Recapitulation of Clinical Individual Susceptibility to Drug-Induced QT Prolongation in Healthy Subjects Using iPSC-Derived Cardiomyocytes

To predict drug-induced serious adverse events (SAE) in clinical trials, a model using a panel of cells derived from human induced pluripotent stem cells (hiPSCs) of individuals with different susceptibilities could facilitate major advancements in translational research in terms of safety and pharmaco-economics. However, it is unclear whether hiPSC-derived cells can recapitulate interindividual differences in drug-induced SAE susceptibility in populations not having genetic disorders such as healthy subjects. Here, we evaluated individual differences in SAE susceptibility based on an in vitro model using hiPSC-derived cardiomyocytes (hiPSC-CMs) as a pilot study. hiPSCs were generated from blood samples of ten healthy volunteers with different susceptibilities to moxifloxacin (Mox)-induced QT prolongation. Different Mox-induced field potential duration (FPD) prolongation values were observed in the hiPSC-CMs from each individual. Interestingly, the QT interval was significantly positively correlated with FPD at clinically relevant concentrations (r > 0.66) in multiple analyses including concentration-QT analysis. Genomic analysis showed no interindividual significant differences in known target-binding sites for Mox and other drugs such as the hERG channel subunit, and baseline QT ranges were normal. The results suggest that hiPSC-CMs from healthy subjects recapitulate susceptibility to Mox-induced QT prolongation and provide proof of concept for in vitro preclinical trials. [Display omitted] •We prepared iPSCs from healthy volunteers with different susceptibilities to drug•Mox-induced FPD prolongation in hiPSC-CMs differed between individuals•QT interval correlated with FPD value around clinically relevant concentrations•We found no significant genetic differences in the TdP-susceptibility SNP analysis Shinozawa and colleagues demonstrate that susceptibility to moxifloxacin-induced QT prolongation is significantly correlated between hiPSC-CMs and the healthy individuals they are derived from, showing no significant differences in any drug target-binding sites or in the hERG channel subunit, and no polymorphisms associated with drug-induced QT prolongation. The data suggest the potential of hiPSC-CMs for intrinsic drug susceptibility testing in healthy humans.