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Ozaki H. [Technology and evaluation best practices for in vivo cardiovascular safety pharmacology studies]. Nihon Yakurigaku Zasshi 2021; 156:364-369. [PMID: 34719571 DOI: 10.1254/fpj.21053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In vivo cardiovascular experiments as part of safety pharmacology studies have been developed for small molecule drug candidates to maximize detection power for potential undesirable pharmacodynamic effects of a drug candidate on physiological functions, and have been established with appropriate expertise. Conscious freely-moving telemeterized non-rodents are generally used for the in vivo cardiovascular experiments. The technology and evaluation best practices for the experiments have been optimized by multiple researchers and as a result, the experiments considerably contribute to the estimation of cardiovascular risks for humans. In addition, as described in ICH E14&S7B Q&A draft, non-clinical studies are gaining importance in the integrated risk assessment for QT prolongation in humans, and high quality data obtained in non-clinical studies are being required. This manuscript introduces actual technology and evaluation for in vivo cardiovascular safety pharmacology studies based on Japan activity for Improvement of Cardiovascular Evaluation by Telemetry system (J-ICET), which is one of the working groups hosted by Japanese Safety Pharmacology Society.
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Nunoi Y, Hagiwara-Nagasawa M, Kambayashi R, Goto A, Chiba K, Wada T, Izumi-Nakaseko H, Matsumoto A, Watanabe Y, Sugiyama A. Characterization of microminipig as a laboratory animal for pharmacological study by analyzing bepridil-induced cardiovascular responses. J Pharmacol Sci 2020; 143:56-59. [PMID: 32144028 DOI: 10.1016/j.jphs.2020.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 12/29/2019] [Accepted: 01/27/2020] [Indexed: 11/19/2022] Open
Abstract
Since microminipig is becoming attractive model for various cardiac electropharmacological applications, which may meet consideration of 3Rs. We characterized microminipigs by analyzing how multi-ionic channel inhibitor bepridil may affect their in situ hearts in comparison with dogs. Bepridil in doses of 0.3 and 3.0 mg/kg were intravenously administered over 10 min under halothane anesthesia (n = 4). Microminipigs may be less sensitive for ICaT inhibition of bepridil, whereas they are more responsive to INa, IKr and IKs suppression than dogs. This information would help predict cardiovascular effects of a drug in patients with the remodeled hearts having similar electrophysiological profile to microminipigs.
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Affiliation(s)
- Yoshio Nunoi
- Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan; Division of Cardiovascular Surgery, Department of Surgery, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Mihoko Hagiwara-Nagasawa
- Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan
| | - Ryuichi Kambayashi
- Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan
| | - Ai Goto
- Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan
| | - Koki Chiba
- Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan
| | - Takeshi Wada
- Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan
| | - Hiroko Izumi-Nakaseko
- Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan
| | - Akio Matsumoto
- Department of Aging Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan
| | - Yoshinori Watanabe
- Division of Cardiovascular Surgery, Department of Surgery, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Atsushi Sugiyama
- Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan; Department of Aging Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan.
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Cao X, Nagasawa Y, Zhang C, Zhang H, Aimoto M, Takahara A. Electropharmacological profile of an atrial-selective sodium channel blocker acehytisine assessed in the isoflurane-anesthetized guinea-pig model. J Pharmacol Sci 2019; 141:153-159. [PMID: 31757741 DOI: 10.1016/j.jphs.2019.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/16/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022] Open
Abstract
Experimental evidence regarding the risk of proarrhythmic potential of acehytisine is limited. We assessed its electropharmacological effect together with proarrhythmic potential at intravenous doses of 4 and 10 mg/kg (n = 6) using isoflurane-anesthetized guinea pigs in comparison with that of bepridil at 1 and 3 mg/kg, intravenously (n = 6). Acehytisine at therapeutic dose (4 mg/kg) decreased the heart rate, prolonged P wave duration, QRS width, QT interval, QTc, MAP90(sinus), MAP90(CL300) and MAP90(CL250). At supratherapeutic dose (10 mg/kg), it prolonged the PR interval besides enhancing the changes induced by the therapeutic dose. Quantitative assessment showed that peak changes in P wave duration by acehytisine at 10 mg/kg were 1.7 times longer than bepridil, and in MAP90(sinus), MAP90(CL300) and MAP90(CL250) by acehytisine were 1.9, 1.5 and 1.5 times shorter than bepridil, respectively. Importantly, qualitative assessment indicated that bepridil increased beat-to-beat variability and J-Tpeakc in a dose-related manner, confirming a higher proarrhythmic risk, whereas such dose-related responses were not observed in acehytisine, suggesting a lower proarrhythmic risk. These results suggest that acehytisine exhibits favorable pharmacological characters, i.e. potent atrial inhibition and lower proarrhythmic toxicity compared with bepridil, being a promising candidate for the treatment of paroxysmal supraventricular tachycardia.
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Affiliation(s)
- Xin Cao
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu District, Chengdu, 610075, Sichuan Province, China; Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University 2-2-1 Miyama, Funabashi, Chiba, 274-8510, Japan.
| | - Yoshinobu Nagasawa
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University 2-2-1 Miyama, Funabashi, Chiba, 274-8510, Japan
| | - Chengshun Zhang
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu District, Chengdu, 610075, Sichuan Province, China
| | - Hanxiao Zhang
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu District, Chengdu, 610075, Sichuan Province, China
| | - Megumi Aimoto
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University 2-2-1 Miyama, Funabashi, Chiba, 274-8510, Japan
| | - Akira Takahara
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University 2-2-1 Miyama, Funabashi, Chiba, 274-8510, Japan.
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Ether N, Leishman D, Bailie M, Lauver A. Relationship of clinical adverse event reports to models of arrhythmia risk. J Pharmacol Toxicol Methods 2019; 100:106622. [PMID: 31398384 DOI: 10.1016/j.vascn.2019.106622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/05/2019] [Accepted: 07/27/2019] [Indexed: 10/26/2022]
Abstract
A vital aspect of the drug discovery and development process is the identification and filtering of drugs with high risk of dangerous adverse events. Torsade de Pointes (TdP) is one example of an adverse event that requires thorough in vitro and in vivo drug screening. This is because TdP, a tachycardic ventricular arrhythmia, can develop into fatal cardiac events if left unresolved and has been missed during drug development with profound consequences. These factors led to the development of pre-clinical screening guidelines based on the presence of drug induced QT prolongation (QTp), which has been linked to TdP. These guidelines have high sensitivity, but low specificity, as they tend to predict QTp, which precedes TdP events but does not always lead to TdP. Computational models have the potential to improve these prediction methods by bridging the gaps between preclinical and clinical data. This study proposes the use of adverse event reports obtained from the FDA Adverse Event Reporting System as a representation of clinical TdP risk. By incorporating these reports into computational models, a more accurate risk prediction may be developed.
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Affiliation(s)
- Nicholas Ether
- Michigan State University, East Lansing, MI 48824, United States
| | - Derek Leishman
- Michigan State University, East Lansing, MI 48824, United States; Eli Lilly and Co., Indianapolis, IN 46285, United States
| | - Marc Bailie
- Michigan State University, East Lansing, MI 48824, United States
| | - Adam Lauver
- Michigan State University, East Lansing, MI 48824, United States.
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Exposure-response analysis of drug-induced QT interval prolongation in telemetered monkeys for translational prediction to human. J Pharmacol Toxicol Methods 2019; 99:106606. [PMID: 31255745 DOI: 10.1016/j.vascn.2019.106606] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/24/2019] [Accepted: 06/24/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The preclinical in vivo assay for QT prolongation is critical for predicting torsadogenic risk, but still difficult to extrapolate to humans. This study ran preclinical tests in cynomolgus monkeys on seven QT reference drugs containing the drugs used in the IQ-CSRC clinical trial and applied exposure-response (ER) analysis to the data to investigate the potential for translational information on the QT effect. METHODS In each of six participating facilities in the J-ICET project, telemetered monkeys were monitored for 24 h following administration of vehicle or 3 doses of test drugs, and pharmacokinetic profiles at the same doses were evaluated separately. An individual rate-corrected QT interval (QTca) was derived and the vehicle-adjusted change in QTca from baseline (∆∆QTca) was calculated. Then the relationship of concentration to QT effect was evaluated by ER analysis. RESULTS For QT-positive drugs in the IQ-CSRC study (dofetilide, dolasetron, moxifloxacin, ondansetron, and quinine) and levofloxacin, the slope of the total concentration-QTca effect was significantly positive, and the QT-prolonging effect, taken as the upper bound of the confidence interval for predicted ∆∆QTca, was confirmed to exceed 10 ms. The ER slope of the negative drug levocetirizine was not significantly positive and the QTca effect was below 10 ms at observed peak exposure. DISCUSSION Preclinical QT assessment in cynomolgus monkeys combined with ER analysis could identify the small QT effect induced by several QT drugs consistently with the outcomes in humans. Thus, the ER method should be regarded as useful for translational prediction of QT effects in humans.
