolongation and cardiac toxicity of new tuberculosis drugs in Europe: A Tuberculosis Network European Trialsgroup (TBnet) study. European Respiratory Journal, 1800537.