Translational Safety & Bioanalytical Sciences, Amgen Research, Thousand Oaks, California, USA.
Amgen Clinical Pharmacology Modeling & Simulation, Thousand Oaks, California, USA.
Clin Transl Sci. 2023 Mar;16(3):436-446. doi: 10.1111/cts.13454. Epub 2022 Nov 27.
In prior clinical studies, levocetirizine (LEVO) has demonstrated no effect on ventricular repolarization (QTc intervals), therefore it is a relevant negative control to assess in nonclinical assays to define low proarrhythmic risk. LEVO was tested in beagle dog and cynomolgus monkey (nonhuman primate [NHP]) telemetry models to understand the nonclinical-clinical translation of this negative control. One oral dose of vehicle, LEVO (10 mg/kg/species) or moxifloxacin (MOXI; 30 mg/kg/dog; 80 mg/kg/NHP) was administered to instrumented animals (N = 8/species) using a cross-over dosing design; MOXI was the in-study positive control. Corrected QT interval values (QTcI) were calculated using an individual animal correction factor. Blood samples were taken for drug exposure during telemetry and for pharmacokinetic (PK) analysis (same animals; different day) for exposure-response (C-QTc) modeling. Statistical analysis of QTc-by-timepoint data showed that LEVO treatment was consistent with vehicle, thus no effect on ventricular repolarization was observed over 24 h in both species. PK analysis indicated that LEVO-maximum concentration levels in dogs (range: 12,300-20,100 ng/ml) and NHPs (range: 4090-12,700 ng/ml) were ≥4-fold higher than supratherapeutic drug levels in clinical QTc studies. Slope analysis values in dogs (0.00019 ms/ng/ml) and NHPs (0.00016 ms/ng/ml) were similar to the human C-QTc relationship and indicated no relationship between QTc intervals and plasma levels of LEVO. MOXI treatment caused QTc interval prolongation (dog: 18 ms; NHP: 29 ms). The characterization of LEVO in these non-rodent telemetry studies further demonstrates the value and impact of the in vivo QTc assay to define a "no QTc effect" profile and support clinical safety assessment.
在先前的临床研究中,左西替利嗪(LEVO)并未显示对心室复极(QTc 间期)有影响,因此它是一种相关的阴性对照物,可用于非临床检测中以确定低致心律失常风险。在比格犬和食蟹猴(非人灵长类动物 [NHP])遥测模型中对 LEVO 进行了测试,以了解该阴性对照物的非临床-临床转化。使用交叉给药设计,对仪器化动物(每种动物 N=8)给予一剂载体、LEVO(10mg/kg/种)或莫西沙星(MOXI;犬 30mg/kg/d;NHP 80mg/kg);MOXI 是研究中的阳性对照物。使用个体动物校正因子计算校正 QT 间期值(QTcI)。在遥测期间采集血样以进行药物暴露,并在同一天采集用于药代动力学(PK)分析(不同动物)以进行暴露-反应(C-QTc)建模。QTc-时间点数据的统计分析表明,LEVO 治疗与载体一致,因此在两种物种中,24 小时内未观察到心室复极的影响。PK 分析表明,LEVO 在犬(范围:12,300-20,100ng/ml)和 NHP(范围:4090-12,700ng/ml)中的最大浓度水平≥临床 QTc 研究中治疗性药物水平的 4 倍。犬(0.00019ms/ng/ml)和 NHP(0.00016ms/ng/ml)的斜率分析值与人体 C-QTc 关系相似,表明 QTc 间期与 LEVO 的血浆水平之间无关系。MOXI 治疗引起 QTc 间期延长(犬:18ms;NHP:29ms)。在这些非啮齿类动物遥测研究中对 LEVO 的特征描述进一步证明了体内 QTc 测定在确定“无 QTc 效应”特征和支持临床安全性评估方面的价值和影响。