Key result
Saquinavir-boosted ritonavir prolongs QTc by ~19 ms at therapeutic doses.
Why the study?
Does saquinavir-boosted ritonavir prolong the QTc interval in healthy participants?
RCT
Double-blind
Does saquinavir-boosted ritonavir prolong the QTc interval in healthy participants?
Mean Difference: 18.9
Saquinavir-boosted ritonavir significantly prolongs the QTc interval at both therapeutic and supratherapeutic doses in healthy participants.
May warrant QTc monitoring with saquinavir-ritonavir; confirms dose-dependent prolongation in this RCT.
The effect of saquinavir-boosted ritonavir at therapeutic (1000/100 mg twice daily [bid]) and supratherapeutic (1500/100 mg bid) doses was evaluated in a double-blind, placebo- and positive-controlled (moxifloxacin 400 mg) 4-way crossover thorough QT/QTc study. Least squares mean estimated study-specific QTc (QTcS) change from dense predose baseline (ddQTcS(dense)) was the primary endpoint. Greatest mean increase in ddQTcS(dense) occurred 12 hours postdose for the 1000/100-mg group (18.9 ms) and 20 hours for the 1500/10-mg group (30.2 ms). The upper 1-sided 95% confidence interval was >20 ms from 2 to 20 hours postdose in both groups. ddQTcB(dense) and ddQTcF(dense) were similar to ddQTcS(dense). No QTcS, QTcF, or QTcB measurements were >500 ms. One participant receiving 1000/100 mg and 3 receiving 1500/100 mg had a maximum ddQTcS(dense) >60 ms. More participants with ≥1 adverse event received saquinavir/ritonavir. PubMed search and Roche postmarketing data did not reveal publications or reports directly presenting the effect of saquinavir on QT/QTc or causing torsade de pointes.
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Zhang et al. (2011) conducted an RCT in Healthy participants. Saquinavir-boosted ritonavir vs. Placebo and moxifloxacin 400 mg was evaluated on Least squares mean estimated study-specific QTc (QTcS) change from dense predose baseline (ddQTcS(dense)) (Mean increase 18.9 ms). Saquinavir-boosted ritonavir increased the QTc interval, with a maximum mean increase of 18.9 ms at therapeutic doses and 30.2 ms at supratherapeutic doses.
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