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Wang C, Lou C, Yang Z, Shi J, Niu N. Plasma metabolomic analysis reveals the metabolic characteristics and potential diagnostic biomarkers of spinal tuberculosis. Heliyon 2024; 10:e27940. [PMID: 38571585 PMCID: PMC10987919 DOI: 10.1016/j.heliyon.2024.e27940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 02/16/2024] [Accepted: 03/08/2024] [Indexed: 04/05/2024] Open
Abstract
Objectives This study aimed to conduct a non-targeted metabolomic analysis of plasma from patients with spinal tuberculosis (STB) to systematically elucidate the metabolomic alterations associated with STB, and explore potential diagnostic biomarkers for STB. Methods From January 2020 to January 2022, 30 patients with spinal tuberculosis (STBs) clinically diagnosed at the General Hospital of Ningxia Medical University and 30 age- and sex-matched healthy controls (HCs) were selected for this study. Using ultra-high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS) based metabolomics, we analyzed the metabolic profiles of 60 plasma samples. Statistical analyses, pathway enrichment, and receiver operating characteristic (ROC) analyses were performed to screen and evaluate potential diagnostic biomarkers. Results Metabolomic profiling revealed distinct alterations between the STBs and HCs cohorts. A total of 1635 differential metabolites were screened, functionally clustered, and annotated. The results showed that the differential metabolites were enriched in sphingolipid metabolism, tuberculosis, cutin, suberine and wax biosynthesis, beta-alanine metabolism, methane metabolism, and other pathways. Through the random forest algorithm, LysoPE (18:1(11Z)/0:0), 8-Demethyl-8-formylriboflavin 5'-phosphate, Glutaminyl-Gamma-glutamate, (2R)-O-Phospho-3-sulfolactate, and LysoPE (P-16:0/0:0) were determined to have high independent diagnostic value. Conclusions STBs exhibited significantly altered metabolite profiles compared with HCs. Here, we provide a global metabolomic profile and identify potential diagnostic biomarkers of STB. Five potential independent diagnostic biomarkers with high diagnostic value were screened. This study provides novel insights into the pathogenesis, diagnosis, and treatment strategies of STB.
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Affiliation(s)
- Chaoran Wang
- Department of Orthopedics, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China
- School of Clinical Medicine, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Caili Lou
- School of Clinical Medicine, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Zongqiang Yang
- Department of Orthopedics, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Jiandang Shi
- Department of Orthopedics, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Ningkui Niu
- Department of Orthopedics, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China
- Research Center for Prevention and Control of Bone and Joint Tuberculosis, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China
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Balhara A, Ladumor MK, Nankar RP, Syed SD, Giri S, Prasad B, Singh S. Exploration of the Plausible Mechanism of Ethambutol Induced Ocular Toxicity by Using Proteomics Informed Physiologically Based Pharmacokinetic (PBPK) Modeling. Pharm Res 2022; 39:677-689. [PMID: 35301670 DOI: 10.1007/s11095-022-03227-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Ethambutol (EMB) is a first-line anti-tubercular drug that is known to cause optic neuropathy. The exact mechanism of its eye toxicity is unknown; however, proposition is metal chelating effect of both EMB and its metabolite 2,2'-(ethylenediamino)-dibutyric acid (EDBA). The latter is formed by sequential metabolism of EMB by alcohol dehydrogenases (ADHs) and aldehyde dehydrogenases (ALDHs). The purpose of this study was to predict the levels of drug and EDBA in the eye using physiologically based pharmacokinetic (PBPK) modeling. METHODS The PBPK model of EMB was developed using GastroPlus. The intrinsic hepatic clearance of ALDH, calculated by the model, was scaled down using proteomics data to estimate the rate of formation of EDBA in the eye. Additionally, the comparative permeability of EMB and EDBA was assessed by employing in silico and in vitro approaches. The rate of formation of EDBA in the eye and permeability data were then incorporated in a compartmental model to predict the ocular levels of EMB and EDBA. RESULTS The simulation results of compartmental model highlighted that there was an on-site formation of EDBA upon metabolism of EMB. Furthermore, in silico and in vitro studies revealed that EDBA possessed much lower permeability than EMB. These observations meant that once EDBA was formed in the eye, it was not permeated out and hence achieved higher ocular concentration. CONCLUSION The on-site formation of EDBA in the eye, its higher local concentration due to lower ocular clearance and its pre-known characteristic to chelate metal species better explains the ocular toxicity shown by EMB.
