Sheep fatigue during transport: Lost in translation?

Although sheep are commonly transported long distances, and sheep welfare during transport is a topic of research and policy discussion, the subject of their fatigue during transport has been under-researched. The current qualitative study, focused on the EU and UK, aimed to critically analyse stakeholder views on issues relating to sheep fatigue, including behavioural indications of fatigue, the interplay between fatigue and other factors, and the practicalities of identifying fatigue in commercial transport conditions. Insight into stakeholder perceptions of these issues could contribute to the body of knowledge regarding sheep fatigue during transport, potentially playing a part in future efforts to improve fatigue understanding and detection. Eighteen experts from different stakeholder groups were interviewed. Reflexive thematic analysis of interview data yielded four themes and three sub-themes. The first theme, "Let's anthropomorphise it a little bit", underscores the pervasiveness of anthropomorphism and suggests using it in a conscious and deliberate way to drive stakeholder engagement and policy change. The second theme, "We think that they're like we are and they're not", cautions against wholesale transfer of human experiences to animals. The third theme, 'See the whole animal', advocates using Qualitative Behaviour Analysis (QBA), proven reliable in other contexts, to deepen and enrich our current understanding of fatigue. The fourth theme, 'Fatigue "never comes up"', highlights the fact that fatigue is rarely if ever discussed in the context of sheep transport. These themes suggest several avenues for future research, including developing QBA-based assessments for fatigue to improve welfare during transport.

Prediction of the Renal Organic Anion Transporter 1 (OAT1)- Mediated Drug Interactions for LY404039, the Active Metabolite of Pomaglumetad Methionil.

PURPOSE: The objective of this work was to demonstrate that clinical OAT1-mediated DDIs can be predicted using physiologically based pharmacokinetic (PBPK) modeling. METHODS: LY404039 is a metabotropic glutamate receptor 2/3 agonist and the active moiety of the prodrug pomaglumetad methionil (LY2140023). After oral administration, pomaglumetad methionil is rapidly taken up by enterocytes via PEPT1 and once absorbed, converted to LY404039 via membrane dehydropeptidase 1 (DPEP1). LY404039 is renally excreted by both glomerular filtration and active secretion and in vitro studies showed that the active secretion of LY404039 was mediated by the organic anion transporter 1 (OAT1). Both clinical and in vitro data were used to build a PBPK model to predict OAT1-mediated DDIs. RESULTS: In vitro inhibitory potencies (IC50) of the known OAT inhibitors, probenecid and ibuprofen, were determined to be 4.00 and 2.63 µM, respectively. Subsequently, clinical drug-drug interaction (DDI) study showed probenecid reduced the renal clearance of LY404039 by 30 to 40%. The PBPK bottom-up model, predicted a renal clearance that was approximately 20% lower than the observed one. The middle-out model, using an OAT1 relative activity factor (RAF) of 3, accurately reproduced the renal clearance of LY404039 and pharmacokinetic (PK) changes of LY404039 in the presence of probenecid. CONCLUSIONS: OAT1- mediated DDIs can be predicted using in vitro measured IC50 and PBPK modeling. The effect of ibuprofen was predicted to be minimal (AUC ratio of 1.15) and not clinically relevant.

Welfare of domestic birds and rabbits transported in containers.

