ecg sensitivity evaluation of d,l-sotalol and moxifloxacin in telemetry implanted beagles using an...

1
These ndings are consistent with previously reported data over non-continuous periods in canines (Cools et al.) and NHP's (Chui et al.) suggesting that a single 24 h assessment period may be insufcient to determine arrhythmia background for a subject. Although additional investigation is necessary, this data may help better understand the volume of data needed to establish the normal frequency and type of inherent arrhythmia for a subject. A best practice recommendation is to determine the background arrhyth- mia rate in each telemetry subject to aid more accurate interpreta- tion of potential proarrhythmic properties of new test articles. doi:10.1016/j.vascn.2013.01.123 118 Correlation of cardiovascular parameters with troponin levels following isoproteronol administration to dogs Peter Harris a , Jason Cordes a , Jill Steidl-Nichols a , William Reagan a,b , Richard Goldstein a,b , Richard Giovanelli a,b , Sandra Summers a,b , Todd Wisialowski a a Global Safety Pharmacology, Pzer, Groton, CT, USA b Biomarkers, Pzer, Groton, CT, USA Evaluation of biomarkers related to cardiac damage is an important part of cardiovascular safety assessment of a compound during development. This study used the beta agonist isoproterenol to induce hemodynamic and ECG changes that were likely to cause increased serum cardiac troponin I (cTnI) concentrations to better understand the relationship between routine safety pharmacology endpoints and troponin as well as other cardiac biomarkers. Telemetry instrumented Beagle dogs were dosed subcutaneously with isoproterenol 1.00.001 mg/kg in decreasing log increments followed by 48 h of telemetry collection to measure ECG, blood pressure (BP), and left ventricular pressure (LVP with derived+dP/dt). Blood samples were collected predose, 4, 7, 24, 48, 72, and 148 h postdose (hpd) for assessment of cTnI and other related biomarkers. Isoproterenol induced dose dependent increases in cTnI, heart rate, and LVP with a marked decrease in BP. Heart rate and + dP/dt increased ~100 bpm and 6000 mmHg/s respectively, following 1.0 and 0.1 mg/kg isoproterenol. The magnitude and duration of effect were less at lower doses. Peak cTnI levels were 80, 10, and 2 ng/ml and occurred between 4 and 7 hpd with isoproterenol at doses of 1.0, 0.1, and 0.01, respectively. Increases in cardiac troponin T, aspartate aminotransferase, and creatine kinase typically occurred with a similar timing to the cTnI peak response. Fatty acid binding protein 3 and myosin light chain 3 typically peaked at 4 and 24 h, respectively. In conclusion, cTnI is a measurable biomarker of cardiac damage that correlates well with other standard cardiovascular measured endpoints. doi:10.1016/j.vascn.2013.01.124 119 Comparison of cardiovascular parameter sensitivities in telemeterized rhesus versus cynomolgus monkeys Lisa Fitzgerald, Patrick Fanelli, Michael Magee, William Keller, David Reynolds, Min Deng, Tara Grady-Styring, Holly McPherson, Jude Ferraro, Ivy Garnkel, Alysia Chaves, Chao-Min Hoe, Gregory Friedrichs, Kimberly Hoagland Merck & Co., Inc., West Point, PA, USA Safety pharmacology models using conscious unrestrained non- human primates (NHPs) with implanted biotelemetry devices are recommended by ICH S7A/S7B guidelines to evaluate the cardiovascular effects of new chemical entities (NCEs), as they allow for long-term monitoring of hemodynamic and ECG parameters under low-stress homeostatic conditions. We characterized baseline cardiovascular proles in telemetered rhesus and cynomolgus monkeys and conducted power analyses using data from both strains of NHPs. In addition, we evaluated oral doses of dl-sotalol (known hERG channel blocker) in both strains and compared sensitivities for detecting changes in QT/QTc interval. Furthermore, a number of correction formulas were assessed for evaluating QT interval independent of heart rate variation. Prominent circadian rhythms for blood pressure (BP), heart rate (HR), QT interval and body temperature were evident in both rhesus and cynomolgus monkeys. HRs in rhesus monkeys were 2050 bpm lower (QT interval values 15 to 30 ms higher) than in cynomolgus monkeys, with longer PR intervals (1520%) observed in cynomolgus monkeys. Dose-related increases in QTc interval after dl-sotalol administration were observed in both strains of NHPs, conrming that both models are valid for preclinical cardiovascular evaluations. Power analyses showed that statistical power to detect changes in QT/QTc interval is slightly higher in rhesus monkeys, which may be a consequence of HR and behavioral differences between NHP strains. Collectively, we demonstrated that both rhesus and cynomolgus monkey telemetry models can detect relatively small, but biologi- cally relevant, changes in QT/QTc interval for making decisions regarding the cardiovascular safety of NCEs. doi:10.1016/j.vascn.2013.01.125 120 ECG sensitivity evaluation of d,l-sotalol and moxioxacin in telemetry implanted beagles using an IV solid tip ECG lead conguration Andrea Z. Mitchell, Andrew J. Bills, John J. Kremer, C. Michael Foley, Mark A. Osinski Covance Laboratories Inc., Madison, WI, USA Dogs are commonly used to evaluate cardiovascular drug effects using radiotelemetry. Mainstream telemetry models include ECG lead placements subcutaneously on the thorax or on the epicardium in a lead 2 conguration. In this study, the negative ECG lead (solid tip) was placed in the right jugular vein and the positive lead onto the abdominal side of the diaphragm. Dogs were given two ECG-active reference drugs via oral gavage and telemetry data were collected continuously for 25 h postdose. Using a double Latin Square (dLS) design, 8 dogs received dose levels of 0, 8, 16, and 32 mg/kg d,l-sotalol. Using a parallel design (PD), 24 dogs (n = 6/group) received dose levels 0, 10, 30, and 100 mg/kg of moxioxacin: data were analyzed by two approaches: 4 groups (4 × 4; n = 4/group) or 3 groups (3 × 6; n = 6/group; 0, 30, 100 mg/kg). Retrospective power analysis (RPA) was performed for each analysis. Parameters evaluated were PR, QRS, QT, QTc (individual animal based, Fridericia, Bazett, and Van de Water corrections) intervals, heart rate, and blood pressures. Sotalol elicited signicant effects on all parameters at all dose levels. Moxioxacin produced signicant effects on QT and QTc at 100 mg/kg using the 4 × 4 PD and at 30 and 100 mg/kg using the 3×6 PD. RPA indicated highest sensitivity for the sotalol dLS design, and higher sensitivity for the 3×6 than the 4×4 moxioxacin PD. In conclusion, the IV solid tip lead conguration yields high sensitivity to drug-induced changes in radiotelemetry studies. doi:10.1016/j.vascn.2013.01.126 Abstracts e34

