Population pharmacokinetic/pharmacodynamic modelling of nifekalant in healthy Chinese volunteers

Abstract

Nifekalant is a class III antiarrhythmic drug, and its major adverse effect is prolongation of the QT interval. This study analysed data generated from a pharmacokinetic (PK) study to develop a population PK/pharmacodynamics (PD) model for describing the relationship between plasma concentrations and prolongation of the QT interval over time following intravenous administration of nifekalant. This open-labelled, phase I clinical study comprised two dose level groups of eight healthy Chinese volunteers. Concentrations of nifekalant in plasma samples collected at set time-points were determined using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. A PK/PD model was constructed using a non-linear mixed-effects approach (Phoenix NLME 8.1). Furthermore, demographic covariates of the model were investigated and a concentration factor (ConcƟ) was introduced as the only covariate which improved the performance of the model. The final population PK model exhibited one-order elimination with two-compartment distribution and adequately described nifekalant plasma concentrations over time. The QT interval prolongation was best described by an indirect effect model with an inhibition build-up effect, representing the relationship between plasma concentrations and effect. The final population PK/PD model may facilitate more accurate predictions of the drug profile in clinical settings in the future.