2
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Mangin O, Zheng Y, Bouazza N, Foissac F, Benaboud S, Lui G, Hirt D, Mouthon L, Tréluyer JM, Urien S. Free prednisolone pharmacokinetics predicted from total concentrations in patients with inflammatory - immunonologic conditions. Fundam Clin Pharmacol 2019; 34:270-278. [PMID: 31625621 DOI: 10.1111/fcp.12515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/25/2019] [Accepted: 10/16/2019] [Indexed: 11/28/2022]
Abstract
Prednisone is an anti-inflammatory drug widely used in internal medicine and rheumatology, but dosing remains empirical. The active metabolite of prednisone is free prednisolone. The aim of this work was to build a population pharmacokinetic (PK) model that can predict free prednisolone concentrations in patients with inflammatory/immunologic conditions.A total of 107 patients from the department of internal medicine of Cochin hospital provided 343 observations. Blood samples drawn for biological analyses were used for drug determination. Total plasma prednisolone concentrations were measured by liquid chromatography-mass spectrometry, and the data were modelled using Monolix. The pharmacokinetics was ascribed a one-compartment open model with three transit compartments standing for the absorption and metabolism process. The model used predicts free concentrations that served to derive total concentrations given published binding constants. Only size parameters influenced the pharmacokinetics. Free prednisolone CLU /F and VU /F, scaled allometrically on lean body weight, were, respectively, 26.7 L/h and 94.3 L for 50 kg LBW. CLU /F interindividual variability was 0.20. The additive and proportional residual variabilities were, respectively, 4.3 µg/L and 0.20. The results point out some dosing issues, that is the possibility of under- or over-dosage in thin or overweight patients respectively.
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Affiliation(s)
- Olivier Mangin
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune of Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Yi Zheng
- Sorbonne Paris Cité, Université Paris Descartes, EA7323, Paris, France.,Service de Pharmacologie Clinique, Hôpital Cochin, AP-HP, Groupe Hospitalier Paris Centre, Paris, France
| | - Naïm Bouazza
- Sorbonne Paris Cité, Université Paris Descartes, EA7323, Paris, France.,Unité de Recherche Clinique Paris Descartes Necker Cochin, AP-HP, Pariss, France.,Cochin-Necker, CIC-1419 Inserm, Paris, France
| | - Frantz Foissac
- Sorbonne Paris Cité, Université Paris Descartes, EA7323, Paris, France.,Unité de Recherche Clinique Paris Descartes Necker Cochin, AP-HP, Pariss, France.,Cochin-Necker, CIC-1419 Inserm, Paris, France
| | - Sihem Benaboud
- Sorbonne Paris Cité, Université Paris Descartes, EA7323, Paris, France.,Service de Pharmacologie Clinique, Hôpital Cochin, AP-HP, Groupe Hospitalier Paris Centre, Paris, France.,Cochin-Necker, CIC-1419 Inserm, Paris, France
| | - Gabrielle Lui
- Sorbonne Paris Cité, Université Paris Descartes, EA7323, Paris, France.,Service de Pharmacologie Clinique, Hôpital Cochin, AP-HP, Groupe Hospitalier Paris Centre, Paris, France.,Cochin-Necker, CIC-1419 Inserm, Paris, France
| | - Déborah Hirt
- Sorbonne Paris Cité, Université Paris Descartes, EA7323, Paris, France.,Service de Pharmacologie Clinique, Hôpital Cochin, AP-HP, Groupe Hospitalier Paris Centre, Paris, France.,Cochin-Necker, CIC-1419 Inserm, Paris, France
| | - Luc Mouthon
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune of Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Jean-Marc Tréluyer
- Sorbonne Paris Cité, Université Paris Descartes, EA7323, Paris, France.,Service de Pharmacologie Clinique, Hôpital Cochin, AP-HP, Groupe Hospitalier Paris Centre, Paris, France.,Unité de Recherche Clinique Paris Descartes Necker Cochin, AP-HP, Pariss, France.,Cochin-Necker, CIC-1419 Inserm, Paris, France
| | - Saïk Urien
- Sorbonne Paris Cité, Université Paris Descartes, EA7323, Paris, France.,Unité de Recherche Clinique Paris Descartes Necker Cochin, AP-HP, Pariss, France.,Cochin-Necker, CIC-1419 Inserm, Paris, France
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3
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Chan TS, Yu H, Moore A, Khetani SR, Tweedie D. Meeting the Challenge of Predicting Hepatic Clearance of Compounds Slowly Metabolized by Cytochrome P450 Using a Novel Hepatocyte Model, HepatoPac. Drug Metab Dispos 2018; 47:58-66. [PMID: 30552098 DOI: 10.1124/dmd.113.053397fullarticlecorrection] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 08/15/2013] [Indexed: 12/17/2022] Open
Abstract
