Effects of Bardoxolone Methyl on QT Interval in Healthy Volunteers

Background: Bardoxolone methyl has been shown to increase eGFR in several clinical trials, including a phase 3 trial in patients with type 2 diabetes and stage 4 CKD (BEACON), which was terminated early due to an increase in heart failure events in bardoxolone methyl-treated patients. A separate, thorough QT study was conducted in parallel with BEACON to evaluate the cardiovascular safety of bardoxolone methyl in healthy subjects. Methods: Subjects in the thorough QT study were randomized to receive bardoxolone methyl 20 mg (therapeutic dose) or 80 mg (supratherapeutic dose), placebo, or moxifloxacin (400 mg; an active comparator). ECG results and supine blood pressure measurements were analyzed. The effects of bardoxolone methyl on QT interval changes from baseline were quantified compared to the effect of placebo by calculating mean, time-matched, placebo-corrected, baseline-adjusted QTcF values (Delta Delta QTcF) after 6 days of daily administration of bardoxolone methyl. Results: The study was halted early due to emerging safety information from the BEACON trial; however, 142/179 patients received all doses of the study drug and completed the study. For both bardoxolone methyl-treated groups (20 and 80 mg), the upper limits of the 2-sided 90% confidence interval for Delta Delta QTcF were less than the significance limit (10 ms) at all time points. Changes in blood pressure were similar in all treatment groups, and no serious adverse events were reported. Conclusions: In healthy subjects, treatment with 20 or 80 mg bardoxolone methyl did not affect the QTcF interval. (C) 2019 The Author(s) Published by S. Karger AG, Basel