Evidence map›Paper›PMID 39866059›Full record

Trial reportClinical and translational science2025

Evaluation of the Effect of Loperamide on the Cardiac Repolarization Interval Using Exposure-Response Analysis.

Belén Valenzuela, Per Olsson Gisleskog, Iolanda Cirillo, Erwin Coenen, Jay Ariyawansa, Saberi Rana Ali, Samiha Takhtoukh, Juan José Pérez-Ruixo, Oliver Ackaert

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Clinical and translational science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Belén ValenzuelaJanssen-Cilag Spain, Part of Janssen Pharmaceutical Companies of Johnson and Johnson, Madrid, Spain.ORCID 0000-0002-2317-5028
Per Olsson GisleskogPOG Pharmacometrics, London, UK.ORCID 0000-0002-0706-8783
Iolanda CirilloJanssen Clinical Pharmacology and Pharmacometrics, Raritan, New Jersey, USA.ORCID 0009-0008-8710-5003
Erwin CoenenJanssen Clinical Pharmacology and Pharmacometrics, Beerse, Belgium.ORCID 0009-0001-0601-9373
Jay AriyawansaJanssen Statistical and Decision Sciences, Raritan, New Jersey, USA.
Saberi Rana AliJanssen Established Products, Titusville, New Jersey, USA.
Samiha TakhtoukhJanssen Pharmaceutica, Clinical Pharmacology Unit, Merksem, Belgium.ORCID 0009-0004-7406-3095
Juan José Pérez-RuixoJanssen-Cilag Spain, Part of Janssen Pharmaceutical Companies of Johnson and Johnson, Madrid, Spain.ORCID 0000-0001-9890-745X
Oliver AckaertJanssen Clinical Pharmacology and Pharmacometrics, Beerse, Belgium.ORCID 0000-0002-5908-5200

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This analysis assessed the relationship between the plasma concentrations of loperamide and its N-desmethyl loperamide meta- bolite (M1) and the potential QT interval prolongation at therapeutic and supratherapeutic doses. The exposure-response analysis was performed using the data from healthy adults participating in a randomized, double-blind, single-dose, four-way (placebo; loperamide 8 mg [therapeutic]; loperamide 48 mg [supratherapeutic]; moxifloxacin 400 mg [positive control]) crossover study. The electrocardiographic measurements extracted from 12-lead digital Holter recordings were time-matched to pharmacokinetic sampling of loperamide/M1. The primary response variable was placebo-adjusted change from baseline in Fridericia-corrected QT interval (ΔΔQTcF); the exposure variable was loperamide and/or M1 concentration. A total of 53 participants with 1408 time-matched pharmacokinetic and ΔΔQTcF measurements was analyzed. Hysteresis between both loperamide and M1 concentrations and ΔΔQTcF was observed with supratherapeutic dose. The pre-specified linear concentration-ΔΔQTcF relationship was driven by M1 concentrations in the effect compartment. The model-predicted mean ΔΔQTcF at the geometric mean of the maximum concentration in the effect compartment was -0.526 msec (90% CI, -1.51 to 0.462) following 8-mg dose (2.1 ng/mL) and 6.06 msec (90% CI, 3.86-8.27) following 48-mg dose (14.2 ng/mL). The upper bound of two-sided 90% CI was < 10 msec for both doses. The sensitivity analysis considering loperamide concentrations in the effect compartment instead of M1 as input for the concentration-ΔΔQTcF analysis confirmed these findings. The data showed that loperamide or M1 does not have an effect on cardiac repolarization that exceeds the threshold of regulatory concern in healthy participants at doses of 8 and 48 mg.

Indexed as

Long QT SyndromeLoperamideAdultAntidiarrhealsCross-Over StudiesDose-Response Relationship, DrugDouble-Blind MethodElectrocardiographyElectrocardiography, AmbulatoryFemaleHealthy VolunteersHeart RateHumansMaleMiddle AgedMoxifloxacinAntidiarrhealsLoperamideMoxifloxacincardiologydrug developmentmodeling and simulationpharmacokineticsphase 1QTc prolongation

Identifiers

PMID39866059
PMCPMC11770325

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.