This opinion, produced upon a request from the European Commission, focuses on transport of domestic birds and rabbits in containers (e.g. any crate, box, receptacle or other rigid structure used for the transport of animals, but not the means of transport itself). It describes and assesses current transport practices in the EU, based on data from literature, Member States and expert opinion. The species and categories of domestic birds assessed were mainly chickens for meat (broilers), end-of-lay hens and day-old chicks. They included to a lesser extent pullets, turkeys, ducks, geese, quails and game birds, due to limited scientific evidence. The opinion focuses on road transport to slaughterhouses or to production sites. For day-old chicks, air transport is also addressed. The relevant stages of transport considered are preparation, loading, journey, arrival and uncrating. Welfare consequences associated with current transport practices were identified for each stage. For loading and uncrating, the highly relevant welfare consequences identified are handling stress, injuries, restriction of movement and sensory overstimulation. For the journey and arrival, injuries, restriction of movement, sensory overstimulation, motion stress, heat stress, cold stress, prolonged hunger and prolonged thirst are identified as highly relevant. For each welfare consequence, animal-based measures (ABMs) and hazards were identified and assessed, and both preventive and corrective or mitigative measures proposed. Recommendations on quantitative criteria to prevent or mitigate welfare consequences are provided for microclimatic conditions, space allowances and journey times for all categories of animals, where scientific evidence and expert opinion support such outcomes.

Long-Distance Transport of Finisher Pigs in the Iberian Peninsula: Effects of Season on Thermal and Enthalpy Conditions, Welfare Indicators and Meat pH.

Current legislation in the European Union places limits on live pig transport according to outside temperature, but less is known about the effects of sudden changes in the thermal microenvironment in trailers, particularly during long-distance transport. In this study, we measured the temperature and relative humidity inside livestock vehicles carrying 1920 Spanish finisher pigs (live weight 100 kg and 240 animals per journey) during eight long-distance (>15 h) commercial journeys to slaughter from northern Spain to Portugal in the summer and winter. Here, we report the rate of change in the air temperature (°C × min-1) and air enthalpies in the transport vehicle (kg water kg dry air-1). At sticking, blood samples were taken for to measure cortisol, glucose, and creatine kinase (CK) as stress response indicators, and the meat pH after 45 min and the pH after 24 h were also determined. The rate of change in the air temperature and enthalpy was higher inside the livestock vehicle during the winter months and was positively related with higher cortisol and glucose levels and lower pH after 45 min (p < 0.05). It is proposed that the rate of temperature change and air enthalpy represent useful integrated indices of thermal stress for pigs during transport.

DIAGNOSING AND CATEGORIZING LEPROSY IN LIVE EURASIAN RED SQUIRRELS (SCIURUS VULGARIS) FOR MANAGEMENT, SURVEILLANCE, AND TRANSLOCATION PURPOSES.

The presence of Mycobacterium lepromatosis and Mycobacterium leprae in Eurasian red squirrel (Sciurus vulgaris, ERS) carcasses throughout the British Isles, and leprosy as a disease, have recently been reported using histological and molecular diagnostic methods. In 2016, the first longitudinal study of ERS affected by leprosy was initiated. One of the main challenges was the reliable diagnosis of leprosy in live ERS, which is important for (a) welfare and case management and (b) surveillance or pretranslocation screening efforts. We explored diagnostic methods ranging from detailed clinical assessment and informative categorization of observed lesions, thermal imaging, serology (antiphenolic glycolipid-I antibody [αPGL-I] detection) to molecular methods (polymerase chain reaction [PCR]). For PCR the ear was established as the optimal sampling site. Based on the experiences from this 2-yr study we propose an objective categorization system for clinical lesions and a diagnostic framework for the combination of the diagnostic tools we found to be effective in live ERS: clinical assessment, αPGL-I serology, and PCR. Thermal imaging did not offer additional information for leprosy diagnostics in ERS. We propose an amended definition of leprosy lesions in ERS as "skin areas of local hair loss, in which a firm-rubbery, glossy swelling develops, that may ulcerate" and standardized terminology for describing ERS leprosy status. The information presented forms the basis of a consistent, reliable diagnostic and reporting system for leprosy cases in ERS.

Impact of pre-slaughter factors on welfare of broilers.

