Why the study?
Cardiovascular safety frequently causes attrition preclinically and clinically, prompting the development of a semi-mechanistic modelling platform to simultaneously assess contractility, heart rate, and mean arterial pressure.
A novel semi-mechanistic modeling platform successfully integrates multiple hemodynamic parameters to improve preclinical cardiovascular safety profiling of new drugs.
May refine preclinical CV safety screening in dogs; leaves open clinical translation and attrition reduction.
Background and Purpose Cardiovascular safety is one of the most frequent causes of safety‐related attrition both preclinically and clinically. Preclinical cardiovascular safety is routinely assessed using dog telemetry monitoring key cardiovascular functions. The present research was to develop a semi‐mechanistic modelling platform to simultaneously assess changes in contractility (dPdt max ), heart rate (HR) and mean arterial pressure (MAP) in preclinical studies. Experimental Approach Data from dPdt max , HR, preload (left ventricular end‐diastolic pressure [LVEDP]) and MAP were available from dog telemetry studies after dosing with atenolol ( n = 27), salbutamol ( n = 5), L–N G –nitroarginine methyl ester (L–NAME; n = 4), milrinone ( n = 4), verapamil ( n = 12), dofetilide ( n = 8), flecainide ( n = 4) and AZ001 ( n = 14). Literature model for rat CV function was used for the structural population pharmacodynamic model development. LVEDP was evaluated as covariate to account for the effect of preload on dPdt max . Key Results The model was able to describe drug‐induced changes in dPdt max , HR and MAP for all drugs included in the developed framework adequately, by incorporating appropriate drug effects on dPdt max , HR and/or total peripheral resistance. Consistent with the Starling's law, incorporation of LVEDP as a covariate on dPdt max to correct for the preload effect was found to be statistically significant. Conclusions and Implications The contractility and haemodynamics semi‐mechanistic modelling platform accounts for diurnal variation, drug‐induced changes and inter‐animal variation. It can be used to hypothesize and evaluate pharmacological effects and provide a holistic cardiovascular safety profile for new drugs.
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Venkatasubramanian et al. (2020) studied this question.
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