©© 2008 American College of Clinical Pharmacology, Inc.
The Journal of Clinical Pharmacology
, 10.1177/0091270008319330
Effects of Aliskiren, a Direct Renin Inhibitor, on Cardiac Repolarization and Conduction in Healthy Subjects
Surya Ayalasomayajula 1,
Ching-Ming Yeh 1,
Sujata Vaidyanathan 1,
Brian Flannery 1,
Hans Armin Dieterich 2,
Dan Howard 1,
Martin P. Bedigian 1,
and
William P. Dole 3*
1 Novartis Pharmaceuticals Corporation
2 Novartis Pharma AG
3 Novartis Institutes for Biomedical Research
* To whom correspondence should be addressed. E-mail: bill.dole{at}novartis.com.
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Abstract |
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This multicenter, double-blind study evaluated the effects of aliskiren, a direct renin inhibitor approved for hypertension, on cardiac repolarization and conduction. Healthy volunteers (n = 298) were randomized to aliskiren 300 mg, aliskiren 1200 mg, moxifloxacin 400 mg (positive control), or placebo once daily for 7 days. Digitized electrocardiograms were obtained at baseline and day 7 of treatment over 23 hours postdose. Placebo-adjusted mean changes from baseline in QTcF (Fridericia corrected), QTcI (individualized correction), PR, and QRS intervals were compared at each time point (time-matched analysis) and for values averaged across the dosing period (baseline-averaged analysis). In time-matched analysis, mean changes in QTcF with aliskiren were below predefined limits for QTc prolongation (mean increase <5 milliseconds; upper 90% confidence interval [CI] <10 milliseconds) except aliskiren 1200 mg at 23 hours (5.2 milliseconds; 90% CI 2.2, 8.1). With moxifloxacin, significant QTcF prolongation occurred at most time points, confirming the sensitivity of the assay. Baseline-averaged analysis was consistent with time-matched analysis. Instances of QTcF interval >450 milliseconds or a >30-millisecond increase from baseline with aliskiren (
1%) were similar or lower than placebo (
4%). Results were similar for QTcI. Aliskiren had no effect on PR or QRS duration. In conclusion, aliskiren at the highest approved dose (300 mg) and a 4-fold higher dose had no effect on cardiac repolarization or conduction in healthy volunteers.