Pre-slaughter factors adversely affecting bird welfare were studied at the slaughterhouse. The incidence of dead on arrival (DoA), bruises and dehydration was investigated in 64 different mixed-sex batches of broilers coming from 64 different farms rearing fast-growing genotypes (Ross or Cobb). The effects of catching team, method of catching, time of day for catching and transport, density per cage, transport duration, transport distance, lairage duration and water withdrawal were considered. The average DoA was 0.29%, ranging from 0.02% to 1.89% per batch. DoA rate has a higher probability of increase with the increase in transport distance (t=2.142; P=0.037; estimate=0.009) and with catching the birds after midnight (t=-2.931; P=0.005; estimate=0.022). Longer transport durations for birds caught after midnight as well as longer lairage durations for birds caught after midnight are associated with the increase of DoA rate. Bruises were observed in 3.37% of birds, ranging from 0.43% to 8.29% per batch. Bruises occurred mostly on wings (3.06%), followed by legs (0.19%) and breast (0.12%). A higher percentage of bruises occurred in batches with more birds per transport crate (t=2.185; P=0.029; estimate=0.001). Dehydrated carcasses were observed in 22 out of 64 batches, accounting for 2.68% of condemnations. Signs of dehydration on carcasses were more frequently observed in batches subjected to longer withdrawal durations. Short transport distances, catching the birds before midnight and doing the transport by night are crucial in decreasing the DoA rate. Catching and crating processes seem to be responsible for the increase of percentage of bruises. Pre-slaughter operations should be adequate planned namely, transport and lairage durations, catching period and crating procedure in view to reduce negative effects on animal welfare.

Spectral entropy of early-life distress calls as an iceberg indicator of chicken welfare.

Chicks (Gallus gallus domesticus) make a repetitive, high energy 'distress' call when stressed. Distress calls are a catch-all response to a range of environmental stressors, and elicit food calling and brooding from hens. Pharmacological and behavioural laboratory studies link expression of this call with negative affective state. As such, there is an a priori expectation that distress calls on farms indicate not only physical, but emotional welfare. Using whole-house recordings on 12 commercial broiler flocks (n = 25 090-26 510/flock), we show that early life (day 1-4 of placement) distress call rate can be simply and linearly estimated using a single acoustic parameter: spectral entropy. After filtering to remove low-frequency machinery noise, spectral entropy per minute of recording had a correlation of -0.88 with a manual distress call count. In videos collected on days 1-3, age-specific behavioural correlates of distress calling were identified: calling was prevalent (spectral entropy low) when foraging/drinking were high on day 1, but when chicks exhibited thermoregulatory behaviours or were behaviourally asynchronous thereafter. Crucially, spectral entropy was predictive of important commercial and welfare-relevant measures: low median daily spectral entropy predicted low weight gain and high mortality, not only into the next day, but towards the end of production. Further research is required to identify what triggers, and thus could alleviate, distress calling in broiler chicks. However, within the field of precision livestock farming, this work shows the potential for simple descriptors of the overall acoustic environment to be a novel, tractable and real-time 'iceberg indicator' of current and future welfare.

A review on yolk sac utilization in poultry.

During incubation, embryonic growth and development are dependent on nutrients deposited in the egg. The content of the yolk can be transferred to the embryo in 2 ways: directly into the intestine via the yolk stalk or through the highly vascularized yolk sac membrane. It has been suggested that, as a result of genetic selection and improved management, the increase in posthatch growth rate and concurrently the increase in metabolic rate of broiler chickens during the last 50 yr has also increased embryonic metabolism. A higher metabolic rate during incubation would imply a lower residual yolk weight and possibly lower energy reserve for the hatchling. This might affect posthatch development and performance. This review examined scientific publications published between 1930 and 2018 to compare residual yolk weight at hatch, metabolic heat production, and yolk utilization throughout incubation. This review aimed to investigate 1) whether or not residual yolk weight and composition has been changed during the 88-yr period considered and 2) which abiotic and biotic factors affect yolk utilization in poultry during incubation and the early posthatch period. It can be concluded that 1) residual yolk weight and the total solid amount of the residual yolk at hatch seem to be decreased in the recent decades. It cannot be concluded whether the (lack of) differences between old and modern strains are due to genetic selection, changed management and incubation conditions, or moment of sampling (immediately after hatch or at pulling). It is remarkable that with the genetic progress and improved management and incubation conditions over the last 88 yr, effects on yolk utilization efficiency and embryonic metabolic heat production are limited; 2) factors specially affecting residual yolk weight at hatch include egg size and incubation temperature, whereas breeder age has more influence on nutrient composition of the residual yolk.

