Pfizer Global Research and Development, New York, New York, USA.
Antimicrob Agents Chemother. 2012 May;56(5):2408-13. doi: 10.1128/AAC.05194-11. Epub 2012 Feb 27.
The objective of this study was to investigate the effect of a supratherapeutic dose of lersivirine (LRV) on corrected QT (QTc) interval using Fridericia's equation (QTcF) in healthy subjects. In this randomized, single-dose, placebo- and active-controlled 3-way crossover study, healthy adult males (n = 48) were randomized to receive LRV (2,400 mg), moxifloxacin (400 mg), or placebo for each treatment period. Triplicate 12-lead electrocardiogram measurements were performed, PK samples were collected, and vital signs were measured. Adverse event monitoring and safety laboratory testing were performed. All subjects were white (mean age, 39 years; body mass index [BMI], 25.6 kg/m(2)) and completed the study. Following LRV administration, the upper bound of the 90% confidence interval (CI) for time-matched adjusted mean differences to placebo QTcF at each time point postdose was below the regulatory threshold of 10 ms, satisfying the criteria for a negative thorough QT/QTc study. The highest upper bound of QTcF 90% CI occurred at 6 h for LRV (3.32 ms; 90% CI, 1.47 to 5.17 ms). The study was deemed adequately sensitive as the lower bound of the 90% CI for the adjusted mean QTcF differences between moxifloxacin and placebo at the moxifloxacin historical T(max) of 3 h was >5 ms (15.29 ms; 90% CI, 13.44 to 17.14 ms). There was no statistically significant relationship between LRV exposure and placebo-adjusted change from baseline QTcF or clinically significant changes in QRS complex, pulse rate (PR) interval, heart rate, or blood pressure. LRV (2,400 mg) did not prolong the QTcF interval, and no clinically relevant electrocardiogram or vital sign changes were observed in healthy subjects.
本研究旨在采用 Fridericia 公式(QTcF)研究超治疗剂量拉替拉韦(LRV)对健康受试者校正 QT(QTc)间期的影响。这是一项随机、单剂量、安慰剂和活性对照三交叉研究,共纳入 48 名健康成年男性,随机接受 LRV(2400mg)、莫西沙星(400mg)或安慰剂治疗。每个治疗周期进行 3 次 12 导联心电图测量,采集药代动力学样本并测量生命体征。对不良事件进行监测和安全实验室检测。所有受试者均为白人(平均年龄 39 岁;体重指数 [BMI] 25.6kg/m2),并完成了研究。LRV 给药后,各时间点时匹配调整后 LRV 与安慰剂的 QTcF 差值的 90%置信区间(CI)上限均低于 10ms 的监管阈值,符合阴性全面 QT/QTc 研究的标准。LRV 的 QTcF 90%CI 上限最高值出现在给药后 6 小时(3.32ms;90%CI:1.47 至 5.17ms)。该研究具有足够的灵敏度,因为莫西沙星历史 T(max)3 小时时,莫西沙星与安慰剂调整后 QTcF 差值的 90%CI 下限大于 5ms(15.29ms;90%CI:13.44 至 17.14ms)。LRV 暴露与 QTcF 自基线的安慰剂校正变化或 QRS 综合波、脉搏率(PR)间期、心率或血压的临床显著变化之间无统计学关联。LRV(2400mg)未延长 QTcF 间期,健康受试者未观察到临床相关心电图或生命体征变化。