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Yoshimatsu Y, Ishizaka T, Chiba K, Mori K. Usefulness of simultaneous and sequential monitoring of glucose level and electrocardiogram in monkeys treated with gatifloxacin under conscious and nonrestricted conditions. Exp Anim 2018; 67:281-290. [PMID: 29311442 PMCID: PMC5955759 DOI: 10.1538/expanim.17-0136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Drug-induced cardiac electrophysiological abnormalities accompanied by hypoglycemia or
hyperglycemia increase the risk for life-threatening arrhythmia. To assess the
drug-induced cardiotoxic potential associated with extraordinary blood glucose (GLU)
levels, the effect of gatifloxacin (GFLX) which was frequently associated with GLU
abnormality and QT/QTc prolongations in the clinic on blood GLU and electrocardiogram
(ECG) parameters was investigated in cynomolgus monkeys (n=4) given GFLX orally in an
ascending dose regimen (10, 30, 60 and 100 mg/kg). Simultaneous and sequential GLU and ECG
monitoring with a continuous GLU monitoring system and Holter ECG, respectively, were
conducted for 24 h under free-moving conditions. Consequently, GFLX at 30 and 60 mg/kg
dose-dependently induced a transient decrease in GLU without any ECG abnormality 2–4 h
postdose. Highest dose of 100 mg/kg caused severe hypoglycemia with a mean GLU of <30
mg/dL, accompanied by remarkable QT/QTc prolongations by 20–30% in all animals. In
contrast, hyperglycemia without QT/QTc prolongations was noted 24 h after dosing in one
animal. A close correlation between GLU and QTc values was observed in animals treated
with 100 mg/kg, suggesting that GFLX-induced hypoglycemia enhanced QT/QTc prolongations.
Furthermore, the 24-h sequential GLU monitoring data clearly distinguished between
GFLX-induced GLU abnormality and physiological GLU changes influenced by feeding
throughout the day. In conclusion, the combined assessment of continuous GLU and ECG
monitoring is valuable in predicting the drug-induced cardio-electrophysiological risk
associated with both GLU and ECG abnormalities.
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Affiliation(s)
- Yu Yoshimatsu
- Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd., 1-16-13 Kita-Kasai, Edogawa-ku, Tokyo 134-8630, Japan
| | - Tomomichi Ishizaka
- Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd., 1-16-13 Kita-Kasai, Edogawa-ku, Tokyo 134-8630, Japan
| | - Katsuyoshi Chiba
- Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd., 1-16-13 Kita-Kasai, Edogawa-ku, Tokyo 134-8630, Japan
| | - Kazuhiko Mori
- Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd., 1-16-13 Kita-Kasai, Edogawa-ku, Tokyo 134-8630, Japan
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Nozaki Y, Honda Y, Watanabe H, Saiki S, Koyabu K, Itoh T, Nagasawa C, Nakamori C, Nakayama C, Iwasaki H, Suzuki S, Tanaka K, Takahashi E, Miyamoto K, Morimura K, Yamanishi A, Endo H, Shinozaki J, Nogawa H, Shinozawa T, Saito F, Kunimatsu T. CSAHi study-2: Validation of multi-electrode array systems (MEA60/2100) for prediction of drug-induced proarrhythmia using human iPS cell-derived cardiomyocytes: Assessment of reference compounds and comparison with non-clinical studies and clinical information. Regul Toxicol Pharmacol 2017. [PMID: 28634147 DOI: 10.1016/j.yrtph.2017.06.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
With the aim of reconsidering ICH S7B and E14 guidelines, a new in vitro assay system has been subjected to worldwide validation to establish a better prediction platform for potential drug-induced QT prolongation and the consequent TdP in clinical practice. In Japan, CSAHi HEART team has been working on hiPS-CMs in the MEA (hiPS-CMs/MEA) under a standardized protocol and found no inter-facility or lot-to-lot variability for proarrhythmic risk assessment of 7 reference compounds. In this study, we evaluated the responses of hiPS-CMs/MEA to another 31 reference compounds associated with cardiac toxicities, and gene expression to further clarify the electrophysiological characteristics over the course of culture period. The hiPS-CMs/MEA assay accurately predicted reference compounds potential for arrhythmogenesis, and yielded results that showed better correlation with target concentrations of QTc prolongation or TdP in clinical setting than other current in vitro and in vivo assays. Gene expression analyses revealed consistent profiles in all samples within and among the testing facilities. This report would provide CiPA with informative guidance on the use of the hiPS-CMs/MEA assay, and promote the establishment of a new paradigm, beyond conventional in vitro and in vivo assays for cardiac safety assessment of new drugs.
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Affiliation(s)
- Yumiko Nozaki
- Preclinical Research Laboratories, Sumitomo Dainippon Pharma Co., Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka 554-0022, Japan.
| | - Yayoi Honda
- Preclinical Research Laboratories, Sumitomo Dainippon Pharma Co., Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka 554-0022, Japan
| | - Hitoshi Watanabe
- Preclinical Research Laboratories, Sumitomo Dainippon Pharma Co., Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka 554-0022, Japan
| | - Shota Saiki
- Research Laboratory for Development, Shionogi & Co., Ltd., 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan; Consortium for Safety Assessment using Human iPS Cells (CSAHi), Japan
| | - Kiyotaka Koyabu
- Research Laboratory for Development, Shionogi & Co., Ltd., 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Tetsuji Itoh
- Research Laboratory for Development, Shionogi & Co., Ltd., 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Chiho Nagasawa
- Drug Safety, Taisho Pharmaceutical Co., Ltd., 1-403, Yoshino-cho, Kita-ku, Saitama-shi, Saitama 331-9530, Japan; Consortium for Safety Assessment using Human iPS Cells (CSAHi), Japan
| | - Chiaki Nakamori
- Drug Safety, Taisho Pharmaceutical Co., Ltd., 1-403, Yoshino-cho, Kita-ku, Saitama-shi, Saitama 331-9530, Japan
| | - Chiaki Nakayama
- Drug Safety, Taisho Pharmaceutical Co., Ltd., 1-403, Yoshino-cho, Kita-ku, Saitama-shi, Saitama 331-9530, Japan
| | - Hiroshi Iwasaki
- Drug Safety, Taisho Pharmaceutical Co., Ltd., 1-403, Yoshino-cho, Kita-ku, Saitama-shi, Saitama 331-9530, Japan
| | - Shinobu Suzuki
- Nippon Boehringer Ingelheim Co., Ltd., 6-7-5, Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Kohji Tanaka
- Nippon Boehringer Ingelheim Co., Ltd., 6-7-5, Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Etsushi Takahashi
- Research Laboratories, Toyama Chemical Co., Ltd., 4-1, Shimookui 2-chome, Toyama 930-8508, Japan; Consortium for Safety Assessment using Human iPS Cells (CSAHi), Japan
| | - Kaori Miyamoto
- Research Laboratories, Toyama Chemical Co., Ltd., 4-1, Shimookui 2-chome, Toyama 930-8508, Japan
| | - Kaoru Morimura
- Research Laboratories, Toyama Chemical Co., Ltd., 4-1, Shimookui 2-chome, Toyama 930-8508, Japan
| | - Atsuhiro Yamanishi
- Toxicology Research Laboratory, Kyorin Pharmaceutical Co., Ltd., 1848, Nogi, Nogi-machi, Shimotsuga-gun, Tochigi 329-0114, Japan; Consortium for Safety Assessment using Human iPS Cells (CSAHi), Japan
| | - Hiroko Endo
- Toxicology Research Laboratory, Kyorin Pharmaceutical Co., Ltd., 1848, Nogi, Nogi-machi, Shimotsuga-gun, Tochigi 329-0114, Japan
| | - Junko Shinozaki
- Toxicology Research Laboratory, Kyorin Pharmaceutical Co., Ltd., 1848, Nogi, Nogi-machi, Shimotsuga-gun, Tochigi 329-0114, Japan
| | - Hisashi Nogawa
- Toxicology Research Laboratory, Kyorin Pharmaceutical Co., Ltd., 1848, Nogi, Nogi-machi, Shimotsuga-gun, Tochigi 329-0114, Japan
| | - Tadahiro Shinozawa
- Drug Safety Research Laboratories, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-chome Fujisawa, Kanagawa 251-8555, Japan; Consortium for Safety Assessment using Human iPS Cells (CSAHi), Japan; Japan Pharmaceutical Manufacturers Association, Drug Evaluation Committee, Non-Clinical Evaluation Expert Committee, Japan
| | - Fumiyo Saito
- Chemicals Assessment and Research Center, Chemicals Evaluation and Research Institute, Japan (CERI), 1600, Shimotakano, Sugito-machi, Kitakatsushika-gun, Saitama 345-0043, Japan; Consortium for Safety Assessment using Human iPS Cells (CSAHi), Japan
| | - Takeshi Kunimatsu
- Preclinical Research Laboratories, Sumitomo Dainippon Pharma Co., Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka 554-0022, Japan; Consortium for Safety Assessment using Human iPS Cells (CSAHi), Japan; Japan Pharmaceutical Manufacturers Association, Drug Evaluation Committee, Non-Clinical Evaluation Expert Committee, Japan.
