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健康受试者中吸入用糠酸氟替卡松/维兰特罗复方制剂的重复给药全面QT研究。

A repeat-dose thorough QT study of inhaled fluticasone furoate/vilanterol combination in healthy subjects.

作者信息

Kempsford Rodger, Allen Ann, Kelly Kathryn, Saggu Parminder, Crim Courtney

机构信息

Clinical Pharmacology, Global Clinical Respiratory Medicines Development Centre, GlaxoSmithKline, Stevenage, UK.

出版信息

Br J Clin Pharmacol. 2014 Mar;77(3):466-79. doi: 10.1111/bcp.12243.

Abstract

AIMS

This study was designed as a thorough QT (TQT) study to evaluate the effects of fluticasone furoate (FF)/vilanterol (VI) in healthy subjects. Supportive data from a TQT study conducted with FF are also presented.

METHODS

This was a randomized, placebo- and positive-controlled, double-dummy, double-blind, four-way crossover study, in which healthy subjects (n = 85) were randomized to 7 days of once-daily treatment of FF/VI (200/25 or 800/100 μg) or placebo or single-dose oral moxifloxacin (single-blind, 400 mg). In the supportive TQT study, subjects (n = 40) were randomized to single-dose inhaled FF (4000 μg), oral moxifloxacin (400 mg) or placebo.

RESULTS

There was a lack of effect of FF/VI (200/25 μg) on QTcF (Fridericia's correction); all time-matched mean differences from baseline relative to placebo (0-24 h) were <5 ms, with upper 90% confidence intervals (CI) of <10 ms. At 800/100 μg, FF/VI had no significant clinical effect on QTcF except at 30 min postdose when the 90% CI was >10 ms [mean (90% CI), 9.6 ms (7.2, 12.0)]. No effect on QTci (individually corrected) was observed at either strength of FF/VI, with mean time-matched treatment differences <5 ms at all time points [upper 90% CIs <10 ms (0-24 h)]. Assay sensitivity was confirmed; moxifloxacin prolonged QTcF and QTci, with time-matched mean differences from baseline relative to placebo of >10 ms (1-8 h postdose).

CONCLUSIONS

Repeat once-daily dosing of FF/VI (200/25 μg), which is the highest therapeutic strength used in phase III studies, is not associated with QTc prolongation in healthy subjects. Supratherapeutic strength FF/VI (800/100 μg) demonstrated a small transient effect on QTcF but not on QTci.

摘要

目的

本研究设计为一项全面的QT(TQT)研究,以评估糠酸氟替卡松(FF)/维兰特罗(VI)对健康受试者的影响。还展示了一项使用FF进行的TQT研究的支持性数据。

方法

这是一项随机、安慰剂和阳性对照、双模拟、双盲、四交叉研究,其中健康受试者(n = 85)被随机分配接受7天每日一次的FF/VI(200/25或800/100μg)治疗或安慰剂或单剂量口服莫西沙星(单盲,400mg)。在支持性TQT研究中,受试者(n = 40)被随机分配接受单剂量吸入FF(4000μg)、口服莫西沙星(400mg)或安慰剂。

结果

FF/VI(200/25μg)对QTcF(弗里德里西亚校正)没有影响;相对于安慰剂(0 - 24小时)的所有时间匹配平均差异均<5毫秒,90%置信区间上限<10毫秒。在800/100μg时,FF/VI对QTcF没有显著临床影响,除了给药后30分钟时90%置信区间>10毫秒[平均值(90%置信区间),9.6毫秒(-7.2,12.0)]。在FF/VI的任何一种剂量下,均未观察到对QTci(个体校正)的影响,所有时间点的时间匹配治疗差异平均值<5毫秒[90%置信区间上限<10毫秒(0 - 24小时)]。确认了检测灵敏度;莫西沙星延长了QTcF和QTci,相对于安慰剂,给药后1 - 8小时与基线的时间匹配平均差异>10毫秒。

结论

重复每日一次给予FF/VI(200/25μg),这是III期研究中使用的最高治疗剂量,在健康受试者中与QTc延长无关。超治疗剂量的FF/VI(800/100μg)对QTcF有较小的短暂影响,但对QTci没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5af5/3952721/45bc8a567be4/bcp0077-0466-f1.jpg

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