Evaluation of reticuloruminal pH measurements from individual cattle: Sampling strategies for the assessment of herd status.

The application of pH observations to clinical practice in dairy cattle is based on criteria derived primarily from single time-point observations more than 20 years ago. The aims of this study were to evaluate these criteria using data collected using continuous recording methods; to make recommendations that might improve their interpretation; and to determine the relationship between the number of devices deployed in a herd and the accuracy of the resulting estimate of the herd-mean reticuloruminal pH. The study made use of 815,475 observations of reticuloruminal pH values obtained from 75 cattle in three herds (one beef and two twice-daily milking herds) to assess sampling strategies for the diagnosis of sub-acute rumen acidosis (SARA), and to evaluate the ability of different numbers of bolus devices to accurately estimate the true herd-mean reticuloruminal pH value at any time. The traditional criteria for SARA provide low diagnostic utility, the probability of detection of animals with pH values below specified thresholds being affected by a strong effect of time of day and herd. The analysis suggests that regardless of time of feeding, sampling should be carried out in the late afternoon or evening to obtain a reasonable probability of detection of animals with pH values below the threshold level. The among-cow variation varied strongly between herds, but for a typical herd, if using reticuloruminal pH boluses to detect a predisposition to fermentation disorders while feeding a diet that is high in rapidly fermentable carbohydrates, it is recommended to use a minimum of nine boluses.

First Evaluation of Infrared Thermography as a Tool for the Monitoring of Udder Health Status in Farms of Dairy Cows.

The aim of the present study was to test infrared thermography (IRT), under field conditions, as a possible tool for the evaluation of cow udder health status. Thermographic images (n. 310) from different farms (n. 3) were collected and evaluated using a dedicated software application to calculate automatically and in a standardized way, thermographic indices of each udder. Results obtained have confirmed a significant relationship between udder surface skin temperature (USST) and classes of somatic cell count in collected milk samples. Sensitivity and specificity in the classification of udder health were: 78.6% and 77.9%, respectively, considering a level of somatic cell count (SCC) of 200,000 cells/mL as a threshold to classify a subclinical mastitis or 71.4% and 71.6%, respectively when a threshold of 400,000 cells/mL was adopted. Even though the sensitivity and specificity were lower than in other published papers dealing with non-automated analysis of IRT images, they were considered acceptable as a first field application of this new and developing technology. Future research will permit further improvements in the use of IRT, at farm level. Such improvements could be attained through further image processing and enhancement, and the application of indicators developed and tested in the present study with the purpose of developing a monitoring system for the automatic and early detection of mastitis in individual animals on commercial farms.

Development of a Machine Vision Method for the Monitoring of Laying Hens and Detection of Multiple Nest Occupations.

Free range systems can improve the welfare of laying hens. However, the access to environmental resources can be partially limited by social interactions, feeding of hens, and productivity, can be not stable and damaging behaviors, or negative events, can be observed more frequently than in conventional housing systems. In order to reach a real improvement of the hens' welfare the study of their laying performances and behaviors is necessary. With this purpose, many systems have been developed. However, most of them do not detect a multiple occupation of the nest negatively affecting the accuracy of data collected. To overcome this issue, a new "nest-usage-sensor" was developed and tested. It was based on the evaluation of thermografic images, as acquired by a thermo-camera, and the performing of patter recognitions on images acquired from the nest interior. The sensor was setup with a "Multiple Nest Occupation Threshold" of 796 colored pixels and a template of triangular shape and sizes of 43 × 33 pixels (high per base). It was tested through an experimental nesting system where 10 hens were reared for a month. Results showed that the evaluation of thermografic images could increase the detection performance of a multiple occupation of the nest and to apply an image pattern recognition technique could allow for counting the number of hens in the nest in case of a multiple occupation. As a consequence, the accuracy of data collected in studies on laying performances and behaviors of hens, reared in a free-range housing system, could result to be improved.

