Neurology

Levetiracetam and QT prolongation: Reason for concern?

April 11, 2024

Compared with oxcarbazepine, levetiracetam didn’t demonstrate an increased risk of ventricular arrhythmia and sudden cardiac death.

• This study included patients who were newly prescribed levetiracetam or oxcarbazepine between January 2010 and December 2019. The combined endpoint was sudden cardiac death or ventricular arrhythmia, which are both associated with QT interval prolongation.
• A total of 104,655 enrollees took levetiracetam and 39,596 enrollees took oxcarbazepine. At baseline, levetiracetam recipients were older, more likely to have diagnosed epilepsy, and more likely to have comorbidities including hypertension, cerebrovascular disease, and CAD. There was no significant difference between levetiracetam and oxcarbazepine in rate of the combined endpoint for the Cox proportional hazards model (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.42-1.47) or Cox regression with time-varying characteristics (HR 0.78; 95% CI, 0.41-1.50).
• Authors conclude that the findings don’t support the concern for cardiac risk to warrant restriction of levetiracetam use nor the requirement of cardiac monitoring.

Source:

Cross MR, et al. (2024, May 14). Neurology. Sudden Cardiac Death or Ventricular Arrhythmia in Patients Taking Levetiracetam or Oxcarbazepine. https://pubmed.ncbi.nlm.nih.gov/38560823/