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Tasigna - Long QT Syndrome


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#1 MCPO

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Posted 30 November 2014 - 06:03 PM

I was on a lowered dose of Sprycel for more than 4 years but had to stop due to suppressed counts and bleeding issues.  I've been PCRu for over a year now.  A few weeks ago, I switched to Tasigna.  I did not get a baseline EKG, but had one within one week of starting treatment which was normal and had another one about a week later.  I have one scheduled at the one month mark, too.  Even though these have been normal, am I screwed since we don't have a baseline?

 

My counts have been better than they've been since long before my diagnosis of CML for a change.  I feel better mentally and energy wise on Tasigna than I did on Sprycel and am only having bone pain and a rash from the Tasigna right now.  Nothing all that major.  Not fun side effects, but better than Sprycel for me.  

 

However, I am a getting a little anxious about Long QT syndrome that is a risk that can accompany Tasigna.  I read about the syndrome and am now wondering if I should be taking any other steps to prevent Long QT syndrome, like avoiding any other activities or medications.  My doctor is monitoring me with ECGs, but will that actually detect if there is a problem if it's only one brief moment in time?  Does long QT syndrome show up on ECGs before it's an actual problem?  II am 32 years old with small kids and Long QT syndrome is freaking me out now that I've read about it.  Anyone know anything more specific about whether ECGs actually give some warning of people who may develop it and if it's developed, is it reversible with stopping Tasigna?  Is there any research someone has found about the trends discovered in the people who have developed Long QT syndrome or died suddenly on Tasigna?  Thanks!  



#2 MCPO

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Posted 30 November 2014 - 06:09 PM

PS:  What is it with the packaging of Tasigna?  I am not a fan.



#3 jjg

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Posted 30 November 2014 - 06:31 PM

As your ECGs are currently normal no need to worry about not having a baseline. If you had been given a baseline which was abnormal and now your ECGs were normal then you'd be thinking that tasigna cured you. 

QT problems with tasigna are pretty rare. I find reading too much about side effects you don't have is counter productive, particularly when I can't stop taking the tasigna. I did get checked out by a cardiologist because my heart rate dropped a bit on tasigna but everything is really normal while excercising. He encouraged me to keep exercising - best thing to keep a healthy heart healthy.


Dx Dec 2010 @37

2x IVF egg collection

Glivec 600 & 800mg

PCRU March 2012

Unsuccessful pregnancy attempt - relapsed, 3 months interferon (intron A), bad side effects from interferon

Nilotinib 600mg Oct 2012

PCRU April 2013, 2 years MR4.5 mostly PCRU with a few blips

April 2015 stopped again for pregnancy attempt (donor egg), pregnant first transfer, 0.110 at 10wks, 2.1 at 14wks, 4.2 at 16wks, started interferon, slow dose increase to 25MIU per wk, at full dose PCR< 1 for remainder of pregnancy

Healthy baby girl Jan 2016, breastfed one month

Nilotinib 600mg Feb 2016

MMR May 2016

PCRU Feb 2017


#4 garfonzo

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Posted 30 November 2014 - 06:35 PM

My understanding is that Tasigna does not cause long QT. Long QT is a preexisting condition that does not mix well with Tasigna. It will show up consistently on an ECG that's why you usually get one before starting Tasigna and a couple of times afterward. The chances of you having it are quite low but the trials did reveal a significant increase of cardiac issues with those who had it so that's why it has a black box warning. Since you have had clean ECGs so far I would consider it a non issue.
I had the same worries when I started Tasigna. Almost two years in with clean ECGs and a heart scan.
1/22/2013 initial dx WBC 550k
1/28/2013 begin Tasigna 600

