News

Health screening is an established component of high-quality medical care and doctors regularly screen their patients for disease risk markers such as high cholesterol or hypertension. Yet, little progress has been made in finding ways to prevent one major problem, sudden cardiac death (SCD) which, according to the American Heart Association (AHA), is responsible for approximately 370,000 deaths annually in the US.

Prolongation of the QT interval is a well-established risk factor that predicts increased mortality from sudden cardiac death.1 Identification of patients with the highest risk of QT prolongation and associated adverse outcomes has been facilitated by the use of QT risk scores that have greater predictive accuracy than the QT interval alone.

AZCERT's Scientific Review Committee has found substantial evidence that Pacritinib (anticancer), Vernakalant (antiarrhythmic) and Fexinidazole (antiparasitic) are associated with the development of QT prolongation but lack convincing evidence of torsades de pointes (TdP).  Therefore, these drugs have been added to the Possible Risk of TdP category (PR) and the List of Drugs to Avoid in patients with Congenital Long QT Syndrome (DTA List).  

AZCERT values and respects the trust so many have placed in CredibleMeds.org and MedSafetyScan.org. We always seek your advice on how AZCERT can better fulfil its mission to improve the safe use of medicines.

AZCERT's Scientific Review Committee has found substantial evidence that Macimorelin (used for diagnosis of growth hormone deficiency),  Dexmedetomidine (sedative), Pralsetinib (Thyroid cancer), Adagrasib (NSC Lung cancer) and Tebentafusp ...

At the heart of the ADECA process that is used to maintain the QTdrugs List is the active and passive surveillance of data for the thousands of prescription drugs  available  in the United States. We analyze this constant stream of new data to keep robust, up-to-date profiles on each drug – profiles that include laboratory research, relevant adverse event reports to FDA, CYP 450 metabolic activity, drug interactions, drug label information and much more.

AZCERT's Scientific Review Committee has reviewed available evidence for Remdesivir, an antiviral drug used to treat COVID-19, and found that its use is associated with the development of QTc prolongation. This analysis failed to find compelling evidence for a risk of torsades de pointes (TdP) arrhythmia. Therefore, Remdesivir has been added to the QTdrugs List in the Possible Risk of TdP category. The Committee has also added Serdexmethylphenidate, a new prodrug of dexmethylphenidate used to treat ADHD, to the List of Drugs to Avoid (DTA List) in patients with congenital Long QT Syndrome because of its adrenaline-like properties.

New icons to convey different categories of risk... To aid in the review and use of these lists, the CredibleMeds website employs specific icons for the risk categories and the drugs on the List of Drugs to Avoid by cLQTS patients.  To facilitate recognition of each drug’s risk category, the icon’s were recently changed to the following:

The QTdrugs List includes three distinct risk categories for Torsades de Pointes (TdP) and QT prolongation but not all drugs in the List should be considered “QT prolonging”. Because of the inherent complexity of drug-induced QT prolongation and the ensuing risk of developing TdP, AZCERT has sub-divided the QTdrugs List into three categories of risk of causing TdP.1 We want to remind those who wish to use the QTdrugs List in clinical decision making of the differences between these categories and caution that the QTdrugs List should not simply be thought of as a list of “QT-prolonging drugs”… it is not.

Deutetrabenazine (used to treat tardive dyskinesia) and Dexmedetomidine (a sedative) were removed from the  Possible Risk of TdP category and are no longer on the QTdrugs list. Our analysis of new evidence did not support their continued placement on the list.  As demonstrated by these revisions, the QTdrugs list is dynamic and can change frequently.