Presence or Absence of QTc Prolongation in Buprenorphine-Naloxone among Youth with Opioid Dependence

Objectives: The aim of the study was to evaluate buprenorphine-naloxone effects on the QTc in youth with opioid dependence. Buprenorphine is a partial agonist that is an effective treatment for opioid dependence. Compared with methadone, it has a lower risk of QTc prolongation in adults, but is less studied in the youth. It may also reduce the risk of torsades de pointes (TdP)-an uncommon variant of polymorphic ventricular tachycardia-that can result in syncope, ventricular fibrillation, and sudden death. Methods: Secondary analysis of the electrocardiogram data from 95 individuals who participated in a multisite trial for youth with opioid dependence. The participants were randomized to a 2-week (DETOX) or a 12-week course of buprenorphine-naloxone (BUP). At baseline, 12-lead electrocardiograms were done at weeks 4 and 12, and QTc intervals were hand-measured and calculated using Bazett formula. Increases above 60 milliseconds were considered clinically significant, and readings above 450 milliseconds (in men) and 470 milliseconds (in women) indicated a prolonged QTc. Results: Mean QTc intervals were higher for BUP than for DETOX participants at baseline, week 4, and week 12 (P=0.045), and women had longer mean QTc intervals than men (P