Delauche-Cavallier M C, Chaufour S, Guérault E, Lacroux A, Murrieta M, Wajman A
Synthélabo Groupe, Le Plessis Robinson, France.
Clin Exp Allergy. 1999 Jul;29 Suppl 3:206-11. doi: 10.1046/j.1365-2222.1999.0290s3206.x.
Some H1 antihistamines are at risk for rare but severe dysrhythmias due to an effect on the ventricular repolarization.
To present an overview of the QT interval monitoring performed during the clinical development of mizolastine, a new selective second-generation H1 antihistamine.
The ECGs database analysis of clinical studies conducted in volunteers and patients is summarized and focused on the results of reported studies and studies specifically designed for the assessment of the effect of mizolastine on cardiac repolarization, through the QT interval measurements. Mizolastine was orally administered up to 75 mg single dose and 40 mg repeated dose in healthy volunteers (i.e. 7. 5 and 4 times the recommended dose, respectively) and at a dose of 10 or 15 mg in patients.
In healthy volunteers, no increased incidence of QTc values >440 msec or DeltaQTc >/=40 msec were recorded compared to placebo. No dose-related increase in QTc interval was observed. The ECG parameters were not modified by the co-administration of mizolastine with digoxin, diltiazem and erythromycin, when compared to the effect of each co-administered drug alone. In patients, the mean QTc interval changes from baseline did not significantly differ from placebo. In comparative studies vs. loratadine a similar incidence of out of range values was observed with mizolastine and loratadine.
ECG monitoring of volunteers and patients included in clinical studies conducted with mizolastine showed no significant effect of mizolastine on cardiac repolarization.
一些H1抗组胺药因对心室复极化有影响,存在罕见但严重心律失常的风险。
概述在新型选择性第二代H1抗组胺药咪唑斯汀临床研发过程中进行的QT间期监测情况。
总结了在志愿者和患者中开展的临床研究的心电图数据库分析,重点关注报告研究以及专门设计用于评估咪唑斯汀对心脏复极化影响(通过QT间期测量)的研究结果。在健康志愿者中,咪唑斯汀单剂量口服高达75mg,重复剂量口服40mg(即分别为推荐剂量的7.5倍和4倍),在患者中剂量为10mg或15mg。
与安慰剂相比,在健康志愿者中,未记录到QTc值>440毫秒或DeltaQTc≥40毫秒的发生率增加。未观察到QTc间期与剂量相关的增加。与单独使用每种联用药物的效果相比,咪唑斯汀与地高辛、地尔硫卓和红霉素联用时,心电图参数未改变。在患者中,与安慰剂相比,平均QTc间期自基线的变化无显著差异。在与氯雷他定的对比研究中,咪唑斯汀和氯雷他定超出范围值的发生率相似。
对咪唑斯汀临床研究中纳入的志愿者和患者进行的心电图监测显示,咪唑斯汀对心脏复极化无显著影响。