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一项关于拉喹莫德的全面 QT/QTc 研究,拉喹莫德是一种新型免疫调节剂,目前正在开发用于多发性硬化症和亨廷顿病。

A Thorough QT/QTc Study With Laquinimod, a Novel Immunomodulator in Development for Multiple Sclerosis and Huntington Disease.

机构信息

Clinical Pharmacology and Pharmacometrics, Teva Pharmaceutical Industries Ltd, Netanya, Israel.

Project Leadership, Teva Pharmaceutical Industries Ltd, Netanya, Israel.

出版信息

Clin Pharmacol Drug Dev. 2019 Jan;8(1):49-59. doi: 10.1002/cpdd.442. Epub 2018 May 22.

DOI:10.1002/cpdd.442
PMID:29786964
Abstract

In this randomized double-blind study, 4 groups of healthy subjects (50 per arm) participated to evaluate the effect of laquinimod, an oral treatment in development for multiple sclerosis and Huntington disease, on the QTc interval. Subjects received a dose of either 0.6 or 1.2 mg/day laquinimod for 14 days, placebo for 14 days, or 13 days of placebo followed by a dose of 400 mg moxifloxacin on day 14. Continuous 12-lead electrocardiograms were recorded on day -1 (baseline) and days 14 to 17,  and quadruplicate electrocardiograms were extracted at predefined time points. The primary measure was time-matched change from baseline in individual QTc (QTcI), and an analysis of variance was conducted on the placebo-corrected change from baseline data (ddQTcI). Pharmacokinetic-pharmacodynamic and safety assessments were included. Results showed that the upper limits of the 2-sided 90%CI for ddQTcI for both laquinimod doses were below 10 millisconds at all time points, whereas lower limits for moxifloxacin were above 5 milliseconds. No notable changes in ECG parameters were observed. Pharmacokinetic/pharmacodynamic analysis showed no positive correlation between laquinimod plasma levels and QTcI. In conclusion, laquinimod was not found to affect cardiac repolarization or to cause prolongation of QTcI at doses of 0.6 and 1.2 mg/day.

摘要

在这项随机、双盲研究中,4 组健康受试者(每组 50 人)参与评估拉喹莫德(一种正在开发用于多发性硬化症和亨廷顿病的口服治疗药物)对 QTc 间期的影响。受试者接受 0.6 或 1.2mg/天拉喹莫德治疗 14 天,安慰剂治疗 14 天,或安慰剂治疗 13 天,然后在第 14 天给予 400mg 莫西沙星。在第-1 天(基线)和第 14 至 17 天连续记录 12 导联心电图,并在预设时间点提取 4 份心电图。主要测量指标为个体 QTc(QTcI)从基线的时间匹配变化,对安慰剂校正的从基线数据的变化(ddQTcI)进行方差分析。包括药代动力学-药效学和安全性评估。结果表明,在所有时间点,两种拉喹莫德剂量的 ddQTcI 的双侧 90%CI 的上限均低于 10 毫秒,而莫西沙星的下限均高于 5 毫秒。未观察到心电图参数的明显变化。药代动力学/药效学分析显示拉喹莫德血浆水平与 QTcI 之间无正相关关系。结论是,在 0.6 和 1.2mg/天的剂量下,拉喹莫德不会影响心脏复极或导致 QTcI 延长。

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引用本文的文献

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Eur J Clin Pharmacol. 2020 May;76(5):611-622. doi: 10.1007/s00228-019-02827-6. Epub 2020 Feb 4.
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Recent Advances in the Treatment for Multiple Sclerosis; Current New Drugs Specific for Multiple Sclerosis.多发性硬化症治疗的最新进展;当前针对多发性硬化症的新型特效药物
Noro Psikiyatr Ars. 2018;55(Suppl 1):S15-S20. doi: 10.29399/npa.23402.
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The effect of laquinimod, a novel immuno-modulator in development to treat Huntington disease, on the pharmacokinetics of ethinylestradiol and levonorgestrel in healthy young women.新型免疫调节剂拉喹莫德(正处于治疗亨廷顿病的研发阶段)对健康年轻女性体内炔雌醇和左炔诺孕酮药代动力学的影响。
Eur J Clin Pharmacol. 2019 Jan;75(1):41-49. doi: 10.1007/s00228-018-2549-7. Epub 2018 Sep 6.