Effects of combined netupitant and palonosetron (NEPA), a cancer supportive care antiemetic, on the ECG of healthy subjects: an ICH E14 thorough QT trial
2014
Chemotherapy-induced nauseaand
vomitingis ranked among the worst side effects of chemotherapy. NEPA is an oral
fixed-dose combination
antiemeticunder development, consisting of
netupitant300 mg, a highly selective
NK1 receptor antagonist(RA), and
palonosetron0.5 mg, a pharmacologically and clinically distinct 5-HT3 RA. Although
palonosetronis not associated with relevant ECG effects, this study evaluated cardiovascular safety of
netupitantin combination with
palonosetron, as well as its tolerability. This randomised, placebo- and positively controlled study in 197 subjects included 4 treatment groups: placebo, 200 mg
netupitant+ 0.5 mg
palonosetron(NEPA200/0.5), 600 mg
netupitant+ 1.5 mg
palonosetron(NEPA600/1.5, a supratherapeutic dose), and 400 mg
moxifloxacin. Assessments included a 24-h baseline ECG recording, followed by a single dose of treatment and ECG measurements for 2 days. Mean placebo-corrected time-averaged changes from baseline were similar in NEPA200/0.5 and NEPA600/1.5 groups primarily for individually heart rate-corrected
QT interval(QTcI: +4.7 and +3.6 ms, respectively) and for heart rate (HR: –3.3 bpm and –3.0 bpm),
PR interval(–0.4 ms and 0.2 ms), and QRS interval (1 ms and 0.5 ms). The time-matched analysis showed no upper confidence interval >10 ms, with no suggestion of a QTc effect by pharmacokinetic-pharmacodynamic modeling for parent/metabolites.
Moxifloxacinshowed the expected placebo-corrected change from baseline (+8.4 ms time average) and the expected profile to establish
assay sensitivity. No new morphologic changes of clinical relevance were observed. Treatment-related adverse events were comparable among groups. This study showed that NEPA treatments produced no significant effects on QTcI, HR,
PR interval, QRS interval, and cardiac morphology relative to placebo, even at supratherapeutic doses.
Keywords:
-
Correction
-
Source
-
Cite
-
Save
39
References
23
Citations
NaN
KQI