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Yokoyama H, Nakamura Y, Saito H, Nagayama Y, Hoshiai K, Wada T, Izumi-Nakaseko H, Ando K, Akie Y, Sugiyama A. Pharmacological characterization of microminipig as a model to assess the drug-induced cardiovascular responses for non-clinical toxicity and/or safety pharmacology studies. J Toxicol Sci 2017; 42:93-101. [PMID: 28070113 DOI: 10.2131/jts.42.93] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
We tried to establish the halothane-anesthetized microminipigs as an alternative animal model for non-clinical toxicity and/or safety pharmacology studies. In order to characterize the halothane-anesthetized microminipigs, we firstly clarified the effects of halothane anesthesia on their cardiovascular system (n = 5). Then, we examined the cardiovascular effects of dl-sotalol in doses of 0.1, 0.3 and 1 mg/kg, i.v. on the halothane-anesthetized microminipigs (n = 6). Induction of the halothane anesthesia by itself prolonged the QT interval as well as QTcF, suggesting that the halothane anesthesia can reduce the cardiac repolarization reserve in microminipigs like in dogs. dl-Sotalol showed more potent negative chronotropic, dromotropic and hypotensive effects together with repolarization delay in microminipigs than in dogs, although each cardiovascular response to dl-sotalol was directionally similar between them, suggesting greater basal sympathetic tone and/or smaller volume of distribution of the drug in microminipigs than in dogs. Analyses of proarrhythmic surrogate markers indicate that Tpeak-Tend and short-term variability of QT interval may be more sensitive to detect the dl-sotalol-induced direct electrophysiological changes in microminipigs than in dogs, but its reverse will be true for J-Tpeakc. Thus, these results may help better understand the drug-induced cardiovascular responses in microminipigs.
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Kitaguchi T, Moriyama Y, Taniguchi T, Maeda S, Ando H, Uda T, Otabe K, Oguchi M, Shimizu S, Saito H, Toratani A, Asayama M, Yamamoto W, Matsumoto E, Saji D, Ohnaka H, Miyamoto N. CSAHi study: Detection of drug-induced ion channel/receptor responses, QT prolongation, and arrhythmia using multi-electrode arrays in combination with human induced pluripotent stem cell-derived cardiomyocytes. J Pharmacol Toxicol Methods 2017; 85:73-81. [DOI: 10.1016/j.vascn.2017.02.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/05/2016] [Accepted: 02/01/2017] [Indexed: 12/20/2022]
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Promising approach for the preclinical assessment of cardiac risks using left ventricular pressure-volume loop analyses in anesthetized monkeys. J Pharmacol Toxicol Methods 2017; 84:1-10. [DOI: 10.1016/j.vascn.2016.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/07/2016] [Accepted: 10/12/2016] [Indexed: 11/23/2022]
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11
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CSAHi study: Evaluation of multi-electrode array in combination with human iPS cell-derived cardiomyocytes to predict drug-induced QT prolongation and arrhythmia — Effects of 7 reference compounds at 10 facilities. J Pharmacol Toxicol Methods 2016; 78:93-102. [DOI: 10.1016/j.vascn.2015.12.002] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/29/2015] [Accepted: 12/02/2015] [Indexed: 12/23/2022]
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12
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CSAHi study: Validation of multi-electrode array systems (MEA60/2100) for prediction of drug-induced proarrhythmia using human iPS cell-derived cardiomyocytes -assessment of inter-facility and cells lot-to-lot-variability. Regul Toxicol Pharmacol 2016; 77:75-86. [PMID: 26884090 DOI: 10.1016/j.yrtph.2016.02.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/01/2016] [Accepted: 02/12/2016] [Indexed: 01/22/2023]
Abstract
In vitro screening of hERG channels are recommended under ICH S7B guidelines to predict drug-induced QT prolongation and Torsade de Pointes (TdP), whereas proarrhythmia is known to be evoked by blockage of other ion channels involved in cardiac contraction and compensation mechanisms. A consortium for drug safety assessment using human iPS cells-derived cardiomyocytes (hiPS-CMs), CSAHi, has been organized to establish a novel in vitro test system that would enable better prediction of drug-induced proarrhythmia and QT prolongation. Here we report the inter-facility and cells lot-to-lot variability evaluated with FPDc (corrected field potential duration), FPDc10 (10% FPDc change concentration), beat rate and incidence of arrhythmia-like waveform or arrest on hiPS-CMs in a multi-electrode array system. Arrhythmia-like waveforms were evident for all test compounds, other than chromanol 293B, that evoked FPDc prolongation in this system and are reported to induce TdP in clinical practice. There was no apparent cells lot-to-lot variability, while inter-facility variabilities were limited within ranges from 3.9- to 20-folds for FPDc10 and about 10-folds for the minimum concentration inducing arrhythmia-like waveform or arrests. In conclusion, the new assay model reported here would enable accurate prediction of a drug potential for proarrhythmia.
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Darpo B, Bjornsson TD, Brathwaite WA, Crincoli CM, Eapen AK, Fisher GL, Kowey PR, Miller MP, Nikiforov AI, Rihner MO, Zhou M. Detection of ECG effects of (2R,4R)-monatin, a sweet flavored isomer of a component first identified in the root bark of the Sclerochitin ilicifolius plant. Food Chem Toxicol 2016; 91:217-24. [PMID: 26747976 DOI: 10.1016/j.fct.2015.12.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 12/04/2015] [Accepted: 12/23/2015] [Indexed: 11/15/2022]
Abstract
Enzymatically-synthesized (2R,4R)-monatin has, due to its pure sweet taste, been evaluated for potential use in foods. Non-clinical studies have shown that (2R,4R)-monatin is well tolerated at high dietary concentrations, is not genotoxic/mutagenic, carcinogenic, or overtly toxic. In a pharmacokinetic and metabolism study involving 12 healthy males, consumption of a single oral dose (2 mg/kg) of (2R,4R)-monatin resulted in a small reduction of heart rate and prolongation of the QTcF interval of 20-24 ms, corresponding to the time of peak plasma levels (t(max)). These findings were evaluated in a cross-over thorough QT/QTc study with single doses of 150 mg (2R,4R)-monatin, placebo and positive control (moxifloxacin) in 56 healthy males. Peak (2R,4R)-monatin plasma concentration (1720 ± 538 ng/mL) was reached at 3.1 h (mean tmax). The placebo-corrected, change-from-baseline QTcF (ΔΔQTcF) reached 25 ms three hours after dosing, with ΔΔQTcF of 23 ms at two and four hours. Using exposure response (QTc) analysis, a significant slope of the relationship between (2R,4R)-monatin plasma levels and ΔΔQTcF was demonstrated with a predicted mean QT effect of 0.016 ms per ng/mL. While similarly high plasma levels are unlikely to be achieved by consumption of (2R,4R)-monatin in foods, QTc prolongation at this level is a significant finding.
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Affiliation(s)
- Borje Darpo
- Karolinska Institutet, Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd's Hospital, Stockholm, Sweden; iCardiac Technologies, Inc., 150 Allens Creek Road, Rochester, NY 14618, USA.
| | | | - Witty A Brathwaite
- Cargill, Limited, 300-240 Graham Avenue, Winnipeg, Manitoba R3C 4C5, Canada.
| | | | - Alex K Eapen
- Cargill, Incorporated, 15407 McGinty Road W., MS 163 Wayzata, MN, USA.
| | | | - Peter R Kowey
- Lankenau Medical Center, Philadelphia, PA, USA; Jefferson Medical College, Philadelphia, PA, USA.
| | - Marvin P Miller
- Cargill, Incorporated, 15407 McGinty Road W., MS 163 Wayzata, MN, USA.
| | - Andrey I Nikiforov
- Toxicology Regulatory Services, 2365 Hunters Way, Charlottesville, VA, USA.
| | - Marisa O Rihner
- Toxicology Regulatory Services, 2365 Hunters Way, Charlottesville, VA, USA.
| | - Meijian Zhou
- iCardiac Technologies, Inc., 150 Allens Creek Road, Rochester, NY 14618, USA.