pcr test %IS Drug Dose
7/24/13 2.889 Tasigna 600
10/23/13 2.442 Tasigna 600
1/24/14 2.497 Tasigna 600
3/5/14 2.158 Tasigna 600
6/4/14 1.319 Tasigna 800
9/3/14 0.982 Tasigna 800
12/8/14 0.845 Tasigna 800
3/16/15 1.984 Tasigna 800
4/27/15 0.802 Sprycel 100 PM
6/22/15 0.277 Sprycel 100
8/24/15 0.466 Sprycel 100 AM
9/14/15 0.365 Sprycel 100 PM
11/9/15 0.307 Sprycel 100
1/6/16 0.1 Sprycel 100 - MMR mayo clinic
4/4/16 0.1 Sprycel 100 - MMR
5/9/16 0.1 Sprycel 100 - MMR
6/6/16 0.06 Sprycel 40 - MMR
7/6/16 0.1 Sprycel 40 - MMR
9/12/16 0.09 Sprycel 40 - MMR
11/15/16 0.1 Sprycel 40 - MMR
2/14/17 0.07 Sprycel 40 - MMR
5/16/17 0.06 Sprycel 40 - MMR
9/11/17 0.05 Sprycel 40 - MMR
1/15/18 0.05 Sprycel 40 - MMR

#5 garfonzo

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Posted 30 November 2014 - 06:39 PM

And yes the packaging sucks. I cut it up into 2 pill packs.
1/22/2013 initial dx WBC 550k
1/28/2013 begin Tasigna 600

pcr test %IS Drug Dose
7/24/13 2.889 Tasigna 600
10/23/13 2.442 Tasigna 600
1/24/14 2.497 Tasigna 600
3/5/14 2.158 Tasigna 600
6/4/14 1.319 Tasigna 800
9/3/14 0.982 Tasigna 800
12/8/14 0.845 Tasigna 800
3/16/15 1.984 Tasigna 800
4/27/15 0.802 Sprycel 100 PM
6/22/15 0.277 Sprycel 100
8/24/15 0.466 Sprycel 100 AM
9/14/15 0.365 Sprycel 100 PM
11/9/15 0.307 Sprycel 100
1/6/16 0.1 Sprycel 100 - MMR mayo clinic
4/4/16 0.1 Sprycel 100 - MMR
5/9/16 0.1 Sprycel 100 - MMR
6/6/16 0.06 Sprycel 40 - MMR
7/6/16 0.1 Sprycel 40 - MMR
9/12/16 0.09 Sprycel 40 - MMR
11/15/16 0.1 Sprycel 40 - MMR
2/14/17 0.07 Sprycel 40 - MMR
5/16/17 0.06 Sprycel 40 - MMR
9/11/17 0.05 Sprycel 40 - MMR
1/15/18 0.05 Sprycel 40 - MMR

#6 rcase13

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Posted 30 November 2014 - 09:13 PM

It is funny how bad the packaging is. Clearly the people that make it don't take it every day like we do.

10/01/2014 100% Diagnosis (WBC 278k, Blasts 6%, Spleen extended 20cm)

01/02/2015 0.06% Tasigna 600mg
04/08/2015 0.01% Tasigna 600mg
07/01/2015 0.01% Tasigna 600mg
10/05/2015 0.02% Tasigna 600mg
01/04/2016 0.01% Tasigna 600mg
04/04/2016 PCRU Tasigna 600mg
07/18/2016 PCRU Tasigna 600mg
10/12/2016 PCRU Tasigna 600mg
01/09/2017 PCRU Tasigna 600mg
04/12/2017 PCRU Tasigna 600mg
10/16/2017 PCRU Tasigna 600mg
01/15/2018 PCRU Tasigna 600mg

 

Cancer Sucks!


#7 Trey

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Posted 30 November 2014 - 11:11 PM

Tasigna can reportedly cause QT elongation in some patients.  It is more likely to be worsened in those who have a pre-existing condition, or take other drugs which also are known to cause QT elongation.  Do not take two types of drugs which both have QT elongation issues.  But otherwise it has not shown itself to be a major issue.  So it is not worth much worry, but you are supposed to have a QT test done when using Tasigna.






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