Population pharmacokinetic and concentration--QTc models for moxifloxacin: pooled analysis of 20 thorough QT studies

J Clin Pharmacol. 2011 Aug;51(8):1152-62. doi: 10.1177/0091270010381498. Epub 2011 Jan 12.

Abstract

To increase our understanding of important subject characteristics and design variables affecting the performance of oral moxifloxacin in thorough QT studies, population pharmacokinetic and concentration-QTc models were developed by pooling data from 20 studies. A 1-compartment model with first-order elimination described the pharmacokinetics. Absorption delay was modeled using 8 transit compartments. Mean (95% confidence interval) values for oral clearance, apparent volume of distribution, the first-order absorption rate constant, and mean transit time were 11.7 (11.5-11.9) L/h, 147 (144-150) L, 1.9 (1.7-2.1) 1/h, and 0.3 (0.28-0.34) hours, respectively. Overencapsulating the moxifloxacin tablet increased mean transit time by 138% and delayed time to maximum concentration by 0.5 hours but had a minimal effect on overall exposure. Administration with food decreased absorption rate constant by 27%. Women had higher moxifloxacin exposure compared with men, which was explained by lower body weights. A linear model described the concentration-QTc relationship with a mean slope of 3.1 (2.8-3.3) milliseconds per µg/mL moxifloxacin. Mean slopes for individual studies ranged from 1.6 to 4.8 milliseconds per µg/mL. Hysteresis between moxifloxacin plasma concentrations and QTc was modest, and incorporating this delay did not result in a different slope (3.3 milliseconds per µg/mL). There were no differences in slope estimates between men and women or among race categories.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Animals
  • Anti-Infective Agents / administration & dosage
  • Anti-Infective Agents / adverse effects
  • Anti-Infective Agents / blood*
  • Anti-Infective Agents / pharmacokinetics*
  • Aza Compounds / administration & dosage
  • Aza Compounds / adverse effects
  • Aza Compounds / blood*
  • Aza Compounds / pharmacokinetics*
  • Clinical Trials as Topic
  • Delayed-Action Preparations / administration & dosage
  • Delayed-Action Preparations / adverse effects
  • Delayed-Action Preparations / pharmacokinetics
  • Drugs, Investigational / administration & dosage
  • Drugs, Investigational / adverse effects
  • Drugs, Investigational / analysis
  • Drugs, Investigational / pharmacokinetics
  • Electrocardiography / drug effects*
  • Female
  • Fluoroquinolones
  • Humans
  • Intestinal Absorption
  • Male
  • Metabolic Clearance Rate
  • Middle Aged
  • Models, Biological*
  • Moxifloxacin
  • Quinolines / administration & dosage
  • Quinolines / adverse effects
  • Quinolines / blood*
  • Quinolines / pharmacokinetics*
  • United States
  • United States Food and Drug Administration
  • Young Adult

Substances

  • Anti-Infective Agents
  • Aza Compounds
  • Delayed-Action Preparations
  • Drugs, Investigational
  • Fluoroquinolones
  • Quinolines
  • Moxifloxacin