Chaufour S, Caplain H, Lilienthal N, L'héritier C, Deschamps C, Dubruc C, Rosenzweig P
Synthélabo Recherche, 31 Av. Paul-Vaillant Couturier, BP110, 92225 Bagneux, France.
Br J Clin Pharmacol. 1999 May;47(5):515-20. doi: 10.1046/j.1365-2125.1999.00927.x.
The occurrence of serious dysrhythmias, such as torsades de pointes, with terfenadine and astemizole had led to a reexamination of the potential effect of H1 antihistamines on cardiac repolarization. Mizolastine is a potent, selective, nonsedating peripherally acting H1-receptor antagonist which is registered for rhinitis and urticaria at a recommended dose of 10 mg once daily. The present study was carried out to investigate the effects of therapeutic and supratherapeutic doses of mizolastine, on ventricular repolarization in healthy volunteers.
Twenty-four healthy young volunteers participated in a double-blind, placebo-controlled, randomised study with three parallel groups. Each group consisted of 2 way cross-over 7 day treatment periods where mizolastine (10, 20 or 40 mg) and placebo were randomly administered. On day 1 and day 7, 12-lead ECG recordings were performed prior and 0.5, 1, 2, 3, 4, 6, 8, 12, 16, and 20 h after dosing and from day 2 to day 6, before dosing and 1, 2, 3, and 4 h after.
Whatever the analysis used (raw data, changes from baseline, incidence of individual out-of-range values) no significant differences were observed at any dose level vs placebo, on any of ECG parameters (HR, PR, QRS, QT, and QTc). In particular, no effect of mizolastine vs placebo was shown on QT and QTc although 95% CIs were wide. The only subject who exhibited a QTc>/=450 ms received placebo for 7 days.
This study found no evidence of an effect of mizolastine up to 40 mg (four times the therapeutic dose) on ventricular repolarization in healthy volunteers.
特非那定和阿司咪唑可引发严重心律失常,如尖端扭转型室速,这促使人们重新审视H1抗组胺药对心脏复极化的潜在影响。咪唑斯汀是一种强效、选择性、非镇静性的外周作用H1受体拮抗剂,以每日10 mg的推荐剂量用于治疗鼻炎和荨麻疹。本研究旨在调查治疗剂量和超治疗剂量的咪唑斯汀对健康志愿者心室复极化的影响。
24名健康年轻志愿者参与了一项双盲、安慰剂对照、随机分组的平行三组研究。每组包括两个为期7天的交叉治疗期,随机给予咪唑斯汀(10、20或40 mg)和安慰剂。在第1天和第7天,给药前以及给药后0.5、1、2、3、4、6、8、12、16和20小时进行12导联心电图记录;从第2天到第6天,给药前以及给药后1、2、3和4小时进行记录。
无论采用何种分析方法(原始数据、相对于基线的变化、个体超出范围值的发生率),在任何剂量水平与安慰剂相比,任何心电图参数(心率、PR间期、QRS波群、QT间期和校正QT间期)均未观察到显著差异。特别是,尽管95%置信区间较宽,但咪唑斯汀与安慰剂相比对QT间期和校正QT间期没有影响。唯一QTc≥450 ms的受试者接受了7天的安慰剂治疗。
本研究未发现高达40 mg(治疗剂量的四倍)的咪唑斯汀对健康志愿者心室复极化有影响的证据。