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Affiliation(s)
- Ankit Balhara
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S Nagar, 160062, Punjab, India
| | - Mayur K Ladumor
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S Nagar, 160062, Punjab, India.,Department of Pharmaceutics, University of Washington, Seattle, WA, 99202, USA
| | - Rakesh P Nankar
- Aurigene Discovery Technologies Ltd., Electronics City Phase II, Bengaluru, 560100, Karnataka, India
| | - Samiulla Dodheri Syed
- Aurigene Discovery Technologies Ltd., Electronics City Phase II, Bengaluru, 560100, Karnataka, India
| | - Sanjeev Giri
- Aurigene Discovery Technologies Ltd., Electronics City Phase II, Bengaluru, 560100, Karnataka, India
| | - Bhagwat Prasad
- Department of Pharmaceutical Sciences, Washington State University, Spokane, WA, 99202, USA
| | - Saranjit Singh
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S Nagar, 160062, Punjab, India.
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Joshi AA, Khairnar SV, Chaudhari HK. In silico ADME/Pharmacokinetic and Target Prediction Studies of Ethambutol as Drug Molecule. Infect Disord Drug Targets 2022; 22:e050122199979. [PMID: 34986777 DOI: 10.2174/1871526522666220105113357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/21/2021] [Accepted: 11/06/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The conventional approach for the development of any pharmaceutically active molecule is a time-consuming and costly process because the synthesis is followed by laboratory tests which are then followed by long clinical trials. Hence a faster approach is desired. This article discusses Ethambutol, a frontline anti-tubercular drug that has its properties predicted by the SwissADME tool and the results would be compared with the findings published in the literature. OBJECTIVE The main objective is to study the predicted and experimental ADME properties, compare them. As well as study the predicted targets and understand the use of SwissADME for designing other drug molecules. METHOD SwissADME, an online tool for ADME prediction was used along with Swiss Target Prediction to understand the targets of the drug. Further, experimental data was obtained from the available scientific literature. RESULTS We found certain similarities between the predicted and experimental data. However, there were some variations, depending on the testing conditions. The results are interpreted ahead in the article. CONCLUSION Ethambutol's predicted ADME properties are discussed and as per findings from results, it can be concluded that other drug molecules can be similarly predicted using these tools. Also, based on predicted data we can reformulate and prepare some different preparations of the drug.
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Affiliation(s)
- Arnav Ajinkya Joshi
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Matunga (E), Mumbai, Maharashtra, India Pin 400 019
| | - Sakshi V Khairnar
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Matunga (E), Mumbai, Maharashtra, India Pin 400 019
| | - Hemchandra K Chaudhari
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Matunga (E), Mumbai, Maharashtra, India Pin 400 019
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An Assessment of Occasional Bio-Inequivalence for BCS1 and BCS3 Drugs: What are the Underlying Reasons? J Pharm Sci 2021; 111:124-134. [PMID: 34363838 DOI: 10.1016/j.xphs.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 11/20/2022]
Abstract
Despite having adequate solubility properties, bioequivalence (BE) studies performed on immediate release formulations containing BCS1/3 drugs occasionally fail. By systematically evaluating a set of 17 soluble drugs where unexpected BE failures have been reported and comparing to a set of 29 drugs where no such reports have been documented, a broad assessment of the risk factors leading to BE failure was performed. BE failures for BCS1/3 drugs were predominantly related to changes in Cmax rather than AUC. Cmax changes were typically modest, with minimal clinical significance for most drugs. Overall, drugs with a sharp plasma peak were identified as a key factor in BE failure risk. A new pharmacokinetic term (t½Cmax) is proposed to identify drugs at higher risk due to their peak plasma profile shape. In addition, the analysis revealed that weak acids, and drugs with particularly high gastric solubility are potentially more vulnerable to BE failure, particularly when these features are combined with a sharp Cmax peak. BCS3 drugs, which are often characterised as being more vulnerable to BE failure due to their potential for permeation and transit to be altered, particularly by excipient change, were not in general at greater risk of BE failures. These findings will help to inform how biowaivers may be optimally applied in the future.