Upload: mark-a

Post on 30-Dec-2016

215 views

Category:

Documents


3 download

TRANSCRIPT

Page 1: ECG sensitivity evaluation of d,l-sotalol and moxifloxacin in telemetry implanted beagles using an IV solid tip ECG lead configuration

These findings are consistent with previously reported data overnon-continuous periods in canines (Cools et al.) and NHP's (Chuiet al.) suggesting that a single 24 h assessment period may beinsufficient to determine arrhythmia background for a subject.Although additional investigation is necessary, this data may helpbetter understand the volume of data needed to establish the normalfrequency and type of inherent arrhythmia for a subject. A bestpractice recommendation is to determine the background arrhyth-mia rate in each telemetry subject to aid more accurate interpreta-tion of potential proarrhythmic properties of new test articles.

doi:10.1016/j.vascn.2013.01.123

118

Correlation of cardiovascular parameters with troponin levelsfollowing isoproteronol administration to dogsPeter Harrisa, Jason Cordesa, Jill Steidl-Nicholsa, William Reagana,b,Richard Goldsteina,b, Richard Giovanellia,b,Sandra Summersa,b, Todd Wisialowskia

aGlobal Safety Pharmacology, Pfizer, Groton, CT, USAbBiomarkers, Pfizer, Groton, CT, USA

Evaluation of biomarkers related to cardiac damage is an importantpart of cardiovascular safety assessment of a compound duringdevelopment. This study used the beta agonist isoproterenol to inducehemodynamic and ECG changes that were likely to cause increasedserum cardiac troponin I (cTnI) concentrations to better understand therelationship between routine safety pharmacology endpoints andtroponin as well as other cardiac biomarkers. Telemetry instrumentedBeagle dogs were dosed subcutaneously with isoproterenol 1.0–0.001 mg/kg in decreasing log increments followedby 48 h of telemetrycollection to measure ECG, blood pressure (BP), and left ventricularpressure (LVP with derived+dP/dt). Blood samples were collectedpredose, 4, 7, 24, 48, 72, and 148 h postdose (hpd) for assessment ofcTnI and other related biomarkers. Isoproterenol induced dosedependent increases in cTnI, heart rate, and LVP with a markeddecrease in BP. Heart rate and+dP/dt increased ~100 bpm and6000 mmHg/s respectively, following 1.0 and 0.1 mg/kg isoproterenol.The magnitude and duration of effect were less at lower doses. PeakcTnI levels were 80, 10, and 2 ng/ml and occurred between 4 and 7 hpdwith isoproterenol at doses of 1.0, 0.1, and 0.01, respectively. Increasesin cardiac troponin T, aspartate aminotransferase, and creatine kinasetypically occurredwith a similar timing to the cTnI peak response. Fattyacid binding protein 3 and myosin light chain 3 typically peaked at 4and 24 h, respectively. In conclusion, cTnI is a measurable biomarker ofcardiac damage that correlates well with other standard cardiovascularmeasured endpoints.

