Marzi Marta, Weitz Darío, Avila Aylén, Molina Gabriel, Caraballo Lucía, Piskulic Laura
Rev Med Chil. 2015 Jan;143(1):14-21. doi: 10.4067/S0034-98872015000100002.
Domperidone is widely prescribed in patients with gastrointestinal disorders but some cardiac adverse effects have been recently reported.
To evaluate the risk of QT prolongation, ventricular arrhythmias and sudden cardiac death associated with the use of oral domperidone in adults without cancer.
Systematic searches in MEDLINE, LILACS, SciELO, the Cochrane Library and regulatory agencies websites were performed, followed by a manual search of cited references. The search strategy consisted of combining free and indexed text words without any date or language restriction.
Three case-control studies met the inclusion criteria; none of them evaluated QT interval prolongation. With low risk of bias, each study quantified the risk of ventricular arrhythmia or sudden cardiac death (VA/SCD). The odds ratios for these events in these studies were 4.7 (95% confidence interval (CI): 1.4-16), 1.59 (95% CI: 1.28-1.98) and 11.02 (95% CI: 2.02-62.3) respectively. A significantly increased risk was observed in patients older than 60 years of age or receiving doses > 30 mg/day.
Heterogeneity between selected studies did not allow the computation of a summary measure. However, evidence was found that an increased risk of VA/SCD is associated with the use of oral domperidone in adults.
多潘立酮在胃肠道疾病患者中被广泛处方，但最近有一些心脏不良反应的报道。
评估在无癌症的成年人中使用口服多潘立酮与QT间期延长、室性心律失常和心源性猝死风险之间的关联。
在MEDLINE、LILACS、SciELO、Cochrane图书馆及监管机构网站进行系统检索，随后手动检索引用文献。检索策略包括结合自由词和索引词，无任何日期或语言限制。
三项病例对照研究符合纳入标准；均未评估QT间期延长情况。每项研究的偏倚风险较低，均对室性心律失常或心源性猝死（VA/SCD）风险进行了量化。这些研究中这些事件的比值比分别为4.7（95%置信区间（CI）：1.4 - 16）、1.59（95% CI：1.28 - 1.98）和11.02（95% CI：2.02 - 62.3）。在年龄大于60岁或接受剂量>30 mg/天的患者中观察到风险显著增加。
所选研究之间的异质性不允许计算汇总测量值。然而，发现有证据表明在成年人中使用口服多潘立酮与VA/SCD风险增加相关。
