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This content will become publicly available on April 23, 2026

Title: Dosing Time of Day Impacts the Safety of Antiarrhythmic Drugs in a Computational Model of Cardiac Electrophysiology
Circadian clocks regulate many aspects of human physiology, including cardiovascular function and drug metabolism. Administering drugs at optimal times of the day may enhance effectiveness and reduce side effects. Certain cardiac antiarrhythmic drugs have been withdrawn from the market due to unexpected proarrhythmic effects such as fatal Torsade de Pointes (TdP) ventricular tachycardia. The Comprehensive in vitro Proarrhythmia Assay (CiPA) is a recent global initiative to create guidelines for the assessment of drug-induced arrhythmias that recommends a central role for computational modeling of ion channels andin silicoevaluation of compounds for TdP risk. We simulated circadian regulation of cardiac excitability and explored how dosing time of day affects TdP risk for 11 drugs previously classified into risk categories by CiPA. The model predicts that a high-risk drug taken at the most optimal time of day may actually be safer than a low-risk drug taken at the least optimal time of day. Based on these proof-of-concept results, we advocate for the incorporation of circadian clock modeling into the CiPA paradigm for assessing drug-induced TdP risk. Since cardiotoxicity is the leading cause of drug discontinuation, modeling cardiac-related chronopharmacology has significant potential to improve therapeutic outcomes.  more » « less
Award ID(s):
2327184 2152115
PAR ID:
10584778
Author(s) / Creator(s):
 ;  
Publisher / Repository:
SAGE Publications
Date Published:
Journal Name:
Journal of Biological Rhythms
Volume:
40
Issue:
3
ISSN:
0748-7304
Format(s):
Medium: X Size: p. 301-310
Size(s):
p. 301-310
Sponsoring Org:
National Science Foundation
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