Generating accurate in vitro intrinsic clearance data is an important aspect of predicting in vivo human clearance. Primary hepatocytes in suspension are routinely used to predict in vivo clearance; however, incubation times have typically been limited to 4-6 hours, which is not long enough to accurately evaluate the metabolic stability of slowly metabolized compounds. HepatoPac is a micropatterened hepatocyte-fibroblast coculture system that can be used for continuous incubations of up to 7 days. This study evaluated the ability of human HepatoPac to predict the in vivo clearance (CL) of 17 commercially available compounds with low to intermediate clearance (<12 ml/min/kg). In vitro half-life for disappearance of each compound was converted to hepatic clearance using the well stirred model, with and without correction for plasma protein binding. Hepatic CL, using three individual donors, was accurately predicted for 11 of 17 compounds (59%; predicted clearance within 2-fold of observed human in vivo clearance values). The accuracy of prediction increased to 82% (14 of 17 compounds) with an acceptance criterion defined as within 3-fold. When considering only low clearance compounds (<5 ml/min per kg), which represented 10 of the 17 compounds, the accuracy of prediction was 70% within 2-fold and 100% within 3-fold. In addition, the turnover of three slowly metabolized compounds (alprazolam, meloxicam, and tolbutamide) in HepatoPac was directly compared with turnover in suspended hepatocytes. The turnover of alprazolam and tolbutamide was approximately 2-fold greater using HepatoPac compared with suspended hepatocytes, which was roughly in line with the extrapolated values (correcting for the longer incubation time and lower cell number with HepatoPac). HepatoPac, but not suspended hepatocytes, demonstrated significant turnover of meloxicam. These results demonstrate the utility of HepatoPac for prediction of in vivo hepatic clearance, particularly with low clearance compounds.
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Affiliation(s)
- Tom S Chan
- Drug Metabolism and Pharmacokinetics, Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut (T.S.C., H.Y., D.T.); Hepregen Corporation, Medford, Massachusetts (A.M.); and Mechanical and Biomedical Engineering, Colorado State University, Fort Collins, Colorado (S.R.K.)
| | - Hongbin Yu
- Drug Metabolism and Pharmacokinetics, Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut (T.S.C., H.Y., D.T.); Hepregen Corporation, Medford, Massachusetts (A.M.); and Mechanical and Biomedical Engineering, Colorado State University, Fort Collins, Colorado (S.R.K.)
| | - Amanda Moore
- Drug Metabolism and Pharmacokinetics, Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut (T.S.C., H.Y., D.T.); Hepregen Corporation, Medford, Massachusetts (A.M.); and Mechanical and Biomedical Engineering, Colorado State University, Fort Collins, Colorado (S.R.K.)
| | - Salman R Khetani
- Drug Metabolism and Pharmacokinetics, Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut (T.S.C., H.Y., D.T.); Hepregen Corporation, Medford, Massachusetts (A.M.); and Mechanical and Biomedical Engineering, Colorado State University, Fort Collins, Colorado (S.R.K.)
| | - Donald Tweedie
- Drug Metabolism and Pharmacokinetics, Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut (T.S.C., H.Y., D.T.); Hepregen Corporation, Medford, Massachusetts (A.M.); and Mechanical and Biomedical Engineering, Colorado State University, Fort Collins, Colorado (S.R.K.)
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4
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Chan TS, Yu H, Moore A, Khetani SR, Kehtani SR, Tweedie D. Meeting the challenge of predicting hepatic clearance of compounds slowly metabolized by cytochrome P450 using a novel hepatocyte model, HepatoPac. Drug Metab Dispos 2013; 41:2024-32. [PMID: 23959596 DOI: 10.1124/dmd.113.053397] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Generating accurate in vitro intrinsic clearance data is an important aspect of predicting in vivo human clearance. Primary hepatocytes in suspension are routinely used to predict in vivo clearance; however, incubation times have typically been limited to 4-6 hours, which is not long enough to accurately evaluate the metabolic stability of slowly metabolized compounds. HepatoPac is a micropatterened hepatocyte-fibroblast coculture system that can be used for continuous incubations of up to 7 days. This study evaluated the ability of human HepatoPac to predict the in vivo clearance (CL) of 17 commercially available compounds with low to intermediate clearance (<12 ml/min per kg). In vitro half-life for disappearance of each compound was converted to hepatic clearance using the well stirred model, with and without correction for plasma protein binding. Hepatic CL, using three individual donors, was accurately predicted for 10 of 17 compounds (59%; predicted clearance within 2-fold of observed human in vivo clearance values). The accuracy of prediction increased to 76% (13 of 17 compounds) with an acceptance criterion defined as within 3-fold. When considering only low clearance compounds (<5 ml/min per kg), which represented 10 of the 17 compounds, the accuracy of prediction was 60% within 2-fold and 90% within 3-fold. In addition, the turnover of three slowly metabolized compounds (alprazolam, meloxicam, and tolbutamide) in HepatoPac was directly compared with turnover in suspended hepatocytes. The turnover of alprazolam and tolbutamide was approximately 2-fold greater using HepatoPac compared with suspended hepatocytes, which was roughly in line with the extrapolated values (correcting for the longer incubation time and lower cell number with HepatoPac). HepatoPac, but not suspended hepatocytes, demonstrated significant turnover of meloxicam. These results demonstrate the utility of HepatoPac for prediction of in vivo hepatic clearance, particularly with low clearance compounds.