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14
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Higa A, Hoshi H, Takagi M. Differing responses of human stem cell-derived cardiomyocytes to arrhythmogenic drugs, determined using impedance measurements. ACTA ACUST UNITED AC 2016. [DOI: 10.2131/fts.3.47] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Arisa Higa
- Medical-industrial Translational Research Center, Fukushima Medical University
| | - Hirotaka Hoshi
- Medical-industrial Translational Research Center, Fukushima Medical University
| | - Motoki Takagi
- Medical-industrial Translational Research Center, Fukushima Medical University
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15
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Harris K. A Human Induced Pluripotent Stem Cell−Derived Cardiomyocyte (hiPSC‐CM) Multielectrode Array Assay for Preclinical Cardiac Electrophysiology Safety Screening. ACTA ACUST UNITED AC 2015; 71:11.18.1-11.18.15. [DOI: 10.1002/0471141755.ph1118s71] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kate Harris
- Safety Pharmacology, GlaxoSmithKline, David Jack Centre for R&D, Ware Hertfordshire United Kingdom
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16
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Dubois VFS, de Witte WEA, Visser SAG, Danhof M, Della Pasqua O. Assessment of Interspecies Differences in Drug-Induced QTc Interval Prolongation in Cynomolgus Monkeys, Dogs and Humans. Pharm Res 2015; 33:40-51. [PMID: 26553352 PMCID: PMC4689776 DOI: 10.1007/s11095-015-1760-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 07/16/2015] [Indexed: 11/30/2022]
Abstract
Background and Purpose The selection of the most suitable animal species and subsequent translation of the concentration-effect relationship to humans are critical steps for accurate assessment of the pro-arrhythmic risk of candidate molecules. The objective of this investigation was to assess quantitatively the differences in the QTc prolonging effects of moxifloxacin between cynomolgus monkeys, dogs and humans. The impact of interspecies differences is also illustrated for a new candidate molecule. Experimental Approach Pharmacokinetic data and ECG recordings from pre-clinical protocols in monkeys and dogs and from a phase I trial in healthy subjects were identified for the purpose of this analysis. A previously established Bayesian model describing the combined effect of heart rate, circadian variation and drug effect on the QT interval was used to describe the pharmacokinetic-pharmacodynamic relationships. The probability of a ≥10 ms increase in QT was derived as measure of the pro-arrhythmic effect. Key Results For moxifloxacin, the concentrations associated with a 50% probability of QT prolongation ≥10 ms (Cp50) varied from 20.3 to 6.4 and 2.6 μM in dogs, monkeys and humans, respectively. For NCE05, these values were 0.4 μM vs 2.0 μM for monkeys and humans, respectively. Conclusions and Implications Our findings reveal significant interspecies differences in the QT-prolonging effect of moxifloxacin. In addition to the dissimilarity in pharmacokinetics across species, it is likely that differences in pharmacodynamics also play an important role. It appears that, regardless of the animal model used, a translation function is needed to predict concentration-effect relationships in humans.
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Affiliation(s)
- V F S Dubois
- Leiden Academic Centre for Drug Research, Division of Pharmacology, Leiden University, Leiden, The Netherlands
| | - W E A de Witte
- Leiden Academic Centre for Drug Research, Division of Pharmacology, Leiden University, Leiden, The Netherlands
| | - S A G Visser
- Global DMPK, AstraZeneca R&D, Sodertalje, Sweden
| | - M Danhof
- Leiden Academic Centre for Drug Research, Division of Pharmacology, Leiden University, Leiden, The Netherlands
| | - O Della Pasqua
- Leiden Academic Centre for Drug Research, Division of Pharmacology, Leiden University, Leiden, The Netherlands. .,Clinical Pharmacology Modelling & Simulation, GlaxoSmithKline, Stockley Park, Uxbridge, UK. .,Clinical Pharmacology & Therapeutics, University College London, London, UK.
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Vargas HM, Bass AS, Koerner J, Matis-Mitchell S, Pugsley MK, Skinner M, Burnham M, Bridgland-Taylor M, Pettit S, Valentin JP. Evaluation of drug-induced QT interval prolongation in animal and human studies: a literature review of concordance. Br J Pharmacol 2015; 172:4002-11. [PMID: 26031452 PMCID: PMC4543608 DOI: 10.1111/bph.13207] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 04/22/2015] [Accepted: 05/20/2015] [Indexed: 01/10/2023] Open
Abstract
Evaluating whether a new medication prolongs QT intervals is a critical safety activity that is conducted in a sensitive animal model during non-clinical drug development. The importance of QT liability detection has been reinforced by non-clinical [International Conference on Harmonization (ICH) S7B] and clinical (ICH E14) regulatory guidance from the International Conference on Harmonization. A key challenge for the cardiovascular safety community is to understand how the finding from a non-clinical in vivo QT assay in animals predicts the outcomes of a clinical QT evaluation in humans. The Health and Environmental Sciences Institute Pro-Arrhythmia Working Group performed a literature search (1960–2011) to identify both human and non-rodent animal studies that assessed QT signal concordance between species and identified drugs that prolonged or did not prolong the QT interval. The main finding was the excellent agreement between QT results in humans and non-rodent animals. Ninety-one percent (21 of 23) of drugs that prolonged the QT interval in humans also did so in animals, and 88% (15 of 17) of drugs that did not prolong the QT interval in humans had no effect on animals. This suggests that QT interval data derived from relevant non-rodent models has a 90% chance of predicting QT findings in humans. Disagreement can occur, but in the limited cases of QT discordance we identified, there appeared to be plausible explanations for the underlying disconnect between the human and non-rodent animal QT outcomes.
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Affiliation(s)
- Hugo M Vargas
- Integrated Discovery and Safety Pharmacology, Amgen, Inc., Thousand Oaks, CA, USA
| | - Alan S Bass
- Safety Assessment, Merck Research Laboratories, Boston, MA, USA
| | - John Koerner
- Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | | | | | | | | | | | - Syril Pettit
- Health and Environmental Sciences Institute, Washington, DC, USA
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18
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Sensitivity and Specificity of the In Vitro Guinea Pig Papillary Muscle Action Potential Duration for the Assessment of Drug-Induced Torsades De Pointes Liability in Humans. Handb Exp Pharmacol 2015; 229:205-19. [PMID: 26091641 DOI: 10.1007/978-3-662-46943-9_8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The ICH S7B document, which provides guidance for the preclinical cardiovascular evaluation of pharmaceutical new chemical entities (NCE), is essentially focused on drug-induced QT lengthening, a biomarker for the proarrhythmic adverse drug reaction, torsades de pointes (TdP). In 2005, this guidance recommended the IKr assay and the in vivo QT telemetry study as mandatory assays for detecting potential torsades de pointes liability and relegated the cardiac action potential (AP) assay as a follow-up study. The IKr assay has become a mandatory screening tool in the early development and safety assessment process. Using only the IKr assay as a go/no go decision arbiter is regrettable since, due to the low specificity of the model (positives that are false for proarrhythmia liability, e.g. verapamil), promising, safe NCEs may be inadvertently discarded. Inclusion of additional medium throughput assays should be performed early to confirm or balance the putatively unfavourable IKr result with positive discovery model output (Pugsley et al., J Pharmacol Toxicol Methods 60:24-27, 2009). In the present chapter, the predictive value of in vitro guinea pig papillary muscle action potential assay will be discussed in terms of sensitivity and specificity and compared to currently available preclinical models such as IKr/hERG assay, dog Purkinje fibre action potential and in vivo QT measurements in dog and cynomolgus monkey.
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Kubo T, Ding WG, Toyoda F, Fujii Y, Omatsu-Kanbe M, Matsuura H. Phosphatidylinositol4-phosphate 5-kinase prevents the decrease in the HERG potassium current induced by Gq protein-coupled receptor stimulation. J Pharmacol Sci 2015; 127:127-34. [PMID: 25704028 DOI: 10.1016/j.jphs.2014.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 11/19/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022] Open
Abstract
The human ether-a-go-go-related gene (HERG) potassium current (IHERG) has been shown to decrease in amplitude following stimulation with Gq protein-coupled receptors (GqRs), such as α1-adrenergic and M1-muscarinic receptors (α1R and M1R, respectively), at least partly via the reduction of membrane phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2). The present study was designed to investigate the modulation of HERG channels by PI(4,5)P2 and phosphatidylinositol4-phosphate 5-kinase (PI(4)P5-K), a synthetic enzyme of PI(4,5)P2. Whole-cell patch-clamp recordings were used to examine the activity of HERG channels expressed heterologously in Chinese Hamster Ovary cells. The stimulation of α1R with phenylephrine or M1R with acetylcholine decreased the amplitude of IHERG accompanied by a significant acceleration of deactivation kinetics and the effects on IHERG were significantly attenuated in cells expressing PI(4)P5-K. The density of IHERG in cells expressing GqRs alone was significantly increased by the coexpression of PI(4)P5-K without significant differences in the voltage dependence of activation and deactivation kinetics. The kinase-deficient substitution mutant, PI(4)P5-K-K138A did not have these counteracting effects on the change in IHERG by M1R stimulation. These results suggest that the current density of IHERG is closely dependent on the membrane PI(4,5)P2 level, which is regulated by PI(4)P5-K and GqRs and that replenishing PI(4,5)P2 by PI(4)P5-K recovers IHERG.
