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Phase 1 N=32 Randomized Basic Science

Food and Insulin Effect on QT/QTC Interval of ECG

Effects of Different Meals on the QT/QTc Interval · Insulin and Oral Hypoglycemic [Antidiabetic] Drugs Causing Adverse Effects in Therapeutic Use · C-Peptide Effects on the QT/QTc Interval · Moxifloxacin ECG Profile in Fed and Fasted State · Japanese vs. Caucasian TQT Comparison

Enrolled (actual)
32
Serious AEs
0.0%
Results posted
Aug 2014
Primary outcome: Primary: The Effect of Food (Fasted and Fed State) on the Degree of QT Prolongation Caused by Moxifloxacin — 14.4; 11.6 ms — p=0.05

Study Design & Population

Study type
Interventional
Phase
Phase 1
Interventions
Moxifloxacin 400 mg fasted (Drug); FDA breakfast (Other); Continental breakfast (Other); Moxifloxacin 400 mg fed (Drug); Insulin Clamp (Procedure); Placebo (Drug)
Age
Adult · 20+ yrs
Sex
All
Sponsor
Richmond Pharmacology Limited
Primary completion
Sep 2011

Outcome Measures

OutcomeResultp-value
PRIMARY
The Effect of Food (Fasted and Fed State) on the Degree of QT Prolongation Caused by Moxifloxacin
14.4; 11.6 0.05
SECONDARY
The Food Effects (Calorie Reduced FDA Breakfast and Carbohydrate Rich Continental Style) on QTcF
-6.8; -7.9; 412.4 0.05
SECONDARY
Moxifloxacin 400 mg (Single Dose) Compared to Placebo on the Mean QT/QTc Interval.
14.4; 414.2
SECONDARY
Insulin, Glucose and C-Peptide Effects on the QT/QTc Interval
-0.01; -0.86; -0.71
SECONDARY
The QTcF Profile of Oral Moxifloxacin (400 mg) in Healthy Japanese Versus Caucasian Subjects
9.0; 13.7; 17.3; 10.1

Summary

Moxifloxacin is routinely used as a probe to confirm assay sensitivity in thorough electrocardiogram (ECG) studies. It has been shown that a meal shortens the QT interval, which may affect pharmacokinetics (PK) and/or pharmacodynamics (PD) of the study drug. However, there is no published data clarifying this issue. There is also a paucity of data investigating ethnic differences of the effects of medicines on QTc. The aims of the study were to compare the effect of different food contents to placebo on the changes in ECG and to demonstrate the effect of insulin, C-peptide and glucose on the ECG. This was done by giving different treatments on separate days, which included intravenous insulin, a high carbohydrate breakfast [>70%], and a calorie reduced low carbohydrate American FDA standard breakfast. Moxifloxacin 400 mg was used as a positive control and was given with and without food to Caucasian and Japanese volunteers to investigate racial differences.

Eligibility Criteria

Inclusion Criteria

  • Healthy male or female, 20 - 45 years old
  • Signed ICF
  • Japanese - a descendant of four Japanese grandparents, carrying a Japanese passport and has not been outside Japan for more than 5 years prior to screening
  • The Caucasian - light to brown skin pigmentation; straight to wavy or curly hair; indigenous to Europe, northern Africa, western Asia, and India. The study may also include Caucasians from North America, Australia and South Africa
  • No clinical findings on the physical examination
  • Body mass index (BMI) = 18 - 25 kg/m2, body weight at least 48 kg.
  • Systolic blood pressure 90-145 mmHg, diastolic blood pressure 40-90 mmHg, and heart rate 40-90 bpm
  • Triplicate 12 lead ECG without clinically relevant abnormalities
  • 24 hour 12 lead Holter ECG without clinically relevant abnormalities
  • Haematology, biochemistry and urinalysis within the normal range
  • Must agree to use acceptable methods of contraception

Exclusion Criteria

  • History or clinical evidence of any disease and/or existence of any surgical or medical condition which might interfere with the absorption, distribution, metabolism or excretion of the study drug
  • History of clinically significant syncope.
  • Family history of sudden death.
  • Family history of premature cardiovascular death.
  • Family history of congenital long QT syndrome or Brugada's syndrome.
  • History of arrhythmias and ischemic heart disease
  • Conditions predisposing to electrolyte imbalances (e.g. altered nutritional states, chronic vomiting, anorexia nervosa, bulimia nervosa).
  • Abnormal ECG in the standard 12-lead ECG and 24-hour 12 lead Holter ECG
  • Abnormal rhythm, conduction or morphology of resting ECG, such as:
  • Sinus node dysfunction.
  • Clinically significant PR (PQ) interval prolongation.
  • Intermittent second or third degree AV block.
  • Incomplete or complete bundle branch block.
  • Abnormal T wave morphology.
  • Prolonged QTcB >450 msec or shortened QTcB 7.8mmol/l)
  • Significant family history of diabetes mellitus.
  • Significantly elevated fasting blood glucose level
  • Signs and/or symptoms of acute illness in the four-week period prior to screening.
  • Veins unsuitable for intravenous puncture or cannulation on either arm
  • Known hypersensitivity to any medicines administered in the trial.
  • Treatment with any prescribed medication during the 2 weeks prior to first baseline day.
  • Treatment with any over-the-counter (OTC) medications during the 2 weeks prior to first baseline day.
  • Treatment with vitamins and/or minerals within 48 hours prior to the first baseline day.
  • Treatment with another investigational drug within 4 weeks prior to dosing or having participated in more than 3 investigational drug studies within a year prior to dosing.
  • Positive urine drug screen (amphetamines, benzodiazepines, cocaine, cannabinoids, opiates, barbiturates and methadone) or the alcohol breath test
  • History or clinical evidence of alcoholism (regular weekly alcohol intake of more than 14 units if female and 21 units if male) or drug abuse (compulsive, repetitive and/or chronic use of drugs or other substances with or without problems related to their use and/or where stopping or a reduction in dose will lead to withdrawal symptoms)
  • Excessive caffeine consumption (≥800 mg per day)
  • Smoking within 3 months prior to screening
  • Loss of 250 mL or more blood within 3 months prior to screening.
  • Positive results from the hepatitis serology, except for vaccinated subjects.
  • Positive results from the HIV serology.
  • Any circumstances or conditions, which may affect full participation in the study or compliance with the protocol.
  • Legal incapacity or limited legal capacity.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01642485). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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