In Vitro and Clinical Evaluations of the Drug-Drug Interaction Potential of a Metabotropic Glutamate 2/3 Receptor Agonist Prodrug with Intestinal Peptide Transporter 1.

Despite peptide transporter 1 (PEPT1) being responsible for the bioavailability for a variety of drugs, there has been little study of its potential involvement in drug-drug interactions. Pomaglumetad methionil, a metabotropic glutamate 2/3 receptor agonist prodrug, utilizes PEPT1 to enhance absorption and bioavailability. In vitro studies were conducted to guide the decision to conduct a clinical drug interaction study and to inform the clinical study design. In vitro investigations determined the prodrug (LY2140023 monohydrate) is a substrate of PEPT1 with Km value of approximately 30 µM, whereas the active moiety (LY404039) is not a PEPT1 substrate. In addition, among the eight known PEPT1 substrates evaluated in vitro, valacyclovir was the most potent inhibitor (IC50 = 0.46 mM) of PEPT1-mediated uptake of the prodrug. Therefore, a clinical drug interaction study was conducted to evaluate the potential interaction between the prodrug and valacyclovir in healthy subjects. No effect of coadministration was observed on the pharmacokinetics of the prodrug, valacyclovir, or either of their active moieties. Although in vitro studies showed potential for the prodrug and valacyclovir interaction via PEPT1, an in vivo study showed no interaction between these two drugs. PEPT1 does not appear to easily saturate because of its high capacity and expression in the intestine. Thus, a clinical interaction at PEPT1 is unlikely even with a compound with high affinity for the transporter.

Relative bioavailability of three formulations of galunisertib administered as monotherapy in patients with advanced or metastatic cancer.

OBJECTIVE: Galunisertib (LY2157299 monohydrate), an inhibitor of the transforming growth factor ß (TGFß) pathway, is currently under investigation in several clinical trials involving multiple tumor types. The primary objective of this study was to assess relative bioavailability of two new galunisertib formulations developed using the roller compaction (RC) dry-milled (RCD) and RC slurry-milled (RCS) processes, compared with the existing formulation developed using the high-sheer wet granulation (HSWG) process. The secondary objective was to report the safety profile after a single dose of the three formulations. METHODS: Patients with advanced or metastatic cancer were enrolled into this single-center, 3-period, 6-sequence crossover study. Patients were assigned sequentially to 1 of 6 sequences in blocks of 6 to ensure that all 6 sequences have the same number of completers. A patient entering a sequence received a different galunisertib formulation as a single 150 mg dose orally during each of the 3 periods. Each period was separated from the next by a washout interval of at least 48 hours. Pharmacokinetic (PK) parameters, including area under curve (AUC) and Cmax, were computed using standard non-compartmentalized methods of analysis. For comparison of exposures between formulations, log-transformed AUC and Cmax values were analyzed using a linear mixed-effects model. Safety assessments included adverse event monitoring, physical examinations, and laboratory tests. RESULTS: Of the 14 patients who entered and completed the study, 13 patients were included in the final statistical analysis. AUC(0-tlast), AUC(0-48 h), and AUC(0-∞) for the RC formulations and the HSWG formulation were similar. Cmax was reduced by approximately 22% and tmax was longer by at least 1.00 h for the RCD and RCS formulations compared with the HSWG formulation. The RC formulations demonstrated a safety profile after a single dose similar to the HSWG formulation. CONCLUSIONS: In this relative bioavailability study comparing galunisertib formulations after a single dose, RCD and RCS formulations had similar exposure and safety profile compared with the HSWG formulation.

