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Xiao D, Jin Y, Zhang M, Di X, Fu L, Jiang C, Lai Z, Ge Y, Ji S, Zhang Y, Zheng L, Wang Z, Gong F. Chiral pharmacokinetics of ibuprofen enantiomers in Chinese preterm neonates with patent ductus arteriosus using a validated UHPLC-MS/MS method. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1227:123765. [PMID: 37454407 DOI: 10.1016/j.jchromb.2023.123765] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 07/18/2023]
Abstract
Persistent patent ductus arteriosus (PDA) is generally observed in preterm neonates. Oral ibuprofen is the standard treatment for closing PDA in China. To investigate the chiral pharmacokinetics of ibuprofen enantiomers in Chinese premature infants with PDA, a simple, fast, and sensitive analytical enantioselective technology was developed with ultra-performance liquid chromatography (UPLC) - tandem mass spectrometry (MS/MS). Chromatographic separation of (R)-ibuprofen and (S)-ibuprofen was accomplished on a Lux® 3 µm Cellulose-3 (150 mm × 2.0 mm, 3 μm) at a flow rate of 0.2 mL/min within 6 min. UPLC separation was achieved by isocratic elution with a mobile phase consisting of formic acid:water (75:1000000, v/v) and acetonitrile:methanol (1:1, v/v). Only 50 µL of plasma samples were pre-treated with acetonitrile precipitation. Ibuprofen-d3 was used as an internal standard. The standard curves of both enantiomers were linear over a concentration range of 0.0500 μg/mL to 50.00 μg/mL. The method has been validated for selectivity, carryover effect, lower limit of quantification, precision, accuracy, matrix effect, extraction recovery, dilution integrity, and stability based on the existing guidelines of the National Medical Products Administration, the United States Food and Drug Administration, and the European Medicines Agency. This method has been successfully applied to investigate the pharmacokinetics of ibuprofen enantiomers in 9 preterm infants with PDA. Our results showed that a high chiral inversion ratio of (R)- to (S)-ibuprofen exists in Chinese preterm neonates. Further studies should be conducted to monitor drug concentration following oral administration of ibuprofen and to consider the effect of individual variations and ethnic differences in metabolizing enantiomers of ibuprofen in premature neonates with PDA.
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Affiliation(s)
- Dan Xiao
- Department of Pediatrics, Yongchuan Hospital Affiliated to Chongqing Medical University, Chongqing 402160, China; Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital, Sichuan University. Chengdu 610041, China; Clinical Trial Center, West China Hospital, Sichuan University. Chengdu 610041, China
| | - Ying Jin
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital, Sichuan University. Chengdu 610041, China; Clinical Trial Center, West China Hospital, Sichuan University. Chengdu 610041, China
| | - Mengyu Zhang
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital, Sichuan University. Chengdu 610041, China; Clinical Trial Center, West China Hospital, Sichuan University. Chengdu 610041, China
| | - Xiangjie Di
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital, Sichuan University. Chengdu 610041, China; Clinical Trial Center, West China Hospital, Sichuan University. Chengdu 610041, China
| | - Lisha Fu
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital, Sichuan University. Chengdu 610041, China; Clinical Trial Center, West China Hospital, Sichuan University. Chengdu 610041, China
| | - Changke Jiang
- Department of Neonates, Woman and Children Hospital of Yongchuan, Chongqing 402160, China
| | - Zhuoli Lai
- Department of Neonates, Children Hospital of Yongchuan, Chongqing 402160, China
| | - Yating Ge
- Department of Clinical Pharmacy and Pharmacy Administration, West China School of Pharmacy, Sichuan University, Chengdu 610041, China
| | - Shanmian Ji
- Department of Pharmacy, West China School of Pharmacy, Sichuan University, Chengdu 610041, China
| | - Yuming Zhang
- West China Medical School, Sichuan University, Chengdu 610041, China
| | - Li Zheng
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital, Sichuan University. Chengdu 610041, China; Clinical Trial Center, West China Hospital, Sichuan University. Chengdu 610041, China
| | - Zhenlei Wang
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital, Sichuan University. Chengdu 610041, China; Clinical Trial Center, West China Hospital, Sichuan University. Chengdu 610041, China.
| | - Fang Gong
- Department of Pediatrics, Yongchuan Hospital Affiliated to Chongqing Medical University, Chongqing 402160, China.
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Padrini R, Ancora C, Nardo D, De Rosa G, Salvadori S, Bonadies L, Frigo AC, Lago P. Ibuprofen enantiomers in premature neonates with patent ductus arteriosus: Preliminary data on an unexpected pharmacokinetic profile of S(+)-ibuprofen. Chirality 2021; 33:281-291. [PMID: 33779002 PMCID: PMC8252714 DOI: 10.1002/chir.23308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/02/2021] [Accepted: 03/08/2021] [Indexed: 12/26/2022]
Abstract
S(+)-ibuprofen (S-IBU) and R(-)-ibuprofen (R-IBU) concentrations were measured in 16 neonates with patent ductus arteriosus during a cycle of therapy (three intravenous doses of 10-5-5 mg kg-1 at 24-h intervals), at the end of the first infusion and 6, 24, 48, and 72 h later. Data were analyzed with a PK model that included enantiomer elimination rate constants and the R- to S-IBU conversion rate constant. The T½ of S-IBU in the newborn was much longer than in adults (41.8 vs. ≈2 h), whereas the T½ of R-IBU appeared to be the same (2.3 h). The mean fraction of R- to S-IBU conversion was much the same as in adults (0.41 vs. ≈0.60). S-IBU concentrations measured 6 h after the first dose were higher than at the end of the infusion in 10 out of 16 cases, and in five cases, they remained higher even after 24 h. This behavior is unprecedented and may be attributable to a rapid R-to-S conversion overlapping with a slow S-IBU elimination rate. In 13 of the 16 neonates, S-IBU concentrations at 48 and/or 72 h were lower than expected, probably due to the rapid postnatal maturation of the newborn's liver metabolism.
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Affiliation(s)
- Roberto Padrini
- Clinical Pharmacology Unit, Department of MedicineUniversity of PadovaPadovaItaly
| | - Caterina Ancora
- Neonatal Intensive Care Unit, Department of Women's and Children's HealthUniversity of PadovaPadovaItaly
| | - Daniel Nardo
- Neonatal Intensive Care Unit, Department of Women's and Children's HealthUniversity of PadovaPadovaItaly
| | - Giovanni De Rosa
- Clinical Pharmacology Unit, Department of MedicineUniversity of PadovaPadovaItaly
| | - Sabrina Salvadori
- Neonatal Intensive Care Unit, Department of Women's and Children's HealthUniversity of PadovaPadovaItaly
| | - Luca Bonadies
- Neonatal Intensive Care Unit, Department of Women's and Children's HealthUniversity of PadovaPadovaItaly
| | - Anna Chiara Frigo
- Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac‐Thoracic‐Vascular Sciences and Public HealthUniversity of PadovaPadovaItaly
| | - Paola Lago
- Neonatal Intensive Care Unit, Department of Women's and Children's HealthUniversity of PadovaPadovaItaly
- Neonatal Intensive Care Unit, Women's and Children's DepartmentCà Foncello HospitalTrevisoItaly
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