在健康参与者中,abemaciclib没有增加纠正的QT间隔
Jill C Chappell1, Alan Y Chiang1, Jane Royalty2
1Eli Lilly and Company, Indianapolis, Indiana, USA.
Clinical and translational science
|June 20, 2023
概括
乳腺癌的CDK4/6抑制剂Abemaciclib在高达400mg的健康参与者中没有显著的QTc间隔变化. 高剂量增加了胃肠道副作用,表明在治疗水平上有良好的心脏安全性.
科学领域:
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
- 在瘤学瘤学.
背景情况:
- 阿贝马西克利布是一种口服的循环素依赖性激酶4和6抑制剂,用于晚期乳腺癌.
- 心脏再极化,特别是QTc间隔,是药物开发的关键安全参数.
研究的目的:
- 用暴露-反应模型评估abemaciclib及其活性代谢物 (M2,M20) 对QTc间隔的影响.
- 在健康志愿者中评估单次上升剂量的abemaciclib的安全性和耐受性.
主要方法:
- 一项单盲,随机,安慰剂控制的研究,涉及35名健康参与者.
- 单次口服abemaciclib (200-600mg) 剂量与串行心电图和药理动力学采样的使用.
- 暴露-反应分析以将药物/代谢物度与QTc变化相关联 (ΔΔQTcF).
主要成果:
- 在abemaciclib/代谢物度和安慰剂校正的QTc变化 (ΔΔQTcF) 之间没有发现统计学上显著的关系.
- 对abemaciclib,其代谢物和总分析物度的ΔΔQTcF的斜率与零没有显著差异.
- 阿贝马西克利布的耐受性高达400毫克;600毫克的剂量导致胃肠道不良事件增加.
结论:
- 在健康个体中,高达400毫克的单次阿贝马西克利布剂量不会导致临床相关的QTc间隔延长.
- 在高达400毫克的剂量下,Abemaciclib表现出良好的心脏安全性,而在更高的剂量下,胃肠道效应是剂量限制的.
相关概念视频
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers
890
Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
890
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
781
Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
781
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
1.1K
Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
1.1K
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
1.5K
Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.5K
Antiepileptic Drugs: Potassium Channel Activators
218
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
218
Antiepileptic Drugs: Calcium Channel Blockers
473
Calcium channel blockers, a class of antiepileptic drugs, regulate the flow of calcium ions within neurons.
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
473


