E2027 Cardiac Safety Evaluation With Concentration-Response Modeling of ECG Data to Inform Dose Selection in Studies in Patients With Dementia With Lewy Bodies.
Alzheimer Dis Assoc Disord
; 36(3): 208-214, 2022.
Article
in En
| MEDLINE
| ID: mdl-35622456
ABSTRACT
BACKGROUND:
E2027 is a novel, highly selective and potent inhibitor of phosphodiesterase 9 in development for dementia with Lewy bodies. Cardiac safety assessments for emerging agents are essential to avoid drug-induced QT interval prolongation, which may predispose individuals to potentially fatal ventricular arrhythmias. To evaluate the cardiac safety of E2027 and to inform dose selection for the phase 2 study of E2027 in dementia with Lewy bodies, we evaluated concentration-response modeling of pooled electrocardiogram data. PATIENTS ANDMETHODS:
A post hoc concentration-QTc analysis evaluated potential QT effects using data from 2 randomized, double-blind studies in healthysubjects:
a single ascending dose (SAD) study and a multiple ascending dose (MAD) study. Daily E2027 doses ranged from 5 to 1200 mg.RESULTS:
A linear mixed-effects model was used to establish the relationship between plasma concentrations of E2027 and change from the baseline of QTcF (ΔQTcF). A significant but shallow relationship was observed in the estimated slope of the concentration-ΔQTcF 0.002 ms/ng/mL (90% confidence interval 0.0007-0.0031) with a small, nonsignificant treatment effect-specific intercept of -0.6 ms. Based on this pooled concentration-QTc analysis, an effect on the QTcF interval >10 ms can be excluded up to E2027 plasma concentrations of â¼3579 ng/mL, corresponding to a dose at least 4-fold larger than the 50 mg phase 2 dose.CONCLUSION:
This pooled post hoc analysis evaluating cardiac safety of E2027 demonstrated that clinically concerning QTcF prolongation and related cardiac complications are highly unlikely with proposed E2027 doses planned for phase 2.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Phosphodiesterase Inhibitors
/
Long QT Syndrome
/
Lewy Body Disease
Type of study:
Clinical_trials
Limits:
Humans
Language:
En
Journal:
Alzheimer Dis Assoc Disord
Journal subject:
NEUROLOGIA
/
PSIQUIATRIA
Year:
2022
Document type:
Article