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Keating AV, Soto J, Forbes C, Zhao M, Craig DQM, Tuleu C. Multi-Methodological Quantitative Taste Assessment of Anti-Tuberculosis Drugs to Support the Development of Palatable Paediatric Dosage Forms. Pharmaceutics 2020; 12:pharmaceutics12040369. [PMID: 32316692 PMCID: PMC7238065 DOI: 10.3390/pharmaceutics12040369] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 11/18/2022] Open
Abstract
The unpalatability of antituberculosis drugs is often cited as a major cause of non-adherence in children, yet limited quantitative taste assessment data are available. The aim of this research was to quantify the bitterness of isoniazid, rifampicin, pyrazinamide, and ethambutol dihydrochloride using two in vivo (a human taste panel and a rat brief-access taste aversion (BATA) model) and one in vitro (sensor) method. The response of the Insent TS-5000Z electronic tongue was compared to the in vivo drug concentration found to elicit and suppress half the maximum taste response (EC50 in human and IC50 in rats). Using dose-relevant concentrations, an overarching rank order of bitterness was derived (rifampicin > ethambutol > pyrazinamid~isoniazid). In vitro, only ethambutol exhibited a linear response for all sensors/concentrations. Based on the EC50/IC50 generated, a ‘taste index’ was proposed to allow for anticipation of the likelihood of taste issues in practice, taking in account the saturability in the saliva and therapeutic doses; ethambutol and isoniazid were found to be the worst tasting using this measure. The study presents the first quantitative taste analysis of these life-saving drugs and has allowed for a comparison of three methods of obtaining such data. Such information allows the operator to identify and prioritise the drugs requiring taste masking to produce palatable formulations.
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Affiliation(s)
- Alison V. Keating
- UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK; (A.V.K.); (J.S.); (D.Q.M.C.)
| | - Jessica Soto
- UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK; (A.V.K.); (J.S.); (D.Q.M.C.)
| | - Claire Forbes
- Pfizer R&D UK Ltd., Ramsgate Road, Sandwich, Kent CT13 9ND, UK;
| | - Min Zhao
- School of Pharmacy, Queen’s University Belfast, Lisburn Road, Belfast BT9 7BL, UK;
| | - Duncan Q. M. Craig
- UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK; (A.V.K.); (J.S.); (D.Q.M.C.)
| | - Catherine Tuleu
- UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK; (A.V.K.); (J.S.); (D.Q.M.C.)
- Correspondence: ; Tel.: +44-207-753-5857
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Zakowiecki D, Hess T, Banach G, Paszkowska J, Garbacz G. Effect of intra- and extragranular addition of highly porous tribasic calcium phosphate on properties of immediate release acyclovir formulation – Comparison with commercial tablets using compendial and biorelevant dissolution methods. J Drug Deliv Sci Technol 2019. [DOI: 10.1016/j.jddst.2019.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gatarić B, Parojčić J. Application of data mining approach to identify drug subclasses based on solubility and permeability. Biopharm Drug Dispos 2019; 40:51-61. [PMID: 30635908 DOI: 10.1002/bdd.2170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 12/18/2018] [Accepted: 12/21/2018] [Indexed: 01/20/2023]
Abstract
Solubility and permeability are recognized as key parameters governing drug intestinal absorption and represent the basis for biopharmaceutics drug classification. The Biopharmaceutics Classification System (BCS) is widely accepted and adopted by regulatory agencies. However, currently established low/high permeability and solubility boundaries are the subject of the ongoing scientific discussion. The aim of the present study was to apply data mining analysis on the selected drugs data set in order to develop a human permeability predictive model based on selected molecular descriptors, and to perform data clustering and classification to identify drug subclasses with respect to dose/solubility ratio (D/S) and effective permeability (Peff ). The Peff values predicted for 30 model drugs for which experimental human permeability data are not available were in good agreement with the reported fraction of drug absorbed. The results of clustering and classification analysis indicate the predominant influence of Peff over D/S. Two Peff cut-off values (1 × 10-4 and 2.7 × 10-4 cm/s) have been identified indicating the existence of an intermediate group of drugs with moderate permeability. Advanced computational analysis employed in the present study enabled the recognition of complex relationships and patterns within physicochemical and biopharmaceutical properties associated with drug bioperformance.