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Affiliation(s)
- Taeko Kubo
- Department of Physiology, Shiga University of Medical Science, Shiga 520-2192, Japan; Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Shiga 520-2192, Japan; Preclinical Research Laboratories, Sumitomo Dainippon Pharma Co., Ltd, Osaka 554-0022, Japan
| | - Wei-Guang Ding
- Department of Physiology, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Futoshi Toyoda
- Department of Physiology, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Yusuke Fujii
- Department of Physiology, Shiga University of Medical Science, Shiga 520-2192, Japan; Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Mariko Omatsu-Kanbe
- Department of Physiology, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Hiroshi Matsuura
- Department of Physiology, Shiga University of Medical Science, Shiga 520-2192, Japan.
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20
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Abstract
Professor Gerhard Zbinden recognized in the 1970s that the standards of the day for testing new candidate drugs in preclinical toxicity studies failed to identify acute pharmacodynamic adverse events that had the potential to harm participants in clinical trials. From his vision emerged the field of safety pharmacology, formally defined in the International Conference on Harmonization (ICH) S7A guidelines as "those studies that investigate the potential undesirable pharmacodynamic effects of a substance on physiological functions in relation to exposure in the therapeutic range and above." Initially, evaluations of small-molecule pharmacodynamic safety utilized efficacy models and were an ancillary responsibility of discovery scientists. However, over time, the relationship of these studies to overall safety was reflected by the regulatory agencies who, in directing the practice of safety pharmacology through guidance documents, prompted transition of responsibility to drug safety departments (e.g., toxicology). Events that have further shaped the field over the past 15 years include the ICH S7B guidance, evolution of molecular technologies leading to identification of new therapeutic targets with uncertain toxicities, introduction of data collection using more sophisticated and refined technologies, and utilization of transgenic animal models probing critical scientific questions regarding novel targets of toxicity. The collapse of the worldwide economy in the latter half of the first decade of the twenty-first century, continuing high rates of compound attrition during clinical development and post-approval and sharply increasing costs of drug development have led to significant strategy changes, contraction of the size of pharmaceutical organizations, and refocusing of therapeutic areas of investigation. With these changes has come movement away from dedicated internal safety pharmacology capability to utilization of capabilities within external contract research organizations. This movement has created the opportunity for the safety pharmacology discipline to come "full circle" and return to the drug discovery arena (target identification through clinical candidate selection) to contribute to the mitigation of the high rate of candidate drug failure through better compound selection decision making. Finally, the changing focus of science and losses in didactic training of scientists in whole animal physiology and pharmacology have revealed a serious gap in the future availability of qualified individuals to apply the principles of safety pharmacology in support of drug discovery and development. This is a significant deficiency that at present is only partially met with academic and professional society programs advancing a minimal level of training. In summary, with the exception that the future availability of suitably trained scientists is a critical need for the field that remains to be effectively addressed, the prospects for the future of safety pharmacology are hopeful and promising, and challenging for those individuals who want to assume this responsibility. What began in the early part of the new millennium as a relatively simple model of testing to assure the safety of Phase I clinical subjects and patients from acute deleterious effects on life-supporting organ systems has grown with experience and time to a science that mobilizes the principles of cellular and molecular biology and attempts to predict acute adverse events and those associated with long-term treatment. These challenges call for scientists with a broad range of in-depth scientific knowledge and an ability to adapt to a dynamic and forever changing industry. Identifying individuals who will serve today and training those who will serve in the future will fall to all of us who are committed to this important field of science.
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21
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Availability of human induced pluripotent stem cell-derived cardiomyocytes in assessment of drug potential for QT prolongation. Toxicol Appl Pharmacol 2014; 278:72-7. [DOI: 10.1016/j.taap.2014.04.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/18/2014] [Accepted: 04/05/2014] [Indexed: 11/20/2022]
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22
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Nakamura Y, Matsuo J, Miyamoto N, Ojima A, Ando K, Kanda Y, Sawada K, Sugiyama A, Sekino Y. Assessment of testing methods for drug-induced repolarization delay and arrhythmias in an iPS cell-derived cardiomyocyte sheet: multi-site validation study. J Pharmacol Sci 2014; 124:494-501. [PMID: 24694996 DOI: 10.1254/jphs.13248fp] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
A prospective comparison study across 3 independent research laboratories of a pure IKr blocker E-4031 was conducted by using the same batch of human iPS cell-derived cardiomyocytes in order to verify the utility and reliability of our original standard protocol. Field potential waveforms were recorded with a multi-electrode array system to measure the inter-spike interval and field potential duration. The effects of E-4031 at concentrations of 1 to 100 nM were sequentially examined every 10 min. In each facility, E-4031 significantly prolonged the field potential duration corrected by Fridericia's formula and caused early afterdepolarizations occasionally resulting in triggered activities, whereas it tended to decrease the rate of spontaneous contraction. These results were qualitatively and quantitatively consistent with previous non-clinical in vitro and in vivo studies as well as clinical reports. There were inter-facility differences in some absolute values of the results, which were not observed when the values were normalized as percentage change. Information described in this paper may serve as a guide when predicting the drug-induced repolarization delay and arrhythmias with this new technology of stem cells.
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Affiliation(s)
- Yuji Nakamura
- Department of Pharmacology, Faculty of Medicine, Toho University, Japan
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23
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Chain ASY, Sturkenboom MCJM, Danhof M, Della Pasqua OE. Establishing in vitro to clinical correlations in the evaluation of cardiovascular safety pharmacology. DRUG DISCOVERY TODAY. TECHNOLOGIES 2013; 10:e373-e383. [PMID: 24050134 DOI: 10.1016/j.ddtec.2012.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Preclinical studies are vital in establishing the efficacy and safety of a new chemical entity (NCE) in humans. To deliver meaningful information, experiments have to be well defined and provide outcome that is relevant and translatable to humans. This review briefly surveys the various preclinical experiments that are frequently conducted to assess drug effects on cardiac conductivity in early drug development. We examine the different approaches used to establish correlations between non-clinical and clinical settings and discuss their value in the evaluation of cardiovascular risk.
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24
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Jahnke HG, Steel D, Fleischer S, Seidel D, Kurz R, Vinz S, Dahlenborg K, Sartipy P, Robitzki AA. A novel 3D label-free monitoring system of hES-derived cardiomyocyte clusters: a step forward to in vitro cardiotoxicity testing. PLoS One 2013; 8:e68971. [PMID: 23861955 PMCID: PMC3704625 DOI: 10.1371/journal.pone.0068971] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 06/03/2013] [Indexed: 11/18/2022] Open
Abstract
Unexpected adverse effects on the cardiovascular system remain a major challenge in the development of novel active pharmaceutical ingredients (API). To overcome the current limitations of animal-based in vitro and in vivo test systems, stem cell derived human cardiomyocyte clusters (hCMC) offer the opportunity for highly predictable pre-clinical testing. The three-dimensional structure of hCMC appears more representative of tissue milieu than traditional monolayer cell culture. However, there is a lack of long-term, real time monitoring systems for tissue-like cardiac material. To address this issue, we have developed a microcavity array (MCA)-based label-free monitoring system that eliminates the need for critical hCMC adhesion and outgrowth steps. In contrast, feasible field potential derived action potential recording is possible immediately after positioning within the microcavity. Moreover, this approach allows extended observation of adverse effects on hCMC. For the first time, we describe herein the monitoring of hCMC over 35 days while preserving the hCMC structure and electrophysiological characteristics. Furthermore, we demonstrated the sensitive detection and quantification of adverse API effects using E4031, doxorubicin, and noradrenaline directly on unaltered 3D cultures. The MCA system provides multi-parameter analysis capabilities incorporating field potential recording, impedance spectroscopy, and optical read-outs on individual clusters giving a comprehensive insight into induced cellular alterations within a complex cardiac culture over days or even weeks.
