Key result
Exposure-response analyses of phase I trials demonstrated no effect of upadacitinib on the QT interval, supporting a waiver for a dedicated thorough QT study.
Why the study?
Does upadacitinib prolong the QT interval in early-stage clinical studies?
Does upadacitinib prolong the QT interval in early-stage clinical studies?
Exposure-response analyses from early-phase trials can demonstrate a lack of QT prolongation for upadacitinib, supporting a waiver for a dedicated thorough QT study.
Supports waiver of dedicated QT study for upadacitinib; extends validation of exposure-response modeling from phase I data.
Exposure-response analyses of QT data from early-stage clinical studies represent a valuable tool to assess the QT prolongation potential for drugs in development in lieu of standalone thorough QT (TQT) studies. However, demonstrating adequate electrocardiogram assay sensitivity can be challenging in the absence of a positive pharmacological control. Upadacitinib is a Janus kinase 1 inhibitor currently being evaluated in phase III rheumatoid arthritis trials. Exposure-response analyses to evaluate the QT prolongation potential for upadacitinib from phase I trials and the utility of the effect of food on QTcF to demonstrate ECG assay sensitivity are presented. The analyses demonstrated no effect of upadacitinib on QT interval and confirmed the sensitivity of the ECG assay to detect the small QT shortening effect caused by food. Lack of bias from manual ECG adjudication was also demonstrated. These analyses supported requesting a waiver for the regulatory requirement for a dedicated thorough QT study for upadacitinib.
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Mohamed et al. (2017) studied Rheumatoid arthritis. Upadacitinib was evaluated on QT interval prolongation. Exposure-response analyses of phase I trials demonstrated no effect of upadacitinib on the QT interval, supporting a waiver for a dedicated thorough QT study.
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