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一项全面的QT研究,以评估治疗剂量和超治疗剂量的达氟沙星对心脏复极化的影响。

A thorough QT study to evaluate the effects of therapeutic and supratherapeutic doses of delafloxacin on cardiac repolarization.

作者信息

Litwin Jeffrey S, Benedict Michael S, Thorn Michael D, Lawrence Laura E, Cammarata Sue K, Sun Eugene

机构信息

ERT, Philadelphia, Pennsylvania, USA

PPD Inc., Austin, Texas, USA.

出版信息

Antimicrob Agents Chemother. 2015;59(6):3469-73. doi: 10.1128/AAC.04813-14. Epub 2015 Apr 6.

Abstract

A randomized, double-blind, placebo-controlled, 4-period crossover study was conducted in 52 healthy adults to assess the effect of delafloxacin on the corrected QT (QTc) interval. The QT interval, corrected for heart rate using Fridericia's formula (QTcF), was determined predose and at 0.5, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 4, 5, 6, 12, 18, and 24 h after dosing with delafloxacin at 300 mg intravenously (i.v.; therapeutic), delafloxacin at 900 mg i.v. (supratherapeutic), moxifloxacin at 400 mg orally (p.o.; positive control), and placebo. The pharmacokinetic profile of delafloxacin was also evaluated. At each time point after delafloxacin administration, the upper limit of the 90% confidence interval (CI) for the placebo-corrected change from the predose baseline in QTcF (ΔΔQTcF) was less than 10 ms (maximum, 3.9 ms at 18 h after dosing), indicating an absence of a clinically meaningful increase in the QTc interval. The lower limit of the 90% CI of ΔΔQTcF for moxifloxacin versus placebo was longer than 5 ms at all 5 time points selected for assay sensitivity analysis, demonstrating that the study was adequately sensitive to assess QTc prolongation. There was no positive relationship between delafloxacin plasma concentrations and ΔΔQTcF. Treatment-emergent adverse events (AEs) were more frequent among subjects receiving a single supratherapeutic dose of 900 mg delafloxacin. There were no deaths, serious AEs, or AEs leading to study discontinuation and no clinically meaningful abnormalities in laboratory values or vital signs observed at any time point after any dose of the study drug.

摘要

在52名健康成年人中进行了一项随机、双盲、安慰剂对照、4周期交叉研究,以评估德拉氟沙星对校正QT(QTc)间期的影响。使用弗里德里西亚公式(QTcF)校正心率后的QT间期,在静脉注射300mg德拉氟沙星(治疗剂量)、900mg德拉氟沙星(超治疗剂量)、口服400mg莫西沙星(阳性对照)和安慰剂给药前及给药后0.5、1、1.25、1.5、1.75、2、2.5、3、4、5、6、12、18和24小时测定。还评估了德拉氟沙星的药代动力学特征。在德拉氟沙星给药后的每个时间点,安慰剂校正的QTcF(ΔΔQTcF)从给药前基线变化的90%置信区间(CI)上限小于10ms(最大为给药后18小时的3.9ms),表明QTc间期无临床意义的增加。在选择用于分析灵敏度的所有5个时间点,莫西沙星与安慰剂相比的ΔΔQTcF的90%CI下限均长于5ms,表明该研究对评估QTc延长具有足够的灵敏度。德拉氟沙星血浆浓度与ΔΔQTcF之间无正相关关系。接受单次900mg超治疗剂量德拉氟沙星的受试者中治疗中出现的不良事件(AE)更频繁。在任何剂量的研究药物给药后的任何时间点均未观察到死亡、严重AE或导致研究中断的AE,也未观察到实验室值或生命体征的临床意义异常。

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