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Effects of Injectable HP[beta]CD-Diclofenac on the Human Delayed Rectifier Potassium Channel Current In Vitro and on Proarrhythmic QTc In Vivo
Background Novel formulations and administration routes of established drugs may result in higher maximum concentrations or total exposures and potentially cause previously unrecognized adverse events. Objective This study evaluated the proarrhythmic potential of hydroxypropyl-β-cyclodextrin (HPβCD)...
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Published in: | Clinical therapeutics 2013-05, Vol.35 (5), p.646 |
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creator | Carr, Daniel B McDonnell Moorehead, Tara Bouchard, Annie Sprenger, Craig R Hamilton, Douglas A Lang, Eric Madden, Donna Lacouture, Peter G Wright, Curtis |
description | Background Novel formulations and administration routes of established drugs may result in higher maximum concentrations or total exposures and potentially cause previously unrecognized adverse events. Objective This study evaluated the proarrhythmic potential of hydroxypropyl-β-cyclodextrin (HPβCD)-diclofenac, a novel injectable diclofenac formulation solubilized with hydroxypropyl-β-cyclodextrin (HPβCD), on ventricular electrical conduction in preclinical and clinical models. Methods We assessed the effects of diclofenac, HPβCD, and HPβCD-diclofenac on the human delayed rectifier potassium channel (IKr) using human embryonic kidney (HEK) 293 cells transfected with a human ether-à-go-go-related gene (hERG) using whole-cell patch-clamp. In a single-dose, active- and placebo-controlled, 4-period crossover, thorough QT in vivo study, 70 healthy volunteers (mean age, 23.3 years; range, 18-49 years; 55.75% male) received HPβCD-diclofenac at 37.5- and 75-mg doses, inactive vehicle (placebo), and an active control (moxifloxacin). Results In vitro, diclofenac produced no statistically significant effect on IKr. Significant, non-dose-dependent effects were observed in the presence of HPβCD or HPβCD-diclofenac of similar magnitude across the 300-fold dose range of concentrations tested, suggesting an artifact due to the detergent effect of HPβCD in this in vitro model. In vivo, neither HPβCD-diclofenac dose resulted in QTc prolongation ≥2 ms (≥5 ms is the threshold of clinical concern). No correlation was evident between changes in QTc and plasma concentrations of diclofenac or HPβCD. Confirming study sensitivity, moxifloxacin produced a mean QTc prolongation >10 ms. Conclusions The findings from the present study suggest that HPβCD-diclofenac does not have a dose-dependent effect in the in vitro hERG assay system and does not produce proarrhythmic QTc prolongation in vivo.ClinicalTrials.govidentifier:NCT01812538. |
doi_str_mv | 10.1016/j.clinthera.2013.03.014 |
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Objective This study evaluated the proarrhythmic potential of hydroxypropyl-β-cyclodextrin (HPβCD)-diclofenac, a novel injectable diclofenac formulation solubilized with hydroxypropyl-β-cyclodextrin (HPβCD), on ventricular electrical conduction in preclinical and clinical models. Methods We assessed the effects of diclofenac, HPβCD, and HPβCD-diclofenac on the human delayed rectifier potassium channel (IKr) using human embryonic kidney (HEK) 293 cells transfected with a human ether-à-go-go-related gene (hERG) using whole-cell patch-clamp. In a single-dose, active- and placebo-controlled, 4-period crossover, thorough QT in vivo study, 70 healthy volunteers (mean age, 23.3 years; range, 18-49 years; 55.75% male) received HPβCD-diclofenac at 37.5- and 75-mg doses, inactive vehicle (placebo), and an active control (moxifloxacin). Results In vitro, diclofenac produced no statistically significant effect on IKr. Significant, non-dose-dependent effects were observed in the presence of HPβCD or HPβCD-diclofenac of similar magnitude across the 300-fold dose range of concentrations tested, suggesting an artifact due to the detergent effect of HPβCD in this in vitro model. In vivo, neither HPβCD-diclofenac dose resulted in QTc prolongation ≥2 ms (≥5 ms is the threshold of clinical concern). No correlation was evident between changes in QTc and plasma concentrations of diclofenac or HPβCD. Confirming study sensitivity, moxifloxacin produced a mean QTc prolongation >10 ms. Conclusions The findings from the present study suggest that HPβCD-diclofenac does not have a dose-dependent effect in the in vitro hERG assay system and does not produce proarrhythmic QTc prolongation in vivo.ClinicalTrials.govidentifier:NCT01812538.