Assessment of an In Silico Mechanistic Model for Proarrhythmia Risk Prediction Under the CiPA Initiative.

Assessment of an In Silico Mechanistic Model for Proarrhythmia Risk Prediction Under the CiPA Initiative.
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评估CIPA倡议下的动脉心律失常风险预测的计算机机械模型。

DOI:
10.1002/cpt.1184
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发表时间:
2019-03
影响因子:
6.7
通讯作者:
Strauss DG
Strauss DG
中科院分区:
医学2区
文献类型:
--
作者:
Li Z;Ridder BJ;Han X;Wu WW;Sheng J;Tran PN;Wu M;Randolph A;Johnstone RH;Mirams GR;Kuryshev Y;Kramer J;Wu C;Crumb WJ Jr;Strauss DG

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人用药品注册技术要求国际协调理事会(ICH)S7 B和E14监管指南对于预测哪些药物具有促代谢作用具有敏感性,但不具有特异性。作为回应,提出了综合性体外致心律失常试验(CiPA),该试验将体外多离子通道药理学数据整合到计算机模拟的人类心肌细胞模型中,用于致心律失常风险评估。之前,我们报告了基于CiPA训练药物的模型优化和致心律失常指标选择。在这项研究中,我们报告了预先指定的模型和度量的独立CiPA验证药物的应用。在两个验证数据集上,CiPA模型的性能满足所有预先指定的用于对验证药物进行排名和分类的指标,并且优于替代品,尽管由于不同的实验条件和质量控制程序,两个数据集之间存在一些体外数据差异。这表明当前的CiPA模型/度量可能适合监管使用,并且实验方案和质量控制标准的标准化可以进一步提高模型预测准确性。
The International Council on Harmonization (ICH) S7B and E14 regulatory guidelines are sensitive but not specific for predicting which drugs are pro‐arrhythmic. In response, the Comprehensive In Vitro Proarrhythmia Assay (CiPA) was proposed that integrates multi‐ion channel pharmacology data in vitro into a human cardiomyocyte model in silico for proarrhythmia risk assessment. Previously, we reported the model optimization and proarrhythmia metric selection based on CiPA training drugs. In this study, we report the application of the prespecified model and metric to independent CiPA validation drugs. Over two validation datasets, the CiPA model performance meets all pre‐specified measures for ranking and classifying validation drugs, and outperforms alternatives, despite some in vitro data differences between the two datasets due to different experimental conditions and quality control procedures. This suggests that the current CiPA model/metric may be fit for regulatory use, and standardization of experimental protocols and quality control criteria could increase the model prediction accuracy even further.
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