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Affiliation(s)
- Biljana Gatarić
- Department of Pharmaceutical Technology and Cosmetology, University of Banja Luka - Faculty of Medicine, Save Mrkalja 14, 78000, Banja Luka, Bosnia and Hercegovina
| | - Jelena Parojčić
- Department of Pharmaceutical Technology and Cosmetology, University of Belgrade - Faculty of Pharmacy, Vojvode Stepe 450, 11221, Belgrade, Serbia
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8
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Du Preez I, Loots DT. Novel insights into the pharmacometabonomics of first-line tuberculosis drugs relating to metabolism, mechanism of action and drug-resistance. Drug Metab Rev 2019; 50:466-481. [PMID: 30558443 DOI: 10.1080/03602532.2018.1559184] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ilse Du Preez
- Human Metabolomics, North-West University , Potchefstroom, South Africa
| | - Du Toit Loots
- Human Metabolomics, North-West University , Potchefstroom, South Africa
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9
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Verbeeck RK, Günther G, Kibuule D, Hunter C, Rennie TW. Optimizing treatment outcome of first-line anti-tuberculosis drugs: the role of therapeutic drug monitoring. Eur J Clin Pharmacol 2016; 72:905-16. [PMID: 27305904 DOI: 10.1007/s00228-016-2083-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/08/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Tuberculosis (TB) remains one of the world's deadliest communicable diseases. Although cure rates of the standard four-drug (rifampicin, isoniazid, pyrazinamide, ethambutol) treatment schedule can be as high as 95-98 % under clinical trial conditions, success rates may be much lower in less well resourced countries. Unsuccessful treatment with these first-line anti-TB drugs may lead to the development of multidrug resistant and extensively drug resistant TB. The intrinsic interindividual variability in the pharmacokinetics (PK) of the first-line anti-TB drugs is further exacerbated by co-morbidities such as HIV infection and diabetes. METHODS Therapeutic drug monitoring has been proposed in an attempt to optimize treatment outcome and reduce the development of drug resistance. Several studies have shown that maximum plasma concentrations (C max), especially of rifampicin and isoniazid, are well below the proposed target C max concentrations in a substantial fraction of patients being treated with the standard four-drug treatment schedule, even though treatment's success rate in these studies was typically at least 85 %. DISCUSSION The proposed target C max concentrations are based on the concentrations of these agents achieved in healthy volunteers and patients receiving the standard doses. Estimation of C max based on one or two sampling times may not have the necessary accuracy since absorption rate, especially for rifampicin, may be highly variable. In addition, minimum inhibitory concentration (MIC) variability should be taken into account to set clinically meaningful susceptibility breakpoints. Clearly, there is a need to better define the key target PK and pharmacodynamic (PD) parameters for therapeutic drug monitoring (TDM) of the first-line anti-TB drugs to be efficacious, C max (or area under the curve (AUC)) and C max/MIC (or AUC/MIC). CONCLUSION Although TDM of first-line anti-TB drugs has been successfully used in a limited number of specialized centers to improve treatment outcome in slow responders, a better characterization of the target PK and/or PK/PD parameters is in our opinion necessary to make it cost-effective.
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Affiliation(s)
- Roger K Verbeeck
- Faculty of Health Sciences, University of Namibia, Windhoek, Namibia.
| | - Gunar Günther
- Katutura State Hospital, Windhoek, Namibia.,Leibniz Center for Medicine and Biosciences, Borstel, Germany
| | - Dan Kibuule
- Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Christian Hunter
- Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Tim W Rennie
- Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
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10
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Saktiawati AMI, Sturkenboom MGG, Stienstra Y, Subronto YW, Sumardi, Kosterink JGW, van der Werf TS, Alffenaar JWC. Impact of food on the pharmacokinetics of first-line anti-TB drugs in treatment-naive TB patients: a randomized cross-over trial. J Antimicrob Chemother 2015; 71:703-10. [PMID: 26661397 DOI: 10.1093/jac/dkv394] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/22/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Concomitant food intake influences pharmacokinetics of first-line anti-TB drugs in healthy volunteers. However, in treatment-naive TB patients who are starting with drug treatment, data on the influence of food intake on the pharmacokinetics are absent. This study aimed to quantify the influence of food on the pharmacokinetics of isoniazid, rifampicin, ethambutol and pyrazinamide in TB patients starting anti-TB treatment. METHODS A prospective randomized cross-over pharmacokinetic study was conducted in treatment-naive adults with drug-susceptible TB. They received isoniazid, rifampicin and ethambutol intravenously and oral pyrazinamide on day 1, followed by oral administration of these drugs under fasted and fed conditions on two consecutive days. Primary outcome was the bioavailability while fasting and with concomitant food intake. This study was registered with clinicaltrials.gov identifier NCT02121314. RESULTS Twenty subjects completed the study protocol. Absolute bioavailability in the fasted state and the fed state was 93% and 78% for isoniazid, 87% and 71% for rifampicin and 87% and 82% for ethambutol. Food decreased absolute bioavailability of isoniazid and rifampicin by 15% and 16%, respectively. Pyrazinamide AUC0-24 was comparable for the fasted state (481 mg·h/L) and the fed state (468 mg·h/L). Food lowered the maximum concentrations of isoniazid, rifampicin and pyrazinamide by 42%, 22% and 10%, respectively. Time to maximum concentration was delayed for isoniazid, rifampicin and pyrazinamide. The pharmacokinetics of ethambutol were unaffected by food. CONCLUSIONS Food decreased absolute bioavailability and maximum concentration of isoniazid and rifampicin, but not of ethambutol or pyrazinamide, in treatment-naive TB patients. In patients prone to low drug exposure, this may further compromise treatment efficacy and increase the risk of acquired drug resistance.