Evaluation of the effect of necitumumab on the corrected QT interval in patients with advanced solid tumors.

PURPOSE: Necitumumab is a second-generation, recombinant, human immunoglobulin G1 monoclonal antibody that blocks the ligand binding site of the epidermal growth factor receptor. The primary objective of this phase 2 study, conducted in accordance with International Conference on Harmonisation E14 guidance, was to determine the effect of necitumumab treatment on QT/QTc interval in patients with advanced solid tumors. METHODS: Patients received necitumumab monotherapy at an absolute dose of 800 mg, once per week for each 6-week cycle. Triplicate electrocardiogram readings were taken at pretreatment (baseline) and then weekly at multiple timepoints that were time-matched with blood samples to determine necitumumab concentrations. RESULTS: Seventy-five patients received treatment. Overall, the upper bound of the two-sided 90 % confidence interval for mean change from baseline in QTc in cycle 1 did not exceed 10 ms. No patients had a mean QTcF interval >500 ms, and no patients had an increase of >60 ms. Necitumumab concentration-QTc analysis also showed that necitumumab is unlikely to cause QTc prolongation. CONCLUSIONS: The results demonstrate lack of effect of necitumumab on the QTc interval in heavily pretreated patients with advanced solid tumors, suggesting that QT prolongation is not a major safety concern for necitumumab at the recommended therapeutic dose. The safety profile was consistent with the known safety profile of necitumumab.

Behavioural, brain and cardiac responses to hypobaric hypoxia in broiler chickens.

A novel approach to pre-slaughter stunning of chickens has been developed in which birds are rendered unconscious by progressive hypobaric hypoxia. Termed Low Atmospheric Pressure Stunning (LAPS), this approach involves application of gradual decompression lasting 280s according to a prescribed curve. We examined responses to LAPS by recording behaviour, electroencephalogram (EEG) and electrocardiogram (ECG) in individual male chickens, and interpreted these with regard to the welfare impact of the process. We also examined the effect of two temperature adjusted pressure curves on these responses. Broiler chickens were exposed to LAPS in 30 triplets (16 and 14 triplets assigned to each pressure curve). In each triplet, one bird was instrumented for recording of EEG and ECG while the behaviour of all three birds was observed. Birds showed a consistent sequence of behaviours during LAPS (ataxia, loss of posture, clonic convulsions and motionless) which were observed in all birds. Leg paddling, tonic convulsions, slow wing flapping, mandibulation, head shaking, open bill breathing, deep inhalation, jumping and vocalisation were observed in a proportion of birds. Spectral analysis of EEG responses at 2s intervals throughout LAPS revealed progressive decreases in median frequency at the same time as corresponding progressive increases in total power, followed later by decreases in total power as all birds exhibited isoelectric EEG and died. There was a very pronounced increase in total power at 50-60s into the LAPS cycle, which corresponded to dominance of the signal by high amplitude slow waves, indicating loss of consciousness. Slow wave EEG was seen early in the LAPS process, before behavioural evidence of loss of consciousness such as ataxia and loss of posture, almost certainly due to the fact that it was completely dark in the LAPS chamber. ECG recordings showed a pronounced bradycardia (starting on average 49.6s into LAPS), often associated with arrhythmia, until around 60s into LAPS when heart rate levelled off. There was a good correlation between behavioural, EEG and cardiac measures in relation to loss of consciousness which collectively provide a loss of consciousness estimate of around 60s. There were some effects of temperature adjusted pressure curves on behavioural latencies and ECG responses, but in general responses were consistent and very similar to those reported in previous research on controlled atmosphere stunning with inert gases. The results suggest that the process is humane (slaughter without avoidable fear, anxiety, pain, suffering and distress). In particular, the maintenance of slow wave EEG patterns in the early part of LAPS (while birds are still conscious) is strongly suggestive that LAPS is non-aversive, since we would expect this to be interrupted by pain or discomfort.