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Affiliation(s)
- Heinz-Georg Jahnke
- Center for Biotechnology and Biomedicine (BBZ), Molecular Biological-Biochemical Processing Tecnology, Leipzig, Germany
| | | | - Stephan Fleischer
- Center for Biotechnology and Biomedicine (BBZ), Molecular Biological-Biochemical Processing Tecnology, Leipzig, Germany
| | - Diana Seidel
- Center for Biotechnology and Biomedicine (BBZ), Molecular Biological-Biochemical Processing Tecnology, Leipzig, Germany
| | - Randy Kurz
- Center for Biotechnology and Biomedicine (BBZ), Molecular Biological-Biochemical Processing Tecnology, Leipzig, Germany
| | - Silvia Vinz
- Center for Biotechnology and Biomedicine (BBZ), Molecular Biological-Biochemical Processing Tecnology, Leipzig, Germany
| | | | - Peter Sartipy
- Cellectis Stem Cells, Cellartis AB, Göteborg, Sweden
| | - Andrea A. Robitzki
- Center for Biotechnology and Biomedicine (BBZ), Molecular Biological-Biochemical Processing Tecnology, Leipzig, Germany
- * E-mail:
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Authier S, Vargas HM, Curtis MJ, Holbrook M, Pugsley MK. Safety pharmacology investigations in toxicology studies: An industry survey. J Pharmacol Toxicol Methods 2013; 68:44-51. [DOI: 10.1016/j.vascn.2013.05.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 04/30/2013] [Accepted: 05/06/2013] [Indexed: 10/26/2022]
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Harris K, Aylott M, Cui Y, Louttit JB, McMahon NC, Sridhar A. Comparison of Electrophysiological Data From Human-Induced Pluripotent Stem Cell–Derived Cardiomyocytes to Functional Preclinical Safety Assays. Toxicol Sci 2013; 134:412-26. [DOI: 10.1093/toxsci/kft113] [Citation(s) in RCA: 177] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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27
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Honda M, Kiyokawa J, Tabo M, Inoue T. Electrophysiological characterization of cardiomyocytes derived from human induced pluripotent stem cells. J Pharmacol Sci 2011; 117:149-59. [PMID: 22027094 DOI: 10.1254/jphs.11038fp] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Cardiomyocytes derived from human induced pluripotent stem cells (hiPS-CMs) hold great promise for development of in vitro research tools to assess cardiotoxicity, including QT prolongation. In the present study, we aimed to clarify the electrophysiological/pharmacological characteristics of hiPS-CMs using the patch-clamp technique. The hiPS cells were differentiated into beating cardiomyocytes by the embryoid body method. The expression of genes related to cardiac ion channels and differentiation markers in cardiomyocytes were detected by RT-PCR. Whole-cell patch-clamp recordings were performed using single hiPS-CMs dispersed from beating colonies. We confirmed voltage-dependence of major cardiac ion currents (I(Na), I(Ca), I(Kr), and I(Ks)) and pharmacological responses to ion-channel blockers. Action potential duration (APD) was prolonged by both I(Kr)/hERG and I(Ks) blockers, whereas it was shortened by an I(Ca) blocker, indicating that these ion current components contribute to action potential generation in hiPS-CMs. As for multiple ion channel blockers, terfenadine prolonged APD, but verapamil did not, results which were identical to clinically relevant pharmacological responses. These data suggest that patch-clamp assay using hiPS-CMs could be an accurate method of predicting the human cardiac responses to drug candidates. This study would be helpful in establishing an electrophysiological assay to assess the risk of drug-induced arrhythmia using hiPS-CMs.
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Affiliation(s)
- Masaki Honda
- Safety Assessment Department, Chugai Pharmaceutical Co., Ltd., 1-135 Komakado, Gotemba, Shizuoka 412-8513, Japan.
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Bass AS, Vargas HM, Valentin JP, Kinter LB, Hammond T, Wallis R, Siegl PK, Yamamoto K. Safety pharmacology in 2010 and beyond: Survey of significant events of the past 10years and a roadmap to the immediate-, intermediate- and long-term future in recognition of the tenth anniversary of the Safety Pharmacology Society. J Pharmacol Toxicol Methods 2011; 64:7-15. [DOI: 10.1016/j.vascn.2011.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 05/19/2011] [Indexed: 11/29/2022]
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Redfern WS, Valentin JP. Trends in safety pharmacology: Posters presented at the annual meetings of the Safety Pharmacology Society 2001–2010. J Pharmacol Toxicol Methods 2011; 64:102-10. [DOI: 10.1016/j.vascn.2011.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 05/13/2011] [Indexed: 01/01/2023]
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30
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Yamamoto K. [Nonclinical prediction and clinical evaluation of drug-induced QT prolongation]. Nihon Yakurigaku Zasshi 2010; 136:160-163. [PMID: 20838019 DOI: 10.1254/fpj.136.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Valentin JP. Reducing QT liability and proarrhythmic risk in drug discovery and development. Br J Pharmacol 2010; 159:5-11. [PMID: 20141515 PMCID: PMC2823346 DOI: 10.1111/j.1476-5381.2009.00547.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Revised: 09/22/2009] [Accepted: 09/23/2009] [Indexed: 11/25/2022] Open
Abstract
Drug-induced torsades de pointes (TdP), a rare, life-threatening, polymorphic, ventricular tachycardia associated with prolongation of the QT interval, has been the main safety reason for the withdrawal of medicines from clinical use over the last decade. Most often, drugs that prolong the action potential and delay ventricular repolarization do so through blockade of outward (repolarizing) currents, predominantly the rapid delayed rectifying potassium current, I(Kr). While QT interval prolongation is not a safety concern per se, in a small percentage of people, it has been associated with TdP, which either spontaneously terminates or degenerates into ventricular fibrillation. Furthermore, recent data suggest that shortening of the QT interval may also be a new safety issue waiting to surface. This review article summarizes the presentations given at a symposium entitled 'Reducing QT liability and proarrhythmic risk in drug discovery and development', which was part of the Federation of the European Pharmacological Societies congress, Manchester, UK, 13-17 July 2008. The objective of this symposium was to assess the effects of implementing the latest regulatory guidance documents (International Conference on Harmonization S7A/B and E14), as well as new scientific and technical trends on the ability of the pharmaceutical industry to reduce and manage the QT liability and associated potential proarrhythmic risk, and contribute to the discovery and development of safer medicines. This review outlines the key messages from communications presented at this symposium and attempts to highlight some of the key challenges that remain to be addressed.
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Tabo M, Komatsu R, Isobe T, Honda M, Yamada Y, Kimura K. Accurate detection of drug-induced delayed ventricular repolarization with a suitable correction formula in Langendorff guinea pig heart. J Toxicol Sci 2010; 35:687-98. [DOI: 10.2131/jts.35.687] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Mitsuyasu Tabo
- Safety Assessment Department, Chugai Pharmaceutical Co., Ltd
| | - Ryuichi Komatsu
- Safety Assessment Department, Chugai Pharmaceutical Co., Ltd
| | - Takehito Isobe
- Safety Assessment Department, Chugai Pharmaceutical Co., Ltd
| | - Masaki Honda
- Safety Assessment Department, Chugai Pharmaceutical Co., Ltd
| | - Yuichiro Yamada
- Safety Assessment Department, Chugai Pharmaceutical Co., Ltd
| | - Kazuya Kimura
- Safety Assessment Department, Chugai Pharmaceutical Co., Ltd
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Age-related differences of QT interval and autonomic nervous system activity in female cynomolgus monkeys. J Pharmacol Toxicol Methods 2009; 60:288-95. [DOI: 10.1016/j.vascn.2009.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Accepted: 06/29/2009] [Indexed: 11/20/2022]
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34
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Yao JA, Feldman HS, Illenberger A, Littell T, Schnee L, Yates D. Evaluation of electrocardiograms recorded in cynomolgus monkeys with short- and long-term intracardiac lead implantations. J Pharmacol Toxicol Methods 2009; 60:185-92. [DOI: 10.1016/j.vascn.2009.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Accepted: 05/26/2009] [Indexed: 10/20/2022]
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35
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Valentin JP, Bialecki R, Ewart L, Hammond T, Leishmann D, Lindgren S, Martinez V, Pollard C, Redfern W, Wallis R. A framework to assess the translation of safety pharmacology data to humans. J Pharmacol Toxicol Methods 2009; 60:152-8. [DOI: 10.1016/j.vascn.2009.05.011] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Accepted: 05/05/2009] [Indexed: 11/16/2022]
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Abi-Gerges N, Valentin JP, Pollard CE. Dog left ventricular midmyocardial myocytes for assessment of drug-induced delayed repolarization: short-term variability and proarrhythmic potential. Br J Pharmacol 2009; 159:77-92. [PMID: 19663882 DOI: 10.1111/j.1476-5381.2009.00338.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND AND PURPOSE Evaluation of the potential for delayed ventricular repolarization and proarrhythmia by new drugs is essential. We investigated if dog left ventricular midmyocardial myocytes (LVMMs) that can be used as a preclinical model to assess drug effects on action potential duration (APD) and whether in these cells, short-term variability (STV) or triangulation could predict proarrhythmic potential. EXPERIMENTAL APPROACH Beagle LVMMs and Purkinje fibres (PFs) were used to record APs. Effects of six reference drugs were assessed on APD at 50% (APD(50)) and 90% (APD(90)) of repolarization, STV(APD), triangulation (ratio APD(90)/APD(50)) and incidence of early afterdepolarizations (EADs) at 1 and 0.5 Hz. KEY RESULTS LVMMs provided stable recordings of AP, which were not affected by four sequential additions of dimethyl sulphoxide. Effects of dofetilide, d-sotalol, cisapride, pinacidil and diltiazem, but not of terfenadine, on APD in LVMMs were found to be comparable with those recorded in PFs. LVMMs, but not PFs, exhibited a proarrhythmic response to I(Kr) blockers. Incidence of EADs was not related to differences in AP prolongation or triangulation, but corresponded to beat-to-beat variability of repolarization, here quantified as STV of APD. CONCLUSIONS AND IMPLICATIONS LVMMs provide a suitable preclinical model to assess the effects of new drugs on APD and also yield additional information about putative indicators of proarrhythmia that add value to an integrated QT/TdP risk assessment. Our findings support the concept that increased STV(APD) may predict drug-induced proarrhythmia.
