Fatal cardiotoxicity related to halofantrine: a review based on a worldwide safety data base

Simple item page
dc.contributor.authorBouchaud, Olivier
dc.contributor.authorImbert, Patrick
dc.contributor.authorTouze, Jean E
dc.contributor.authorDodoo, Alex NO
dc.contributor.authorDanis, Martin
dc.contributor.authorLegros, Fabrice
dc.date.accessioned2014-08-14T13:30:28Z
dc.date.available2014-08-14T13:30:28Z
dc.date.issued2009-12-10
dc.date.updated2014-08-14T13:30:43Z
dc.description.abstractAbstract Background Halofantrine (HF) was considered an effective and safe treatment for multi-drug resistant falciparum malaria until 1993, when the first case of drug-associated death was reported. Since then, numerous studies have confirmed cardiac arrythmias, possibly fatal, in both adults and children. The aim of the study was to review fatal HF related cardiotoxicity. Methods In addition, to a systematic review of the literature, the authors have had access to the global safety database on possible HF related cardiotoxicity provided by GlaxoSmithKline. Results Thirty-five cases of fatal cardiotoxicity related to HF, including five children, were identified. Females (70%) and patients from developing countries (71%) were over-represented in this series. Seventy-four percent of the fatal events occurred within 24 hours of initial exposure to HF. Twenty six patients (74%) had at least one predisposing factor for severe cardiotoxicity, e.g., underlying cardiac disease, higher than recommended doses, or presence of a concomitant QT-lengthening drug. All (100%) of the paediatric cases had either a contraindication to HF or an improper dose was given. In six cases there was no malaria. Conclusion A distinction should be made between common but asymptomatic QT-interval prolongation and the much less common ventricular arrhythmias, such as torsades de pointes, which can be fatal and seem to occur in a very limited number of patients. The majority of reported cardiac events occurred either in patients with predisposing factors or with an improper dose. Therefore, in the rare situations in which HF is the only therapeutic option, it can still be given after carefully checking for contraindications, such as underlying cardiac disease, bradycardia, metabolic disorders, personal or family history of long QT-interval or concomitant use of another QT-prolonging drug (e.g., mefloquine), especially in females.
dc.description.versionPeer Reviewed
dc.identifier.urihttp://197.255.68.203/handle/123456789/5628
dc.language.rfc3066en
dc.rights.holderOlivier Bouchaud et al.; licensee BioMed Central Ltd.
dc.titleFatal cardiotoxicity related to halofantrine: a review based on a worldwide safety data base
dc.typeJournal Article

Files

Original bundle
Now showing 1 - 2 of 2
Thumbnail Image
Name:
1475-2875-8-289.pdf
Size:
566.83 KB
Format:
Adobe Portable Document Format
Download
No Thumbnail Available
Name:
1475-2875-8-289.xml
Size:
106.96 KB
Format:
Extensible Markup Language
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.82 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

Department of Centre for Tropical Clinical Pharmacology and Therapeutics