Amount of Testosterone on Laundered Clothing After Use of Testosterone Topical 2% Solution by Healthy Male Volunteers.

INTRODUCTION: Testosterone 2% solution (Axiron) applied to armpit(s) is used for replacement therapy in men with a deficiency of endogenous testosterone. AIM: To determine the amount of testosterone on subjects' T-shirts 12 hours after applying testosterone solution, the residual testosterone on subjects' T-shirts after laundering, and the testosterone transferred to unworn textile items during laundering with worn T-shirts. METHODS: Healthy males ≥18 years old applied 2 × 1.5 mL of testosterone 2% solution to both axillae (total testosterone dose: 120 mg) and dressed in cotton long-sleeved T-shirts after a ≥3-minute waiting period. T-shirts were worn 12 hours before being removed and cut into halves, after which a 10 × 10 cm sample of each armpit area was excised for testosterone quantification before or after laundering with samples of unworn textiles. MAIN OUTCOME MEASURES: Testosterone on worn T-shirts before and after laundering, and on unworn textiles laundered with the worn T-shirts. RESULTS: Twelve subjects enrolled and completed, with only minor adverse events. Mean testosterone in unwashed worn T-shirts was 7603 µg, with high between-subject variability (3359 µg to 13,069 µg), representing 13% of the dose to 1 armpit. Mean testosterone in worn, laundered T-shirts was 260 µg (7.55 µg to 1343 µg), representing 3% of the dose to 1 armpit. Mean transferred testosterone to other textiles during laundering ranged from 69 µg on texturized Dacron 56T Double to 10,402 µg on 87/13 nylon/Lycra knit, representing 0.0382% to 5.78% of the dose to 1 armpit. CONCLUSION: Thirteen percent of the testosterone applied to axillae was transferred to T-shirts during wear. Ninety-seven percent of the transferred testosterone was removed from the T-shirts during washing, some of which was then absorbed to various degrees by other textiles. Clinical implications of these findings and biological activity of the remaining/transferred testosterone are unknown.

Considerations for assessing the potential effects of antidiabetes drugs on cardiac ventricular repolarization: A report from the Cardiac Safety Research Consortium.

Thorough QT studies conducted according to the International Council on Harmonisation E14 guideline are required for new nonantiarrhythmic drugs to assess the potential to prolong ventricular repolarization. Special considerations may be needed for conducting such studies with antidiabetes drugs as changes in blood glucose and other physiologic parameters affected by antidiabetes drugs may prolong the QT interval and thus confound QT/corrected QT assessments. This review discusses potential mechanisms for QT/corrected QT interval prolongation with antidiabetes drugs and offers practical considerations for assessing antidiabetes drugs in thorough QT studies. This article represents collaborative discussions among key stakeholders from academia, industry, and regulatory agencies participating in the Cardiac Safety Research Consortium. It does not represent regulatory policy.

Effect of pomaglumetad methionil on the QT interval in subjects with schizophrenia.

OBJECTIVE: This thorough QT/QTc (TQT) study assessed the effects of a supratherapeutic dose of pomaglumetad methionil, a potential treatment for schizophrenia, compared to placebo on the QT interval in subjects with schizophrenia. METHODS: This double-blind, 3-period crossover study enrolled 86 subjects aged 22 - 63 years, who met Diagnostic and Statistical Manual, Fourth Edition, Test Revision (DSM-IV-TR) criteria for schizophrenia; 78 subjects completed the study. Subjects were randomly assigned to sequences of 3 treatment periods of single oral doses of pomaglumetad methionil 400 mg, moxifloxacin 400 mg, and placebo. Quadruplicate electrocardiograms (ECGs) were extracted from 2 hours predose to 12 hours postdose and were overread by a blinded central reader. Time-matched pharmacokinetic (PK) parameters were assessed. RESULTS: At all-time points, the upper bound of the 90% 2-sided confidence interval (CI) for the least squares (LS) mean difference in changes from baseline in Fridericia's corrected QT interval (ΔQTcF) between pomaglumetad methionil and placebo was < 10 milliseconds (msec). Sufficient assay sensitivity was not achieved, likely due to food effect; although the maximum observed drug concentration (Cmax) with moxifloxacin (1,410 ng/mL) was lower than expected, the slope of the regression line of moxifloxacin plasma concentrations versus placebo-subtracted ΔQTcF was similar to that reported in the literature. CONCLUSIONS: A single supratherapeutic dose of 400 mg pomaglumetad methionil did not prolong QTcF to a clinically significant degree and, importantly, did not result in any absolute QTcF > 450 msec or increase in QTcF from predose > 30 msec.