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Affiliation(s)
- Najah Abi-Gerges
- Safety Pharmacology Department, Safety Assessment UK, AstraZeneca R&D, Mereside, Alderley Park, Macclesfield, Cheshire, UK.
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Chui RW, Fosdick A, Conner R, Jiang J, Bruenner BA, Vargas HM. Assessment of two external telemetry systems (PhysioJacket™ and JET™) in beagle dogs with telemetry implants. J Pharmacol Toxicol Methods 2009; 60:58-68. [DOI: 10.1016/j.vascn.2009.04.196] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Accepted: 04/28/2009] [Indexed: 10/20/2022]
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Ishizaka T, Yoshimatsu Y, Ozawa M, Kimotsuki T, Takasaki W, Manabe S, Yasuda M. Evaluation of drug-induced QT prolongation in a halothane-anesthetized monkey model: effects of sotalol. J Pharmacol Toxicol Methods 2009; 59:86-93. [PMID: 19367688 DOI: 10.1016/j.vascn.2009.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Cynomolgus monkeys are used in in vivo models of safety pharmacological studies to evaluate the effects of drug candidates on the cardiovascular system. Models using halothane-anesthetized animals have been used for the detection of drug-induced QT interval prolongation, but few studies with anesthetized monkeys have been reported. METHODS The electrophysiological changes induced by dl-sotalol, a representative class III antiarrhythmic drug, were assessed in halothane-anesthetized monkeys (n = 4) or conscious and unrestrained monkeys (n = 4). RESULTS In terms of basal characteristics, the QT interval was longer and the heart rate (HR) was lower under anesthesia than those under conscious conditions. Intravenous administration of 0.1 to 3 mg/kg dl-sotalol to anesthetized monkeys decreased the HR and prolonged the QT interval, monophasic action potential (MAP) duration and ventricular effective refractory period in a dose-dependent manner. In addition, reverse use-dependent prolongation of MAP duration was detected by electrical pacing, whereas the terminal repolarization period was hardly affected at any dose. Oral administration of 3 to 30 mg/kg dl-sotalol to conscious monkeys also decreased the HR and prolonged the QT interval in a dose-dependent manner. When compared at similar plasma concentrations of sotalol, the extent of QT interval prolongation under halothane anesthesia was equal to or greater than that under conscious conditions. DISCUSSION The sensitivity for detection of drug-induced QT prolongation under halothane anesthesia may be satisfactory compared with that under conscious conditions. The present examinations indicated the usefulness of a model using halothane-anesthetized monkeys for evaluation of drug-induced QT interval prolongation.
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Affiliation(s)
- Tomomichi Ishizaka
- Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd., 717 Horikoshi, Fukuroi, Shizuoka 437-0065, Japan.
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Trepakova ES, Koerner J, Pettit SD, Valentin JP. A HESI consortium approach to assess the human predictive value of non-clinical repolarization assays. J Pharmacol Toxicol Methods 2009; 60:45-50. [PMID: 19439186 DOI: 10.1016/j.vascn.2009.05.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Accepted: 04/22/2009] [Indexed: 11/18/2022]
Abstract
Drug-induced ventricular arrhythmia and Torsades de Pointes remain a serious public health issues in bringing safe new pharmaceuticals to the market place. Under the auspices of the International Life Science Institute (ILSI)-Health and Environmental Sciences Institute (HESI), a consortium involving representatives from pharmaceutical companies, regulatory agencies and opinion leaders from the scientific and medical research communities has been initiated. The objectives are (1) to assess the concordance between signals in non-clinical repolarization assays and clinical QT interval prolongation; (2) to investigate the mechanisms for any discrepancy identified between non-clinical and clinical results and to determine viable and successful alternative approaches to identify these compounds; and (3) to assess the proarrhythmic potential of such compounds. At present, the consortium is conducting a retrospective analysis of non-clinical and clinical data from both FDA and contributing companies' databases and supplementing with a literature review. The overall objectives of these initial efforts are to establish a quantitative integrated risk assessment for each compound; to define criteria for concordance and apply them to the database in order to identify non-concordant compounds.
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Affiliation(s)
- Elena S Trepakova
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, WP81-220, West Point, PA 19486, USA.
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Rock EP, Finkle J, Fingert HJ, Booth BP, Garnett CE, Grant S, Justice RL, Kovacs RJ, Kowey PR, Rodriguez I, Sanhai WR, Strnadova C, Targum SL, Tsong Y, Uhl K, Stockbridge N. Assessing proarrhythmic potential of drugs when optimal studies are infeasible. Am Heart J 2009; 157:827-36, 836.e1. [PMID: 19376308 DOI: 10.1016/j.ahj.2009.02.020] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 02/24/2009] [Indexed: 11/24/2022]
Abstract
Assessing the potential for a new drug to cause life-threatening arrhythmias is now an integral component of premarketing safety assessment. International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use Guideline (ICH) E14 recommends the "Thorough QT Study" (TQT) to assess clinical QT risk. Such a study calls for careful evaluation of drug effects on the electrocardiographic QT interval at multiples of therapeutic exposure and with a positive control to confirm assay sensitivity. Yet for some drugs and diseases, elements of the TQT Study may be impractical or unethical. In these instances, alternative approaches to QT risk assessment must be considered. This article presents points to consider for evaluation of QT risk when alternative approaches are needed.
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Tabo M, Hara T, Sone S, Shishido N, Kuramoto S, Nakano K, Onodera H, Kimura K, Kobayashi K. Prediction of drug-induced QT interval prolongation in telemetered common marmosets. J Toxicol Sci 2008; 33:315-25. [PMID: 18670163 DOI: 10.2131/jts.33.315] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Drug-induced QT interval prolongation is a critical issue in development of new chemical entities, so the pharmaceutical industry needs to evaluate risk as early as possible. Common marmosets have been in the limelight in early-stage development due to their small size, which requires only a small amount of test drug. The purpose of this study was to determine the utility of telemetered common marmosets for predicting drug-induced QT interval prolongation. Telemetry transmitters were implanted in common marmosets (male and female), and QT and RR intervals were measured. The QT interval was corrected for the RR interval by applying Bazett's and Fridericia's correction formulas and individual rate correction. Individual correction showed the least slope for the linear regression of corrected QT (QTc) intervals against RR intervals, indicating that it dissociated changes in heart rate most effectively. With the individual correction method, the QT-prolonging drugs (astemizole, dl-sotalol) showed QTc interval prolongations and the non-QT-prolonging drugs (dl-propranolol, nifedipine) did not show QTc interval prolongations. The plasma concentrations of astemizole and dl-sotalol associated with QTc interval prolongations in common marmosets were similar to those in humans, suggesting that the sensitivity of common marmosets would be appropriate for evaluating risk of drug-induced QT interval prolongation. In conclusion, telemetry studies in common marmosets are useful for predicting clinical QT prolonging potential of drugs in early stage development and require only a small amount of test drug.
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Affiliation(s)
- Mitsuyasu Tabo
- Safety Assessment Department, Research Division, Chugai Pharmaceutical Co., Ltd., Shizuoka.
