Electrocardiographic Effects of a Supratherapeutic Dose of WCK 2349, a Benzoquinolizine Fluoroquinolone

  • Clin Transl Sci. 2019 Jan;12(1):47-52. doi: 10.1111/cts.12594.
Jay W Mason  1  2 ,  Rakesh Chugh  3 ,  Anasuya Patel  3 ,  Ranjeet Gutte  3 ,  Ashima Bhatia  3
Affiliations
  • 1. Division of Cardiology, University of Utah, Salt Lake City, Utah,, USA.
  • 2. Spaulding Clinical Research, West Bend, Wisconsin,, USA.
  • 3. Wockhardt, Mumbai,, India.
PMID: 30369076 DOI: 10.1111/cts.12594
Abstract

The purpose of this study was to measure the electrocardiographic (ECG) effects of WCK 2349 (the L-alanine ester prodrug of levonadifloxacin) at a supratherapeutic oral dose of 2,600 mg. A total of 48 healthy volunteers were randomized to treatment with placebo, WCK 2349, or oral moxifloxacin, 400 mg, in a crossover-designed thorough QT study. A supratherapeutic mean maximum levonadifloxacin concentration (Cmax ) of 43.3 μg/mL was achieved at 3.1 hours. A therapeutic dose of 1,000 mg b.i.d. in a previous study in patients resulted in a Cmax of 17.8 μg/mL. WCK 2349 exerted no significant effect on baseline- and placebo-corrected QTcF (QT interval corrected for heart rate (HR) by the Fridericia formula), QRS, or PR interval. HR was transiently accelerated by a maximum of 14.4 (95% confidence interval, 11.80-16.92) beats per minute (bpm) at 3 hours. Concentration-effect modeling predicted a mean increase of 8.0 bpm at Cmax at the standard therapeutic dose. A therapeutic dose of 1,000 mg b.i.d. of WCK 2349 is not expected to cause clinically significant ECG effects, except for a possible transient increase in HR, which seems to be clinically insignificant.

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