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一项在健康受试者中单次超治疗剂量雷巴他定的全面 QTc 研究。

Thorough QTc Study of a Single Supratherapeutic Dose of Relebactam in Healthy Participants.

机构信息

Merck & Co, Inc, Kenilworth, New Jersey, USA.

Sanofi, Bridgewater, New Jersey, USA.

出版信息

Clin Pharmacol Drug Dev. 2020 May;9(4):466-475. doi: 10.1002/cpdd.786. Epub 2020 Mar 25.

Abstract

The effects of supratherapeutic doses of intravenous (IV) relebactam on duration of ventricular depolarization and subsequent repolarization were assessed in a thorough QT/corrected QT study. This was a single-dose, double-blind (relebactam only), randomized, placebo- and positive-controlled, 3-period, balanced crossover study in healthy participants. Participants received in randomized order, and separated by a washout (≥4 days), a single dose of IV relebactam 1150 mg, oral moxifloxacin 400 mg (open-label positive control), and IV placebo. Least squares mean and 2-sided 90% confidence interval for change from baseline in population-derived corrected QT intervals for relebactam, moxifloxacin, and placebo were estimated for 24 hours. The upper limit of the 90% confidence interval of all least squares mean population-derived corrected QT treatment differences from placebo was not >10 milliseconds at any time point for 24 hours. Corrected QT assay sensitivity was confirmed with moxifloxacin treatment. Analysis of electrocardiogram parameters resulted in no additional cardiac safety concerns. Overall, a supratherapeutic dose of relebactam yielded no cardiac safety events; the 1150-mg supratherapeutic dose (4.6-fold above the 250-mg therapeutic dose) was not associated with QT prolongation or other abnormal cardiodynamic parameters. This study lends additional support to relebactam's use as a β-lactamase inhibitor in antimicrobial therapy.

摘要

在一项全面的 QT/cQT 研究中评估了静脉(IV)雷利巴坦超治疗剂量对心室去极化和随后复极持续时间的影响。这是一项在健康参与者中进行的单次、双盲(仅雷利巴坦)、随机、安慰剂和阳性对照、3 期、平衡交叉研究。参与者按随机顺序接受治疗,并在洗脱期(≥4 天)后间隔开,分别单次静脉注射雷利巴坦 1150mg、口服莫西沙星 400mg(开放性阳性对照)和静脉注射安慰剂。估计雷利巴坦、莫西沙星和安慰剂的人群校正 QT 间期自基线的变化的最小二乘均数和双侧 90%置信区间在 24 小时内。在 24 小时内的任何时间点,所有最小二乘均数人群校正 QT 治疗差异与安慰剂的上限均未超过 10 毫秒。莫西沙星治疗证实了校正 QT 检测的敏感性。心电图参数分析未发现其他心脏安全性问题。总体而言,超治疗剂量的雷利巴坦未引起心脏安全性事件;1150mg 超治疗剂量(比 250mg 治疗剂量高 4.6 倍)与 QT 延长或其他异常心动力学参数无关。这项研究进一步支持雷利巴坦作为抗菌治疗中β-内酰胺酶抑制剂的应用。

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