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Model‐based evaluation of drug‐induced QT c prolongation for compounds in early development
Author(s) -
Dubois Vincent F. S.,
Yu Huixin,
Danhof Meindert,
Della Pasqua Oscar
Publication year - 2015
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12482
Subject(s) - qt interval , pharmacokinetics , pharmacodynamics , prolongation , pharmacology , medicine , long qt syndrome , drug , torsades de pointes
Aims Significant differences between dogs and humans have been observed in the concentration– QTc effect relationship of compounds with known pro‐arrhythmic properties. These findings suggest that interspecies differences must be considered when evaluating drug effects. The aim of this study was to evaluate the performance of a model‐based approach to assess the risk of QT c prolongation for three investigational compounds ( NCE01 , NCE02 and NCE03 ). Methods Pharmacokinetic and pharmacodynamic data from experiments in conscious dogs and healthy subjects were included in this analysis. Pharmacokinetic modelling and deconvolution methods were applied to derive drug concentrations at the time of each QT measurement. An integrated pharmacokinetic–pharmacodynamic ( PKPD ) model was then used to describe QT prolongation. A threshold of ≥10 ms was used to characterize the probability of QTc prolongation. Results The PKPD relationships of all three compounds were successfully described in both species. A strong effect was observed after administration of NCE01 to dogs and humans, with a slope of 0.0061 and 0.0662 ms n m −1 , respectively, and maximal probability of QT c prolongation ≥10 ms at peak concentration. For NCE02 and NCE03 , QT c‐shortening and borderline QT effects were observed both in dogs and humans, as described by negative or very shallow slopes ( NCE02 , −0.00098 and −0.01 ms n m −1 ; NCE03 , 0.00064 and −0.0002 ms n m −1 ). Conclusions Whilst NEC01 shows clear pro‐arrhythmic effects, the liability for QT/QTc prolongation for NCE02 and NCE03 can be deemed low at the expected therapeutic exposure. Moreover, our results show the advantages of an integrated PKPD approach as the basis for translating pro‐arrhythmic effects from dogs to humans.