Cholinesterase Inhibitors with Torsade de pointes/QT prolongation: a
real-world pharmacovigilance study
Abstract
Objective:Cholinesterase inhibitor (ChEIs) is the first-line drug for
Alzheimer’s disease (AD). Understanding torsade de pointes (TdP)/QT
prolongation with different ChEIs is essential for its safe and rational
administration. This study aimed to evaluate the correlation between
different ChEIs and TdP/QT prolongation. Methods:All ChEIs related
TdP/QT prolongation cases were retrieved from the FAERS database using
standard MedDRA query (SMQ) from the first quarter of 2004 to the third
quarter of 2022. Disproportionality and sensitivity analysis were used
to determine the signal of TdP/QT prolongation related to ChEIs.
Results:557 cases of TdP/QT prolongation related to 3 ChEIs were
searched by SMQ. The patients were mostly elderly people, with markedly
more female than male. The signals of TdP/QT prolongation for ChEIs were
detected by disproportionality analysis, and the signal of Donepezil was
the strongest. The sensitivity analysis results indicate a robust and
stable correlation between these signals with ChEIs. TdP/QT prolongation
usually occurs within one month after taking ChEIs. Conclusion:The
signals of TdP/QT prolongation related to ChEIs were strong and stable.
It is necessary to be vigilant about the TdP/QT prolongation of various
ChEIs, especially in the initial stage after taking ChEIs.