The genetics of drug-induced QT prolongation: evaluating the evidence for pharmacodynamic variants

Pharmacogenomics. 2022 Jun;23(9):543-557. doi: 10.2217/pgs-2022-0027. Epub 2022 Jun 14.

Abstract

Drug-induced long QT syndrome (diLQTS) is an adverse effect of many commonly prescribed drugs, and it can increase the risk for lethal ventricular arrhythmias. Genetic variants in pharmacodynamic genes have been associated with diLQTS, but the strength of the evidence for each of those variants has not yet been evaluated. Therefore, the purpose of this review was to evaluate the strength of the evidence for pharmacodynamic genetic variants associated with diLQTS using a novel, semiquantitative scoring system modified from the approach used for congenital LQTS. KCNE1-D85N and KCNE2-T8A had definitive and strong evidence for diLQTS, respectively. The high level of evidence for these variants supports current consideration as risk factors for patients that will be prescribed a QT-prolonging drug.

Keywords: arrhythmias; drug-induced QT prolongation; ionic channels; pharmacogenetics; pharmacogenomics; polymorphism; torsades de pointes; variant.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Arrhythmias, Cardiac / chemically induced
  • Arrhythmias, Cardiac / drug therapy
  • Arrhythmias, Cardiac / genetics
  • Drug-Related Side Effects and Adverse Reactions* / genetics
  • Humans
  • Long QT Syndrome* / chemically induced
  • Long QT Syndrome* / genetics
  • Risk Factors
  • Torsades de Pointes* / chemically induced
  • Torsades de Pointes* / complications
  • Torsades de Pointes* / genetics