Evaluation of the likelihood of a selective CHK1 inhibitor (LY2603618) to inhibit CYP2D6 with desipramine as a probe substrate in cancer patients.

LY2603618 is a selective inhibitor of deoxyribonucleic acid damage checkpoint kinase 1 (CHK1) and has been in development for the enhancement of chemotherapeutic agents. The study described was to assess the potential interaction between LY2603618 and cytochrome P450 isoform 2D6 (CYP2D6) substrate desipramine in patients with cancer. Before clinical investigation, in silico simulations (using Simcyp®) were conducted. An open-label, two-period, fixed-sequence study was planned in 30 patients with advanced or metastatic cancers, in which a 50 mg oral dose of desipramine was administered alone and in combination with 275 mg of LY2603618 (i.v. infusion). An interim analysis was planned after 15 patients completed both periods. Ratios of geometric least squares means (LSMs) of primary pharmacokinetic (PK) parameters and 90% repeated confidence intervals (RCIs) between desipramine plus LY2603618 and desipramine alone were calculated. Lack of an interaction was declared if the 90% RCI fell between 0.8 and 1.25. The LSM ratios (90% RCI) for areas under the plasma concentration-time curve from time zero to tlast (AUC[0-tlast]) and to infinity (AUC[0-∞]) and maximum plasma concentration (Cmax) were 1.14 (1.04, 1.25), 1.09 (0.99, 1.21) and 1.16 (1.05, 1.29). In silico simulations were predictive of clinical results. Single doses of 275 mg LY2603618 administered with 50 mg desipramine were generally well tolerated. In conclusion, no clinically significant interaction was observed between LY2603618 and desipramine in patients with cancer. In silico predictions of clinical results demonstrated that mechanistic and physiologically based PK approaches may inform clinical study design in cancer patients.

Relative contributions of presystemic and systemic peptidases to oral exposure of a novel metabotropic glutamate 2/3 receptor agonist (LY404039) after oral administration of prodrug pomaglumetad methionil (LY2140023).

Pomaglumetad methionil (LY2140023) is the prodrug of a novel metabotropic glutamate 2/3 receptor agonist (LY404039) being investigated for the treatment of schizophrenia. Using accelerator mass spectrometry (AMS) and an intravenous (i.v.) radiolabeled tracer approach, the absolute bioavailability of the prodrug and the extent of its conversion to active moiety (LY404039) were estimated at presystemic (intestinal/first pass) and systemic sites after simultaneous oral and i.v. dosing in healthy subjects. The mean absolute bioavailability of prodrug (80 mg oral) was 0.68. On the basis of these data and a previous radiolabeled mass balance study in which no prodrug was recovered in feces, we concluded that 0.32 of the dose is converted to active drug in the intestinal tract. The fraction of prodrug converted to active moiety was approximately 1, indicating complete conversion of the prodrug that reaches the systemic circulation to the active moiety. Prodrug (80 mg oral and 100 µg i.v.) and active moiety (100 µg i.v.) were well tolerated in healthy subjects. Thus, the absolute bioavailability of prodrug LY2140023 and the fraction converted presystemically and systemically to active moiety LY404039 were estimated simultaneously using radiolabeled tracer microdosing and AMS.