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Affiliation(s)
- Antonia M I Saktiawati
- Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marieke G G Sturkenboom
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ymkje Stienstra
- Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Yanri W Subronto
- Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Sumardi
- Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Jos G W Kosterink
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Section of Pharmacotherapy and Pharmaceutical Care, Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Tjip S van der Werf
- Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan-Willem C Alffenaar
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Parr A, Hidalgo IJ, Bode C, Brown W, Yazdanian M, Gonzalez MA, Sagawa K, Miller K, Jiang W, Stippler ES. The Effect of Excipients on the Permeability of BCS Class III Compounds and Implications for Biowaivers. Pharm Res 2015; 33:167-76. [PMID: 26286187 PMCID: PMC4689772 DOI: 10.1007/s11095-015-1773-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 08/10/2015] [Indexed: 11/30/2022]
Abstract
Purpose Currently, the FDA allows biowaivers for Class I (high solubility and high permeability) and Class III (high solubility and low permeability) compounds of the Biopharmaceutics Classification System (BCS). Scientific evidence should be provided to support biowaivers for BCS Class I and Class III (high solubility and low permeability) compounds. Methods Data on the effects of excipients on drug permeability are needed to demonstrate that commonly used excipients do not affect the permeability of BCS Class III compounds, which would support the application of biowaivers to Class III compounds. This study was designed to generate such data by assessing the permeability of four BCS Class III compounds and one Class I compound in the presence and absence of five commonly used excipients. Results The permeability of each of the compounds was assessed, at three to five concentrations, with each excipient in two different models: Caco-2 cell monolayers, and in situ rat intestinal perfusion. No substantial increases in the permeability of any of the compounds were observed in the presence of any of the tested excipients in either of the models, with the exception of disruption of Caco-2 cell monolayer integrity by sodium lauryl sulfate at 0.1 mg/ml and higher. Conclusion The results suggest that the absorption of these four BCS Class III compounds would not be greatly affected by the tested excipients. This may have implications in supporting biowaivers for BCS Class III compounds in general.
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Affiliation(s)
- Alan Parr
- GlaxoSmithKline Inc., Research Triangle Park, North Carolina, 27709, USA
| | | | - Chris Bode
- Absorption Systems LP, Exton, Pennsylvania, 19341-2556, USA.
