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Clinical and Translational Science
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Clinical Evaluation of the Effect of Aficamten on QT/QTc Interval in Healthy Participants

Authors: Neha Maharao; Donghong Xu; Tyrell J. Simkins; Owen Bowles; Genzhou Liu; Youcef Benattia; Adrienne Griffith; +3 Authors

Clinical Evaluation of the Effect of Aficamten on QT/QTc Interval in Healthy Participants

Abstract

ABSTRACTAficamten is a next‐in‐class, small‐molecule, cardiac myosin inhibitor in development for treating hypertrophic cardiomyopathy (HCM). This 2‐part study evaluated aficamten's impact on QTc interval in healthy participants. Part A (n = 10) was an open‐label study to find the appropriate dose for thorough QT (TQT) evaluation in Part B. Part B (n = 34) was a double‐blind, 3‐way crossover TQT study conducted as per ICH E14 guidance using negative (placebo) and positive (moxifloxacin) controls. A single 50 mg aficamten dose achieved exposures (Cmax range: 124–1660 ng/mL) comparable to the highest clinical dose (20 mg QD) in obstructive HCM patients (NCT05186818; [Cmax range: 131–1230 ng/mL]) and was chosen for TQT evaluation. Using concentration‐QT (C‐QT) modeling, the placebo‐ and baseline‐corrected QT interval using Fridericia's correction (ΔΔQTcF) was −1.82 msec (90% CI: −3.43, −0.214) at peak aficamten concentrations (298.3 ng/mL) following the 50 mg dose. The 90% CI upper bound of ΔΔQTcF for aficamten was < 10 msec at all post‐dose time points. Assay sensitivity was established by the 90% CI lower bound for moxifloxacin (ΔΔQTcF) exceeding 5 msec. Aficamten did not cause QTc prolongation (using C‐QT and by time point analyses) within observed plasma concentrations up to 1660 ng/mL (aficamten), 213 ng/mL (metabolite CK‐3834282), and 343 ng/mL (metabolite CK‐3834283). No clinically meaningful effect on electrocardiogram parameters, including absolute QTcF (≤ 450 msec) and change from baseline in QTcF (≤ 30 msec) was noted in aficamten‐treated participants. Aficamten was generally well tolerated. In conclusion, there was no evidence of aficamten‐mediated QTc prolongation across the therapeutic concentration range in a formal TQT study.

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Keywords

safety, Adult, Male, Cross-Over Studies, Dose-Response Relationship, Drug, Moxifloxacin, QT, QTc interval, RM1-950, Middle Aged, Article, Healthy Volunteers, Young Adult, Electrocardiography, Long QT Syndrome, phase 1, Double-Blind Method, cardiovascular disease, Heart Rate, Humans, Pyrazoles, Female, Therapeutics. Pharmacology, Public aspects of medicine, RA1-1270

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    influence
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
5
Top 10%
Average
Top 10%
Green
gold