Mendell Jeanne, Matsushima Nobuko, O'Reilly Terry E, Lee James
Daiichi Sankyo Pharma Development, Edison, NJ, USA.
Daiichi Sankyo Co., Ltd, Tokyo, Japan.
J Clin Pharmacol. 2016 Apr;56(4):484-91. doi: 10.1002/jcph.610. Epub 2015 Nov 9.
Two studies (ROADMAP and ORIENT) evaluating the renoprotective effects of olmesartan medoxomil (OM) in patients with type 2 diabetes suggested OM is associated with increased cardiovascular mortality. We conducted a thorough QTc study to evaluate the effects of OM on cardiac repolarization. A randomized, double-blind, phase 1 study was conducted per E14 Guidance to assess the effects of single doses of OM therapeutic dose (40 mg), OM supratherapeutic dose (160 mg), placebo, or moxifloxacin (MOXI; 400 mg) on QTc in 56 healthy subjects. The primary endpoint was the baseline-adjusted, placebo-corrected QTc interval using Fridericia's formula (ΔΔQTcF) for OM and MOXI. Assay sensitivity was concluded if lower limit of 1-sided 95%CI > 5 milliseconds of ΔΔQTcF for MOXI. No threshold pharmacologic effect for OM was concluded if upper limit of 1-sided 95%CI <10 milliseconds for ΔΔQTcF at any timepoint. Pharmacokinetics, ECGs, and safety were assessed. Assay sensitivity was demonstrated. The largest upper limit of the 1-sided 95%CI for ΔΔQTcF was <5 milliseconds for OM. No clinically significant changes were observed in ECGs. Pharmacokinetics and safety profile were consistent with previous data. Therapeutic and supratherapeutic OM doses had no clinically significant effect on cardiac repolarization and were well tolerated.
两项评估奥美沙坦酯(OM)对2型糖尿病患者肾脏保护作用的研究(ROADMAP和ORIENT)表明,OM与心血管死亡率增加有关。我们进行了一项全面的QTc研究,以评估OM对心脏复极化的影响。根据E14指南进行了一项随机、双盲的1期研究,以评估单剂量OM治疗剂量(40毫克)、OM超治疗剂量(160毫克)、安慰剂或莫西沙星(MOXI;400毫克)对56名健康受试者QTc的影响。主要终点是使用弗里德里西亚公式(ΔΔQTcF)对OM和MOXI进行基线调整、安慰剂校正的QTc间期。如果MOXI的单侧95%CI下限>ΔΔQTcF的5毫秒,则得出测定灵敏度结论。如果在任何时间点,ΔΔQTcF的单侧95%CI上限<10毫秒,则未得出OM的阈值药理效应结论。评估了药代动力学、心电图和安全性。证明了测定灵敏度。OM的ΔΔQTcF的单侧95%CI最大上限<5毫秒。心电图未观察到临床显著变化。药代动力学和安全性概况与先前数据一致。治疗剂量和超治疗剂量的OM对心脏复极化无临床显著影响,且耐受性良好。