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在健康志愿者中评估依洛司他仑超治疗剂量对心脏复极的影响:一项 I 期、随机研究。

An evaluation of a supratherapeutic dose of inclisiran on cardiac repolarization in healthy volunteers: A phase I, randomized study.

机构信息

Former Employee of The Medicines Company (Schweiz) GmbH, Zurich, Switzerland.

Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.

出版信息

Clin Transl Sci. 2022 Nov;15(11):2663-2672. doi: 10.1111/cts.13391. Epub 2022 Oct 5.

Abstract

Inclisiran is a small interfering RNA molecule that has been shown to provide an effective and sustained reduction in low-density lipoprotein cholesterol levels. This study aimed to determine whether a supratherapeutic dose of inclisiran affects cardiac repolarization and conduction in healthy volunteers. A phase I, randomized, double-blind, double-dummy, placebo- and positive-controlled, three-way crossover study was performed in 48 healthy volunteers. Volunteers were assigned to three treatments in a randomized sequence: a supratherapeutic dose of inclisiran sodium (900 mg), placebo, or moxifloxacin 400 mg as a positive control, with a minimum 7-day washout period between treatments. Continuous electrocardiogram monitoring was performed from >60 min before dosing until 48 h after dosing. Pharmacokinetics, pharmacodynamics, and safety were also assessed. Inclisiran, at a supratherapeutic dose, did not show a clinically significant effect on the QT interval (Fridericia correction formula [QTcF]; maximal placebo- and baseline-corrected change: 2.5 ms [90% confidence interval: 0.6, 4.5]) near the maximal plasma concentrations at 4 h. In addition, inclisiran did not show any effects on other electrocardiogram intervals or ST- and T-wave morphology. The positive control, moxifloxacin, demonstrated the expected changes in QTcF interval, validating the adequate sensitivity of the study. A supratherapeutic dose of inclisiran sodium (900 mg) had no effect on the QTcF interval or other electrocardiogram parameters, providing additional insight and reassurance regarding the safety profile of inclisiran.

摘要

依洛西仑是一种小干扰 RNA 分子,已被证明能有效且持续降低低密度脂蛋白胆固醇水平。本研究旨在确定超治疗剂量的依洛西仑是否会影响健康志愿者的心脏复极和传导。在 48 名健康志愿者中进行了一项 I 期、随机、双盲、双模拟、安慰剂对照和阳性对照的三交叉研究。志愿者按照随机顺序分为三组治疗:依洛西仑钠(900mg)超治疗剂量、安慰剂或莫西沙星 400mg 作为阳性对照,每组之间有至少 7 天的洗脱期。给药前>60min 至给药后 48h 进行连续心电图监测。还评估了药代动力学、药效学和安全性。超治疗剂量的依洛西仑对 QT 间期(Fridericia 校正公式[QTcF];最大安慰剂和基线校正变化:2.5ms[90%置信区间:0.6, 4.5])没有显示出临床显著影响,接近 4 小时时的最大血浆浓度。此外,依洛西仑对其他心电图间期或 ST 波和 T 波形态没有任何影响。阳性对照莫西沙星显示了 QTcF 间隔预期的变化,验证了研究的充分敏感性。依洛西仑钠(900mg)超治疗剂量对 QTcF 间隔或其他心电图参数没有影响,为依洛西仑的安全性概况提供了额外的见解和保证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95ec/9652432/21542fe1b28e/CTS-15-2663-g002.jpg

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