| | - William Brown
- US Pharmacopeial Convention, Rockville, Maryland, 20852, USA
| | - Mehran Yazdanian
- Teva Branded Pharmaceuticals R&D Inc., West Chester, Pennsylvania, 19380, USA
| | - Mario A Gonzalez
- P'Kinetics International, Inc., Pembroke Pines, Florida, 33027, USA
| | - Kazuko Sagawa
- Pfizer Global Research and Development, Groton, Connecticut, 06340, USA
| | - Kevin Miller
- GlaxoSmithKline Inc., Research Triangle Park, North Carolina, 27709, USA
| | - Wenlei Jiang
- Food and Drug Administration, Office of Generic Drugs, Silver Spring, Maryland, 20841, USA
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Gwaza L, Gordon J, Welink J, Potthast H, Leufkens H, Stahl M, García-Arieta A. Adjusted Indirect Treatment Comparison of the Bioavailability of WHO-Prequalified First-Line Generic Antituberculosis Medicines. Clin Pharmacol Ther 2014; 96:580-8. [DOI: 10.1038/clpt.2014.144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 06/25/2014] [Indexed: 11/10/2022]
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13
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Gellan gum nanohydrogel containing anti-inflammatory and anti-cancer drugs: a multi-drug delivery system for a combination therapy in cancer treatment. Eur J Pharm Biopharm 2014; 87:208-16. [DOI: 10.1016/j.ejpb.2013.11.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 10/28/2013] [Accepted: 11/04/2013] [Indexed: 11/21/2022]
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14
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Charoo NA, Shamsher AA, Lian LY, Abrahamsson B, Cristofoletti R, Groot D, Kopp S, Langguth P, Polli J, Shah VP, Dressman J. Biowaiver Monograph for Immediate-Release Solid Oral Dosage Forms: Bisoprolol Fumarate. J Pharm Sci 2014; 103:378-91. [DOI: 10.1002/jps.23817] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 11/20/2013] [Accepted: 11/20/2013] [Indexed: 11/10/2022]
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15
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Sediq A, Kubbinga M, Langguth P, Dressman J. The impact of the EMA change in definition of "dose" on the BCS dose-solubility ratio: a review of the biowaiver monographs. J Pharm Sci 2013; 103:65-70. [PMID: 24338749 DOI: 10.1002/jps.23769] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/11/2013] [Accepted: 10/11/2013] [Indexed: 11/06/2022]
Abstract
The Biopharmaceutics Classification System (BCS) defines the solubility characteristics of an active pharmaceutical substance based on its dose-solubility ratio: for highly soluble drugs this ratio is less than 250 mL over a defined pH range. Prior to the revision of the European Medicines Agency (EMA, formerly EMEA) guideline in 2010, the "dose" in this ratio was consistently defined by the US FDA, the EMA, and the WHO biowaiver guidelines as the highest dosage strength. However, in the revised EMA guideline, the dose is defined as the highest single dose administered according to the Summary of Product Characteristics. The new EMA criterion for highly soluble may be closer to the actual conditions of use, but it is not in line with the dose that would be used in the in vivo bioequivalence study. This paper evaluates the impact on the BCS classification of the active pharmaceutical ingredients of the published biowaiver monographs and discusses the consequences of the possible change in classification on biowaiver recommendations. Using the current definition of dose by the EMA, the biowaiver recommendations for metoclopramide hydrochloride and verapamil hydrochloride are no longer valid according to EMA criteria. For prednisolone and prednisone, a reevaluation of the biowaiver recommendation, taking into account the usual dosing levels, seems appropriate.
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Affiliation(s)
- Ahmad Sediq
- National Institute of Public Health and the Environment, Bilthoven, The Netherlands
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Darwich AS, Henderson K, Burgin A, Ward N, Whittam J, Ammori BJ, Ashcroft DM, Rostami-Hodjegan A. Trends in oral drug bioavailability following bariatric surgery: examining the variable extent of impact on exposure of different drug classes. Br J Clin Pharmacol 2013; 74:774-87. [PMID: 22463107 DOI: 10.1111/j.1365-2125.2012.04284.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Changes to oral drug bioavailability have been observed post bariatric surgery. However, the magnitude and the direction of changes have not been assessed systematically to provide insights into the parameters governing the observed trends. Understanding these can help with dose adjustments. WHAT THIS STUDY ADDS Analysis of drug characteristics based on a biopharmaceutical classification system is not adequate to explain observed trends in altered oral drug bioavailability following bariatric surgery, although the findings suggest solubility to play an important role. AIMS To identify the most commonly prescribed drugs in a bariatric surgery population and to assess existing evidence regarding trends in oral drug bioavailability post bariatric surgery. METHODS A retrospective audit was undertaken to document commonly prescribed drugs amongst patients undergoing bariatric surgery in an NHS hospital in the UK and to assess practice for drug administration following bariatric surgery. The available literature was examined for trends relating to drug permeability and solubility with regards to the Biopharmaceutics Classification System (BCS) and main route of elimination. RESULTS No significant difference in the 'post/pre surgery oral drug exposure ratio' (ppR) was apparent between BCS class I to IV drugs, with regards to dose number (Do) or main route of elimination. Drugs classified as 'solubility limited' displayed an overall reduction as compared with 'freely soluble' compounds, as well as an unaltered and increased ppR. CONCLUSION Clinical studies establishing guidelines for commonly prescribed drugs, and the monitoring of drugs exhibiting a narrow therapeutic window or without a readily assessed clinical endpoint, are warranted. Using mechanistically based pharmacokinetic modelling for simulating the multivariate nature of changes in drug exposure may serve as a useful tool in the further understanding of postoperative trends in oral drug exposure and in developing practical clinical guidance.
