Pharmacokinetic equivalence of 5(ethyl(2H)5)- and unlabelled phenobarbitone

Assessing the bioequivalence of analogues of endogenous substances ('endogenous drugs'): considerations to optimize study design

BACKGROUND

Assessment of the bioequivalence of generic versions of certain reference drugs is complicated by the presence of endogenous levels of said compounds which cannot be distinguished from externally derived compound levels following drug administration. If unaccounted for, the presence of endogenous compound biases towards equivalence in bioequivalence studies of these drugs. Bioequivalence assessments may be complicated further as disposition of the exogenous analogue can be subject to various endogenous processes resulting in nonlinear pharmacokinetics. To overcome these inherent biases a number of different strategies have been employed.

AIMS

To critically review methods used to overcome confounding biases in bioequivalence studies of 'endogenous' drugs.

METHODS

A literature search of the EMBASE and PubMed databases was performed.

RESULTS

The following strategies were identified: ablation/modulation of baseline endogenous substance levels; recruitment of 'substance-deficient' populations; restriction of dietary intake of the relevant substance; standardization of conditions with the potential to affect relevant homeostatic mechanisms; correction for baseline substance levels; and administration of supra-therapeutic drug doses.

CONCLUSIONS

On the basis of this review key study design concepts, intended to optimize the design of future bioequivalence studies of these so-called 'endogenous drugs', are described. The dual stable isotope method, which could be used in a specific context, is also discussed.

Deuterium isotope effects on noncovalent interactions between molecules

The topic of deuterium isotope effects is usually concerned with the effects on chemical reactions that are caused by the substitution of deuterium atoms for protium, or hydrogen, atoms in a molecule. These effects include changes in the rate of cleavage of covalent bonds to deuterium, or to an atom located adjacent to deuterium, in a reactant molecule. Deuterium isotope effects on other, noncovalent, interactions between molecules are known to occur, but they are generally considered to be insignificant, especially in biological experiments where deuterium substituted molecules are used as tracers. Noncovalent interactions between molecules include hydrogen bonding, and ionic and van der Waals interactions. This article reviews evidence for deuterium isotope effects on noncovalent interactions, with an emphasis on binding interactions between molecules of biological interest, but also including examples of nonbiological molecules in order to demonstrate the generality of these effects. The reality of this effect relies on the assumption that the only difference between the isotopomers considered is the presence of deuterium or hydrogen; there are no impurities present. The physical basis of the effect may be due to differences in the polarities and/or sizes of deuterated versus nondeuterated isomers, and the extent of a deuterium isotope effect on a noncovalent interaction depends on the site of deuteration within a biomolecule. The presence of this effect requires careful interpretation of results obtained in experiments with deuterium labeled compounds.