Key result
Single-dose vorapaxar fails to prolong the QTcF interval compared with placebo in healthy adults.
Why the study?
The potential of the thrombin receptor antagonist vorapaxar to prolong the QT/QTc interval to a degree of regulatory concern needed to be assessed.
RCT (n=120)
Double-blind
Parallel group
Supports vorapaxar use without QTc monitoring; confirms cardiac safety in a dedicated randomized trial.
In a randomized, double-blind (vorapaxar and placebo), placebo- and positive-controlled (moxifloxacin 400 mg) parallel group study, the effect of single-dose vorapaxar 120 mg on QT/QTc interval was assessed in 120 adults 18-50 years. Twelve-lead digital ECGs were obtained in triplicate using Mortara H12+ Holter monitors at 9 timepoints over 24 hours. If the largest upper bound of the 95% one-sided CI for the mean difference in QTcF between vorapaxar and placebo was <10 milliseconds, vorapaxar was considered to have no potential for QT/QTc prolongation of regulatory concern. Vorapaxar was well-tolerated. The lower bound of the 95% CI for the difference in QTcF between moxifloxacin and placebo was >5 milliseconds, confirming study sensitivity. Vorapaxar had no significant effect on QTcF. At all timepoints the upper 95% CI for the mean difference between placebo and vorapaxar was ≤3.8 milliseconds (mean difference ≤1.0 milliseconds). Vorapaxar does not prolong the QT/QTc interval in healthy subjects.
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Kosoglou et al. (2013) conducted an RCT in Healthy volunteers (QT/QTc interval assessment) (n=120). Vorapaxar vs. Placebo and positive control (moxifloxacin 400 mg) was evaluated on Mean difference in QTcF interval between vorapaxar and placebo over 24 hours (MD ≤1.0 ms, 95% CI upper bound ≤3.8 ms). Single-dose vorapaxar 120 mg did not prolong the QTcF interval in healthy adults compared with placebo (mean difference ≤1.0 ms; upper 95% CI ≤3.8 ms).
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