Cardiac safety liability assessment is essential in drug development to prevent arrhythmias like torsades de pointes (TdP), which can cause sudden death. Traditional ICH S7B and E14 guidelines focus on hERG blockade and QT prolongation, but these lack specificity, leading to high attrition or missed risks. The Comprehensive in vitro Proarrhythmia Assay (CiPA), launched in 2013 by FDA, academia, and industry, shifts to a mechanistic paradigm. It integrates in vitro ion channel assays, in silico modeling, hiPSC-CM evaluations, and clinical ECGs to predict proarrhythmia accurately, reducing animal use and improving efficiency. Validated with 28 reference compounds, CiPA enhances specificity.
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