doi:10.1016/j.vascn.2013.01.124

119

Comparison of cardiovascular parameter sensitivities intelemeterized rhesus versus cynomolgus monkeysLisa Fitzgerald, Patrick Fanelli, Michael Magee, William Keller,David Reynolds, Min Deng, Tara Grady-Styring, Holly McPherson,Jude Ferraro, Ivy Garfinkel, Alysia Chaves, Chao-Min Hoe,Gregory Friedrichs, Kimberly Hoagland

Merck & Co., Inc., West Point, PA, USA

Safety pharmacology models using conscious unrestrained non-human primates (NHPs) with implanted biotelemetry devices arerecommendedby ICHS7A/S7B guidelines to evaluate the cardiovasculareffects of new chemical entities (NCEs), as they allow for long-termmonitoring of hemodynamic and ECG parameters under low-stresshomeostatic conditions. We characterized baseline cardiovascularprofiles in telemetered rhesus and cynomolgusmonkeys and conductedpower analyses using data from both strains of NHPs. In addition, weevaluated oral doses of dl-sotalol (known hERG channel blocker) inboth strains and compared sensitivities for detecting changes in QT/QTcinterval. Furthermore, a number of correction formulas were assessedfor evaluating QT interval independent of heart rate variation.

Prominent circadian rhythms for blood pressure (BP), heart rate(HR), QT interval and body temperature were evident in both rhesusand cynomolgus monkeys. HRs in rhesus monkeys were 20–50 bpmlower (QT interval values 15 to 30 ms higher) than in cynomolgusmonkeys, with longer PR intervals (15–20%) observed in cynomolgusmonkeys. Dose-related increases in QTc interval after dl-sotaloladministration were observed in both strains of NHPs, confirmingthat both models are valid for preclinical cardiovascular evaluations.Power analyses showed that statistical power to detect changes inQT/QTc interval is slightly higher in rhesus monkeys, which may be aconsequence of HR and behavioral differences between NHP strains.Collectively, we demonstrated that both rhesus and cynomolgusmonkey telemetry models can detect relatively small, but biologi-cally relevant, changes in QT/QTc interval for making decisionsregarding the cardiovascular safety of NCEs.

doi:10.1016/j.vascn.2013.01.125

120

ECG sensitivity evaluation of d,l-sotalol and moxifloxacinin telemetry implanted beagles using an IV solid tip ECGlead configurationAndrea Z. Mitchell, Andrew J. Bills, John J. Kremer,C. Michael Foley, Mark A. Osinski

Covance Laboratories Inc., Madison, WI, USA

Dogs are commonly used to evaluate cardiovascular drug effectsusing radiotelemetry. Mainstream telemetry models include ECG leadplacements subcutaneously on the thorax or on the epicardium in a lead2 configuration. In this study, the negative ECG lead (solid tip) wasplaced in the right jugular vein and the positive lead onto the abdominalside of the diaphragm. Dogs were given two ECG-active reference drugsvia oral gavage and telemetry data were collected continuously for 25 hpostdose. Using a double Latin Square (dLS) design, 8 dogs receiveddose levels of 0, 8, 16, and 32 mg/kg d,l-sotalol. Using a parallel design(PD), 24 dogs (n=6/group) receiveddose levels 0, 10, 30, and100 mg/kgof moxifloxacin: data were analyzed by two approaches: 4 groups(4×4; n=4/group) or 3 groups (3×6; n=6/group; 0, 30, 100 mg/kg).Retrospective power analysis (RPA) was performed for each analysis.Parameters evaluated were PR, QRS, QT, QTc (individual animal based,Fridericia, Bazett, and Van de Water corrections) intervals, heart rate,and blood pressures. Sotalol elicited significant effects on all parametersat all dose levels. Moxifloxacin produced significant effects on QT andQTc at 100 mg/kg using the 4×4 PD and at 30 and 100 mg/kg using the3×6 PD. RPA indicated highest sensitivity for the sotalol dLS design,and higher sensitivity for the 3×6 than the 4×4 moxifloxacin PD. Inconclusion, the IV solid tip lead configuration yields high sensitivity todrug-induced changes in radiotelemetry studies.

doi:10.1016/j.vascn.2013.01.126

Abstractse34