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Affiliation(s)
- Tom S Chan
- Drug Metabolism and Pharmacokinetics, Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut (T.S.C., H.Y., D.T.); Hepregen Corporation, Medford, Massachusetts (A.M.); and Mechanical and Biomedical Engineering, Colorado State University, Fort Collins, Colorado (S.R.K.)
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Poelmans S, De Wasch K, Noppe H, Van Hoof N, Van de Wiele M, Courtheyn D, Gillis W, Vanthemsche P, Janssen CR, De Brabander HF. Androstadienetrione, a boldenone-like component, detected in cattle faeces with GC-MSnand LC-MSn. ACTA ACUST UNITED AC 2005; 22:798-807. [PMID: 16192066 DOI: 10.1080/02652030500239508] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Boldenone (1,4-androstadiene-17-ol-3-one, Bol) has been the subject of a heated debate because of ongoing confusion about its endogenous or exogenous origin when detected in one of its forms in faecal or urine samples from cattle. An expert report was recently written on the presence and metabolism of Bol in various animal species. Androstadienedione (ADD) is a direct precursor of 17beta-boldenone (betaBol). It is a 3,17-dione; ssBol is a 17-ol-3-one. Not much is published on 1,4-androstadiene-3,17-diol, which is a 3,17-diol (ADL). If animals were exposed for a longer period to one of these analytes, a metabolic pathway would be initiated to eliminate these compounds. Similar to recent testosterone metabolism studies in the aquatic invertebrate Neomysis integer, ADD, ssBol and ADL could also be eliminated as hydroxymetabolites after exposure. The presence of 11-keto-steroids or 11-hydroxy-metabolites in faecal samples can interfere with a confirmation method by gas chromatography-negative chemical ionization mass spectrometry (GC-NCI-MS), after oxidation of corticosteroids with a double bond in the A-ring (e.g. prednisolone or its metabolite prednisone). The presence of androstadienetrione (ADT) in faecal samples of cattle has never been reported. The origin of its presence can be explained through different pathways, which are presented in this paper.
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Affiliation(s)
- S Poelmans
- Laboratory of Chemical Analysis, Research Group of Veterinary Public Health and Zoonoses, Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium
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Al-Habet SM, Rogers HJ. Effect of food on the absorption and pharmacokinetics of prednisolone from enteric-coated tablets. Eur J Clin Pharmacol 1989; 37:423-6. [PMID: 2598978 DOI: 10.1007/bf00558515] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Prednisolone absorption and bioavailability of 10 mg enteric-coated (EC) and plain (uncoated) tablets were investigated after fasting and heavy meals (EC only) consumed to satiety in normal healthy volunteers. The same volunteers had also received 16 mg of prednisolone intravenously. In fasted subjects, the absolute bioavailability fraction, as normalised for intravenous doses, of prednisolone from plain tablets was 1.055 and from EC tablets was 0.996. The peak concentrations after plain and EC tablets were 309 and 249 ng/ml attained at 0.98 and 5.14 h, respectively. The means plasma elimination half-lives following the plain, EC tablets and intravenous administration in fasting conditions were 3.73, 3.89 and 3.78 h, respectively. Food interfered with both the absorption and the pharmacokinetics of prednisolone after EC tablets resulting in variability in its plasma levels. In some cases absorption of prednisolone was delayed for 12 h and remained at a measurable level for 24 h. In other cases, a normal absorption pattern was observed. This inter- and intrasubject variability of the effect of food appears to be related to its quantity, constituents and also the subjects physiological characteristics. It is concluded that enteric-coated prednisolone tablets should be administered at least 2 h between meals. However, for more predictable corticosteroid absorption (perhaps thus avoiding the therapeutic failure), plain prednisolone tablets are preferable.
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Affiliation(s)
- S M Al-Habet
- Department of Clinical Pharmacology, Guy's Hospital Medical School, University of London, England
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