</description><identifier>ISSN: 0149-2918</identifier><identifier>EISSN: 1879-114X</identifier><identifier>DOI: 10.1016/j.clinthera.2013.03.014</identifier><language>eng</language><publisher>Bridgewater: Elsevier Limited</publisher><subject>Aging ; Cell culture ; Colorectal cancer ; Gene expression ; Nonsteroidal anti-inflammatory drugs</subject><ispartof>Clinical therapeutics, 2013-05, Vol.35 (5), p.646</ispartof><rights>Copyright Elsevier Limited May 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Carr, Daniel B</creatorcontrib><creatorcontrib>McDonnell Moorehead, Tara</creatorcontrib><creatorcontrib>Bouchard, Annie</creatorcontrib><creatorcontrib>Sprenger, Craig R</creatorcontrib><creatorcontrib>Hamilton, Douglas A</creatorcontrib><creatorcontrib>Lang, Eric</creatorcontrib><creatorcontrib>Madden, Donna</creatorcontrib><creatorcontrib>Lacouture, Peter G</creatorcontrib><creatorcontrib>Wright, Curtis</creatorcontrib><title>Effects of Injectable HP[beta]CD-Diclofenac on the Human Delayed Rectifier Potassium Channel Current In Vitro and on Proarrhythmic QTc In Vivo</title><title>Clinical therapeutics</title><description>Background Novel formulations and administration routes of established drugs may result in higher maximum concentrations or total exposures and potentially cause previously unrecognized adverse events. Objective This study evaluated the proarrhythmic potential of hydroxypropyl-β-cyclodextrin (HPβCD)-diclofenac, a novel injectable diclofenac formulation solubilized with hydroxypropyl-β-cyclodextrin (HPβCD), on ventricular electrical conduction in preclinical and clinical models. Methods We assessed the effects of diclofenac, HPβCD, and HPβCD-diclofenac on the human delayed rectifier potassium channel (IKr) using human embryonic kidney (HEK) 293 cells transfected with a human ether-à-go-go-related gene (hERG) using whole-cell patch-clamp. In a single-dose, active- and placebo-controlled, 4-period crossover, thorough QT in vivo study, 70 healthy volunteers (mean age, 23.3 years; range, 18-49 years; 55.75% male) received HPβCD-diclofenac at 37.5- and 75-mg doses, inactive vehicle (placebo), and an active control (moxifloxacin). Results In vitro, diclofenac produced no statistically significant effect on IKr. Significant, non-dose-dependent effects were observed in the presence of HPβCD or HPβCD-diclofenac of similar magnitude across the 300-fold dose range of concentrations tested, suggesting an artifact due to the detergent effect of HPβCD in this in vitro model. In vivo, neither HPβCD-diclofenac dose resulted in QTc prolongation ≥2 ms (≥5 ms is the threshold of clinical concern). No correlation was evident between changes in QTc and plasma concentrations of diclofenac or HPβCD. Confirming study sensitivity, moxifloxacin produced a mean QTc prolongation >10 ms. Conclusions The findings from the present study suggest that HPβCD-diclofenac does not have a dose-dependent effect in the in vitro hERG assay system and does not produce proarrhythmic QTc prolongation in vivo.ClinicalTrials.govidentifier:NCT01812538.</description><subject>Aging</subject><subject>Cell culture</subject><subject>Colorectal cancer</subject><subject>Gene expression</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><issn>0149-2918</issn><issn>1879-114X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNqNTe1KxDAQDKJg_XgGF_zdmrTnXfu7Pan_qhwiiBy53IampInmQ7iX8JnNoQ8guzDDzOwsITeMFoyy5d1UCK1MGNHxoqSsKmhatjghGatXTc7Y4vWUZElp8rJh9Tm58H6ilFbNfZmR77WUKIIHK-HRTInynUboh7cdBv7ednmnhLYSDRdgDaQ_0MeZG-hQ8wPu4TndKKnQwWAD917FGdqRG4Ma2ugcmpCa4UUFZ4Gb_bFlcJY7Nx7COCsBTxvxm_iyV-RMcu3x-g8vye3DetP2-YeznxF92E42OpOsLauW9XFWdfW_1A_jUF4d</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>Carr, Daniel B</creator><creator>McDonnell Moorehead, Tara</creator><creator>Bouchard, Annie</creator><creator>Sprenger, Craig R</creator><creator>Hamilton, Douglas A</creator><creator>Lang, Eric</creator><creator>Madden, Donna</creator><creator>Lacouture, Peter G</creator><creator>Wright, Curtis</creator><general>Elsevier Limited</general><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope></search><sort><creationdate>20130501</creationdate><title>Effects