Wu, Fan, Heimbach, Tycho, Hatsis, Panagiotis, Tang, Hai-Ming, Dugyala, Raviprakash, Yue, Qin, Wang, Tao and He, Handan (2017) Integrated TK–TD modeling for drug-induced concurrent tachycardia and QT changes in beagle dogs. Journal of Pharmacokinetics and Pharmacodynamics. pp. 1-14. ISSN 15738744

Abstract

Drug-induced cardiotoxicity, including tachycardia and QT prolongation, remains a major safety concern that needs to be identified and its risk mitigated in early stages of drug development. In the present study, an integrated toxicokinetic–toxicodynamic (TK–TD) modeling approach within a nonlinear mixed-effect modeling framework is applied to investigate concurrent abnormal heart rate and QT changes in three beagle dogs, using a Novartis internal compound (NVS001) as the case example. By accounting for saturable drug absorption, circadian rhythms, drug-effect tolerance, and nonlinear rate-dependency of QT interval, the dynamic TK–TD model captures the experimentally observed drug effects on heart rate and QT interval across a wide dosing range of NVS001 in beagle dogs. Further analyses reveal that the NVS001-induced QT prolongation observed in the low-dose groups is potentially caused by direct drug inhibition on the hERG channel, while the apparent QT shortening in the high-dose groups may be due to strong rate-dependency of QT at high heart rates. This study also suggests that the TK–TD model can be used to identify direct drug effects on the non-rate-dependent QT component by dissociating QT changes from tachycardia and deriving a new QT correction method. The integrated TK–TD model presented here may serve as a novel quantitative framework for evaluating drug-induced concurrent changes in heart rate and QT to potentially facilitate preclinical and clinical safety studies.

Item Type:	Article
Keywords:	Heart rate NLME Nonlinear rate-dependency Population PK–PD modeling QT/QTc
Date Deposited:	19 Sep 2017 00:45
Last Modified:	25 Jan 2019 00:45
URI:	https://oak.novartis.com/id/eprint/33414