Vigabatrin Lacks Proarrhythmic Potential: Results from a Thorough QT/QTc Study in Healthy Volunteers

Clin Ther. 2017 Aug;39(8):1639-1648. doi: 10.1016/j.clinthera.2017.06.006. Epub 2017 Jun 28.

Abstract

Purpose: A thorough QT study was performed to assess the proarrhythmic potential of vigabatrin, an antiepileptic drug approved in the United States for the treatment of infantile spasms and refractory complex partial seizures.

Methods: In this Phase I, randomized, double-blind, placebo- and active-controlled (moxifloxacin), 4-sequence, crossover study conducted at a single center, healthy participants received 1 of 4 randomly assigned treatments: 3.0g vigabatrin solution (therapeutic dose) and 1 moxifloxacin placebo tablet; 6.0g vigabatrin solution (supratherapeutic dose) and 1 moxifloxacin placebo tablet; 400 mg moxifloxacin and vigabatrin placebo solution; moxifloxacin placebo tablet and vigabatrin placebo solution.

Findings: Mean changes from baseline in placebo-corrected QTcF, QTcB, and QTcI with vigabatrin 3.0 g and 6.0 g indicated no signal for any QTc effect relative to baseline. All 1-sided upper 95% confidence intervals for the differences between each vigabatrin dose and placebo were <10 ms at all time points. QTcF was unaffected by increasing plasma vigabatrin concentrations; no arrhythmias were observed in any treatment group. Low rates of first-degree atrioventricular block, sinus tachycardia, and sinus bradycardia occurred in all treatment groups. Most adverse events were mild.

Implications: The findings from this thorough QT study are consistent with existing clinical data and confirm a lack of proarrhythmic potential of vigabatrin.

Keywords: ECG; QT interval; infantile spasms; refractory complex partial seizures; thorough QT; vigabatrin.

Publication types

  • Clinical Trial, Phase I
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Anticonvulsants / adverse effects
  • Anticonvulsants / pharmacology*
  • Cross-Over Studies
  • Double-Blind Method
  • Electrocardiography / drug effects
  • Female
  • Fluoroquinolones / adverse effects
  • Fluoroquinolones / pharmacology
  • Healthy Volunteers
  • Heart Rate / drug effects*
  • Humans
  • Male
  • Middle Aged
  • Moxifloxacin
  • Vigabatrin / adverse effects
  • Vigabatrin / pharmacology*
  • Young Adult

Substances

  • Anticonvulsants
  • Fluoroquinolones
  • Vigabatrin
  • Moxifloxacin