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Case report of QT interval prolongation induced by anamorelin in an obese patient with non-small cell lung cancer.
Yokota, Hayato; Asahi, Ruriko; Akamine, Yumiko; Kobayashi, Mizuki; Wakabayashi, Hiyu; Sakamoto, Sho; Okuda, Yuji; Sato, Kazuhiro; Nakayama, Katsutoshi; Kikuchi, Masafumi.
Afiliación
  • Yokota H; Department of Pharmacy, Akita University Hospital, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Asahi R; Department of Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
  • Akamine Y; Department of Pharmacy, Akita University Hospital, 1-1-1 Hondo, Akita, 010-8543, Japan. yumiko-ai@hos.akita-u.ac.jp.
  • Kobayashi M; Department of Pharmacy, Akita University Hospital, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Wakabayashi H; Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Akita, Japan.
  • Sakamoto S; Department of Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
  • Okuda Y; Department of Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
  • Sato K; Department of Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
  • Nakayama K; Department of Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
  • Kikuchi M; Department of Pharmacy, Akita University Hospital, 1-1-1 Hondo, Akita, 010-8543, Japan.
J Pharm Health Care Sci ; 10(1): 33, 2024 Jun 26.
Article en En | MEDLINE | ID: mdl-38926760
ABSTRACT

BACKGROUND:

Anamorelin, a drug to treat cancer cachexia, binds to ghrelin receptors and improves body weight and appetite. In clinical trials in Japan, patients experienced a 10.7% frequency of stimulant conduction system depression as a severe side effect. Although rare, anamorelin sometimes causes fatal arrhythmias. Because patients with cancer cachexia are often underweight, data on the safety of anamorelin in obese patients are lacking. We report a case of QT interval prolongation after anamorelin administration to an obese patient with non-small cell lung cancer. CASE PRESENTATION A female patient with a body mass index of 30 kg/m2 underwent immunotherapy for lung adenocarcinoma. She presented with severe weight loss, anorexia, and fatigue. She had no history of heart disease. On day 12, after administration of anamorelin 100 mg once daily, the patient developed nausea, diarrhea, and anorexia, which were considered cancer immunotherapy-induced immune-related adverse events, and she was admitted to the hospital. An electrocardiogram (ECG) on admission showed a QTc interval of 502 ms. On admission, her hepatic function was Child-Pugh class B, and anamorelin was discontinued the next day. On day 3 after anamorelin discontinuation, the QTc interval was prolonged by up to 557 ms, then decreased to 490 ms on day 6, and improved to 450 ms on day 16. Re-administration of anamorelin was avoided.

CONCLUSIONS:

When administering anamorelin to obese patients, we should be aware of the potential for stimulatory conduction system depression, as in underweight patients. Therefore, we should monitor patients by ECG from the early stages of anamorelin administration. Anamorelin is lipophilic, and its volume of distribution is increased in obese patients. Consequently, obese patients may continue to have QT interval prolongation after discontinuation of anamorelin, requiring long-term side-effect monitoring.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pharm Health Care Sci Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pharm Health Care Sci Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido