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QTc 公式选择对癌症患者入组 I 期临床试验的影响。

Effect of selection of QTc formula on eligibility of cancer patients for phase I clinical trials.

机构信息

Mayo Clinic Arizona, Scottsdale, AZ 85259, USA.

出版信息

Invest New Drugs. 2013 Aug;31(4):1056-65. doi: 10.1007/s10637-012-9909-4. Epub 2012 Dec 16.

Abstract

A retrospective analysis of 130 patients was conducted in a Phase I oncology clinic to assess the effect of QTc formula selection on clinical trial eligibility. QTc values were calculated from screening electrocardiograms using 7 formulae (Bazett, Fridericia, Framingham, Hodges, Mayeda, Van de Water and Wohlfart). QTc values > 470 ms for females and > 450 ms for males were used to define prolongation. Concomitant medication potential for QTc prolongation was determined using a public database (AzCert). Ineligibility rates ranged from 3.1 % to 17.7 % (Framingham: 3.1 %, Van de Water: 3.1 %, Hodges: 3.1 %, Wohlfart: 3.1 %, Fridericia: 3.9 %, Bazett: 10.8 % and Mayeda: 17.7 %). A consistent ineligibility rate was achieved by using formulae-specific thresholds. Fifty one percent of patients were taking concomitant medications with QTc prolongation potential. The proportion of concomitant medications with the potential to prolong QTc was 11.57 % (96 of 830). Uniform criteria and guidelines for selection of QTc formulae need to be developed. Formulae-specific QTc thresholds also need to be specified.

摘要

在一家肿瘤学 I 期临床试验中心,对 130 例患者进行了回顾性分析,以评估 QTc 公式选择对临床试验资格的影响。从筛查心电图中使用 7 种公式(Bazett、Fridericia、Framingham、Hodges、Mayeda、Van de Water 和 Wohlfart)计算 QTc 值。女性 QTc 值>470ms,男性 QTc 值>450ms 用于定义延长。使用公共数据库(AzCert)确定伴随药物对 QTc 延长的潜在影响。无资格率范围为 3.1%至 17.7%(Framingham:3.1%,Van de Water:3.1%,Hodges:3.1%,Wohlfart:3.1%,Fridericia:3.9%,Bazett:10.8%,Mayeda:17.7%)。使用特定公式的阈值可实现一致的无资格率。51%的患者正在服用具有 QTc 延长潜力的伴随药物。有潜在延长 QTc 作用的伴随药物的比例为 11.57%(830 例中的 96 例)。需要制定用于选择 QTc 公式的统一标准和指南。还需要指定特定公式的 QTc 阈值。

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