Is Methadone Linked To Initial QTc Prolongation In Chronic Pain?

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For patients with chronic pain, methadone is associated with a small, but nonsignificant, initial increase in QTc, which does not persist.
For patients with chronic pain, methadone is associated with a small, but nonsignificant, initial increase in QTc, which does not persist.

HealthDay News -- For patients with chronic pain, methadone is associated with a small, but nonsignificant, initial increase in QTc, which does not persist, according to a study published in Pain Medicine.

Samuel Grodofsky, MD, from the University of Pennsylvania in Philadelphia, and colleagues conducted a prospective cohort study in a chronic pain clinic involving 82 patients receiving methadone and 102 receiving non-methadone opioid therapy. Automated QTc calculations from 12-lead electrocardiograms were analyzed at baseline and during the subsequent six months.

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The researchers found that there was no overall higher frequency of QTc >470 milliseconds in the methadone group (6% one group versus 5 percent for controls; P = 0.722).

Furthermore, the methadone group had no increase in the incidence of QTc >60 milliseconds from baseline (4 and 4%, respectively; P = 0.94). Patients in the methadone group exhibited an increase in QTc compared with controls in the first month after initiating methadone (5 versus 0 percent; P = 0.073), but the difference did not persist at three and six months.

"We believe larger scale studies to further characterize the safety profile of low-dose methadone are warranted," the authors wrote.

Reference

1. Grodofsky S, et al. Pain Med. 2015 doi: 10.1111/pme.12658.

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