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Affiliation(s)
- Adam S Darwich
- Centre of Applied Pharmacokinetic Research, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK
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Nair A, Abrahamsson B, Barends DM, Groot D, Kopp S, Polli JE, Shah VP, Dressman JB. Biowaiver Monographs for Immediate-Release Solid Oral Dosage Forms: Primaquine Phosphate. J Pharm Sci 2012; 101:936-45. [DOI: 10.1002/jps.23006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 11/08/2011] [Accepted: 11/15/2011] [Indexed: 01/15/2023]
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18
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Strauch S, Jantratid E, Dressman JB, Junginger HE, Kopp S, Midha KK, Shah VP, Stavchansky S, Barends DM. Biowaiver monographs for immediate release solid oral dosage forms: mefloquine hydrochloride. J Pharm Sci 2011; 100:11-21. [PMID: 20602454 DOI: 10.1002/jps.22249] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Literature data relevant to the decision to allow a waiver of in vivo bioequivalence (BE) testing for the approval of immediate release solid oral dosage forms containing mefloquine hydrochloride as the only active pharmaceutical ingredient (API) are reviewed. The solubility and permeability data of mefloquine hydrochloride as well as its therapeutic use and therapeutic index, its pharmacokinetic properties, data related to the possibility of excipient interactions and reported BE/bioavailability studies were taken into consideration. Mefloquine hydrochloride is not a highly soluble API. Since no data on permeability are available, it cannot be classified according to the Biopharmaceutics Classification System with certainty. Additionally, several studies in the literature failed to demonstrate BE of existing products. For these reasons, the biowaiver cannot be justified for the approval of new multisource drug products containing mefloquine hydrochloride. However, scale-up and postapproval changes (HHS-FDA SUPAC) levels 1 and 2 and most EU type I variations may be approvable without in vivo BE, using the dissolution tests described in these regulatory documents.
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Affiliation(s)
- S Strauch
- Institute of Pharmaceutical Technology, Goethe University, Frankfurt am Main, Germany
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19
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Strauch S, Jantratid E, Stahl M, Rägo L, Dressman JB. The Biowaiver Procedure: Its Application to Antituberculosis Products in the WHO Prequalification Programme. J Pharm Sci 2011; 100:822-30. [DOI: 10.1002/jps.22349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 08/26/2010] [Accepted: 08/26/2010] [Indexed: 11/06/2022]
Affiliation(s)
- Stefanie Strauch
- Institute of Pharmaceutical Technology, Goethe University, 60438 Frankfurt am Main, Germany
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20
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Tsume Y, Amidon GL. The Biowaiver Extension for BCS Class III Drugs: The Effect of Dissolution Rate on the Bioequivalence of BCS Class III Immediate-Release Drugs Predicted by Computer Simulation. Mol Pharm 2010; 7:1235-43. [DOI: 10.1021/mp100053q] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yasuhiro Tsume
- College of Pharmacy, University of Michigan, Ann Arbor, Michigan 48109-1065
| | - Gordon L. Amidon
- College of Pharmacy, University of Michigan, Ann Arbor, Michigan 48109-1065
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Granero G, Longhi M, Mora M, Junginger H, Midha K, Shah V, Stavchansky S, Dressman J, Barends D. Biowaiver Monographs for Immediate Release Solid Oral Dosage Forms: Furosemide. J Pharm Sci 2010; 99:2544-56. [DOI: 10.1002/jps.22030] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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22
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Jantratid E, Strauch S, Becker C, Dressman J, Amidon G, Junginger H, Kopp S, Midha K, Shah V, Stavchansky S, Barends D. Biowaiver monographs for immediate release solid oral dosage forms: Doxycycline hyclate**A project of the International Pharmaceutical Federation (FIP), BCS and Biowaiver, www.fip.org/bcs.**This article reflects the scientific opinion of the authors and not the policies of regulating agencies, the International Pharmaceutical Federation (FIP) and the World Health Organization (WHO). J Pharm Sci 2010; 99:1639-53. [DOI: 10.1002/jps.21954] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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23
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Ramenskaya GV, Shokhin IE. Modern approaches to quality evaluation of generic drugs for their registration (a review). Pharm Chem J 2009. [DOI: 10.1007/s11094-009-0337-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Sakuma S, Ogura R, Masaoka Y, