Evidence map›Paper›PMID 40560402›Full record

ArticleJournal of pharmacokinetics and pharmacodynamics2025

FDA's insights: implementing new strategies for evaluating drug-induced QTc prolongation.

Yanyan Ji, Lars Johannesen, Christine Garnett

Abstract read
In one paragraph

Article in Journal of pharmacokinetics and pharmacodynamics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. 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

3 authors.

Yanyan JiDivision of Cardiology and Nephrology, Office of New Drugs, Center for Drugs Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, USA. yanyan.ji@fda.hhs.gov.
Lars JohannesenDivision of Cardiology and Nephrology, Office of New Drugs, Center for Drugs Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, USA.
Christine GarnettDivision of Cardiology and Nephrology, Office of New Drugs, Center for Drugs Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The questions and answers (Q&A) document for ICH E14/S7B provides the following advancements for QTc assessment: concentration-QTc modeling (C-QTc) as the primary analysis, accepting alternative approaches (Q&A 5.1 and 6.1) to thorough QT (TQT) studies, and incorporating an integrated nonclinical risk assessment as supporting evidence. Based on QT study reports reviewed by the FDA between 2016 and 2024, changes to the E14 guideline have resulted in a 34% decrease in the proportion of TQT studies, while the use of C-QTc analysis as the primary analysis has significantly increased. Studies using C-QTc instead of by-time analysis as the primary analysis reduced median sample sizes by 67%, 42%, and 35% for parallel, nested crossover, and crossover studies, respectively. The white paper C-QTc model was used for 60% of drugs that prolonged the QTc interval. From 2020 to 2024, reviews incorporating an integrated nonclinical risk assessment have also increased. The advancements in QTc assessments have streamlined QTc assessment and made clinical trials less resource-intensive. As the advancements continue to evolve the drug safety evaluation is likely to become even more adaptive and enable more precise and targeted QTc assessment.

Indexed as

Drug-Related Side Effects and Adverse ReactionsLong QT SyndromeCross-Over StudiesElectrocardiographyHumansRisk AssessmentUnited StatesUnited States Food and Drug AdministrationElectrocardiogramICH E14 guidelineQTc interval prolongationThorough QT study

Identifiers

PMID40560402
PMCPMC12198268

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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.