of Injectable HP[beta]CD-Diclofenac on the Human Delayed Rectifier Potassium Channel Current In Vitro and on Proarrhythmic QTc In Vivo</title><author>Carr, Daniel B ; McDonnell Moorehead, Tara ; Bouchard, Annie ; Sprenger, Craig R ; Hamilton, Douglas A ; Lang, Eric ; Madden, Donna ; Lacouture, Peter G ; Wright, Curtis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-proquest_journals_13686868783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aging</topic><topic>Cell culture</topic><topic>Colorectal cancer</topic><topic>Gene expression</topic><topic>Nonsteroidal anti-inflammatory drugs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carr, Daniel B</creatorcontrib><creatorcontrib>McDonnell Moorehead, Tara</creatorcontrib><creatorcontrib>Bouchard, Annie</creatorcontrib><creatorcontrib>Sprenger, Craig R</creatorcontrib><creatorcontrib>Hamilton, Douglas A</creatorcontrib><creatorcontrib>Lang, Eric</creatorcontrib><creatorcontrib>Madden, Donna</creatorcontrib><creatorcontrib>Lacouture, Peter G</creatorcontrib><creatorcontrib>Wright, Curtis</creatorcontrib><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest Health Management</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest research library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><jtitle>Clinical therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carr, Daniel B</au><au>McDonnell Moorehead, Tara</au><au>Bouchard, Annie</au><au>Sprenger, Craig R</au><au>Hamilton, Douglas A</au><au>Lang, Eric</au><au>Madden, Donna</au><au>Lacouture, Peter G</au><au>Wright, Curtis</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of Injectable HP[beta]CD-Diclofenac on the Human Delayed Rectifier Potassium Channel Current In Vitro and on Proarrhythmic QTc In Vivo</atitle><jtitle>Clinical therapeutics</jtitle><date>2013-05-01</date><risdate>2013</risdate><volume>35</volume><issue>5</issue><spage>646</spage><pages>646-</pages><issn>0149-2918</issn><eissn>1879-114X</eissn><abstract>Background Novel formulations and administration routes of established drugs may result in higher maximum concentrations or total exposures and potentially cause previously unrecognized adverse events. Objective This study evaluated the proarrhythmic potential of hydroxypropyl-β-cyclodextrin (HPβCD)-diclofenac, a novel injectable diclofenac formulation solubilized with hydroxypropyl-β-cyclodextrin (HPβCD), on ventricular electrical conduction in preclinical and clinical models. Methods We assessed the effects of diclofenac, HPβCD, and HPβCD-diclofenac on the human delayed rectifier potassium channel (IKr) using human embryonic kidney (HEK) 293 cells transfected with a human ether-à-go-go-related gene (hERG) using whole-cell patch-clamp. In a single-dose, active- and placebo-controlled, 4-period crossover, thorough QT in vivo study, 70 healthy volunteers (mean age, 23.3 years; range, 18-49 years; 55.75% male) received HPβCD-diclofenac at 37.5- and 75-mg doses, inactive vehicle (placebo), and an active control (moxifloxacin). Results In vitro, diclofenac produced no statistically significant effect on IKr. Significant, non-dose-dependent effects were observed in the presence of HPβCD or HPβCD-diclofenac of similar magnitude across the 300-fold dose range of concentrations tested, suggesting an artifact due to the detergent effect of HPβCD in this in vitro model. In vivo, neither HPβCD-diclofenac dose resulted in QTc prolongation ≥2 ms (≥5 ms is the threshold of clinical concern). No correlation was evident between changes in QTc and plasma concentrations of diclofenac or HPβCD. Confirming study sensitivity, moxifloxacin produced a mean QTc prolongation >10 ms. Conclusions The findings from the present study suggest that HPβCD-diclofenac does not have a dose-dependent effect in the in vitro hERG assay system and does not produce proarrhythmic QTc prolongation in vivo.ClinicalTrials.govidentifier:NCT01812538.</abstract><cop>Bridgewater</cop><pub>Elsevier Limited</pub><doi>10.1016/j.clinthera.2013.03.014</doi></addata></record> |
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subjects | Aging Cell culture Colorectal cancer Gene expression Nonsteroidal anti-inflammatory drugs |
title | Effects of Injectable HP[beta]CD-Diclofenac on the Human Delayed Rectifier Potassium Channel Current In Vitro and on Proarrhythmic QTc In Vivo |
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