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42
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Ishizaka T, Takahara A, Iwasaki H, Mitsumori Y, Kise H, Nakamura Y, Sugiyama A. Comparison of electropharmacological effects of bepridil and sotalol in halothane-anesthetized dogs. Circ J 2008; 72:1003-11. [PMID: 18503230 DOI: 10.1253/circj.72.1003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Bepridil is known to have a multiple ion channel-blocking property in the heart, which has been applied for the treatment of atrial fibrillation and drug-refractory ventricular tachyarrhythmias. In this study, the electro-pharmacological effects of bepridil were compared with those of dl-sotalol, a representative class III antiarrhythmic drug, using the halothane-anesthetized canine model. METHODS AND RESULTS Cardiovascular and electrophysiological variables were measured under the halothane anesthesia. Intravenous administration of bepridil (0.3 mg/kg, n=4) delayed the intraventricular conduction and prolonged the ventricular effective refractory period, whereas dl-sotalol (0.3 mg/kg, iv, n=4) inhibited atrioventricular conduction and prolonged the atrial and ventricular effective refractory period. The additional administration of 10 times the higher dose of bepridil or dl-sotalol (ie, 3 mg/kg, iv, n=4 for each group) decreased blood pressure, suppressed ventricular contraction and sinus automaticity, and prolonged the atrial and ventricular effective refractory period and monophasic action potential duration, in addition to the effects of the low dose. CONCLUSIONS The electropharmacological effects of bepridil and dl-sotalol were similar, although their potency for each cardiovascular variable varied significantly. These findings can be useful when selecting these drugs according to the pathophysiological condition of a patient.
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Affiliation(s)
- Tomomichi Ishizaka
- Department of Pharmacology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
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43
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Valentin JP, Hammond T. Safety and secondary pharmacology: Successes, threats, challenges and opportunities. J Pharmacol Toxicol Methods 2008; 58:77-87. [DOI: 10.1016/j.vascn.2008.05.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 05/19/2008] [Indexed: 12/15/2022]
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Benchmarking Safety Pharmacology regulatory packages and best practice. J Pharmacol Toxicol Methods 2008; 58:99-109. [DOI: 10.1016/j.vascn.2008.07.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Accepted: 07/06/2008] [Indexed: 10/21/2022]
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Bass AS, Darpo B, Valentin JP, Sager P, Thomas K. Moving towards better predictors of drug-induced torsades de pointes. Br J Pharmacol 2008; 154:1550-3. [PMID: 18574462 PMCID: PMC2492097 DOI: 10.1038/bjp.2008.215] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Revised: 05/06/2008] [Accepted: 05/09/2008] [Indexed: 12/19/2022] Open
Abstract
Drug-induced torsades de pointes (TdP) remains a significant public health concern that has challenged scientists who have the responsibility of advancing new medicines through development to the patient, while assuring public safety. As a result, from the point of discovering a new molecule to the time of its registration, significant efforts are made to recognize potential liabilities, including the potential for TdP. With this background, the ILSI (HESI) Proarrhythmia Models Project Committee recognized that there was little practical understanding of the relationship between drug effects on cardiac ventricular repolarization and the rare clinical event of TdP. A workshop was therefore convened at which four topics were considered including: Molecular and Cellular Biology Underlying TdP, Dynamics of Periodicity, Models of TdP Proarrhythmia and Key Considerations for Demonstrating Utility of Pre-Clinical Models. The series of publications in this special edition has established the background, areas of debate and those that deserve scientific pursuit. This is intented to encourage the research community to contribute to these important areas of investigation in advancing the science and our understanding of drug-induced proarrhythmia.
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Affiliation(s)
- A S Bass
- Drug Safety and Metabolism, Schering-Plough Research Institute, Kenilworth, NJ 07033-0539, USA.
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46
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Pugsley MK, Authier S, Curtis MJ. Principles of safety pharmacology. Br J Pharmacol 2008; 154:1382-99. [PMID: 18604233 PMCID: PMC2492105 DOI: 10.1038/bjp.2008.280] [Citation(s) in RCA: 146] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Revised: 06/09/2008] [Accepted: 06/12/2008] [Indexed: 11/09/2022] Open
Abstract
Safety Pharmacology is a rapidly developing discipline that uses the basic principles of pharmacology in a regulatory-driven process to generate data to inform risk/benefit assessment. The aim of Safety Pharmacology is to characterize the pharmacodynamic/pharmacokinetic (PK/PD) relationship of a drug's adverse effects using continuously evolving methodology. Unlike toxicology, Safety Pharmacology includes within its remit a regulatory requirement to predict the risk of rare lethal events. This gives Safety Pharmacology its unique character. The key issues for Safety Pharmacology are detection of an adverse effect liability, projection of the data into safety margin calculation and finally clinical safety monitoring. This article sets out to explain the drivers for Safety Pharmacology so that the wider pharmacology community is better placed to understand the discipline. It concludes with a summary of principles that may help inform future resolution of unmet needs (especially establishing model validation for accurate risk assessment). Subsequent articles in this issue of the journal address specific aspects of Safety Pharmacology to explore the issues of model choice, the burden of proof and to highlight areas of intensive activity (such as testing for drug-induced rare event liability, and the challenge of testing the safety of so-called biologics (antibodies, gene therapy and so on.).
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Affiliation(s)
- M K Pugsley
- Department of Toxicology & Pathology, Global Preclinical Development, Johnson & Johnson Pharmaceutical Research & Development Raritan, NJ, USA
| | - S Authier
- LAB Research Inc., 445 Armand Frappier, Laval Quebec, Canada
| | - M J Curtis
- Cardiovascular Division St Thomas' Hospital, King's College London, London, UK
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Safety evaluation to support First-In-Man investigations I: Kinetic and safety pharmacology studies. Regul Toxicol Pharmacol 2008; 51:230-6. [DOI: 10.1016/j.yrtph.2008.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Accepted: 04/11/2008] [Indexed: 11/18/2022]
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Hashimoto K. Torsades de pointes liability inter-model comparisons: the experience of the QT PRODACT initiative. Pharmacol Ther 2008; 119:195-8. [PMID: 18486227 DOI: 10.1016/j.pharmthera.2008.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Accepted: 03/10/2008] [Indexed: 11/18/2022]
Abstract
Safety pharmacologists from the Japanese pharmaceutical industries and contract laboratories made a database to evaluate drug effects on the QT interval in 2005. This QT PRODACT project was a prospective study of 12 QT-prolonging (positive) drugs and 10 non-prolonging (negative) drugs to evaluate the specificity and sensitivity of several in vivo and in vitro animal models: in vitro guinea pig papillary muscle action potential recordings and in vivo ECG recordings in unanesthetized or anesthetized beagle dogs, cynomolgus monkeys and miniature pigs. In guinea pig papillary muscle action potential recordings, positive drugs showed lengthening of the action potential duration (APD). By using a new measure to detect triangulation of the action potential configuration, an IKr blocking activity of drugs with Ca channel blocking action was detected. All in vivo studies showed a QT-prolonging effect of greater than 10% for the positive drugs. These in vivo models were useful to distinguish positive from negative drugs. The QT PRODACT project showed reliability and sensitivity of the experiments to detect positive drugs. The proarrhythmic effects of these positive drugs could not be detected even though, in some animal models (e.g., unanesthetized monkey), torsades de pointes (TdP)-type arrhythmias were shown by terfenadine. We compared in vivo arrhythmia models for proarrhythmia. The halothane-anesthetized open chest coronary occlusion-reperfusion canine model, the halothane-adrenaline arrhythmia model and the chronic AV block dog models seemed to be useful to detect the arrhythmogenic potential of QT-prolonging drugs.
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Affiliation(s)
- Keitaro Hashimoto
- Department of Clinical Pharmacology, Yokohama College of Pharmacy, 601, Matano-cho, Totsuka-ku, Yokohama, 245-0066 Japan.
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Tabo M, Komatsu R, Honda M, Itoh M, Kimura K. Cardiovascular safety profile of MA-2029, a novel motilin receptor antagonist. J Toxicol Sci 2008; 33:631-9. [DOI: 10.2131/jts.33.631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Mitsuyasu Tabo
- Fuji Gotemba Research Laboratories, Chugai Pharmaceutical Co., Ltd
| | - Ryuichi Komatsu
- Fuji Gotemba Research Laboratories, Chugai Pharmaceutical Co., Ltd
| | - Masaki Honda
- Fuji Gotemba Research Laboratories, Chugai Pharmaceutical Co., Ltd
| | - Misae Itoh
- Fuji Gotemba Research Laboratories, Chugai Pharmaceutical Co., Ltd
| | - Kazuya Kimura
- Fuji Gotemba Research Laboratories, Chugai Pharmaceutical Co., Ltd
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50
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Yamamoto K. [Pharmacology studies]. Nihon Yakurigaku Zasshi 2007; 130:299-303. [PMID: 17938516 DOI: 10.1254/fpj.130.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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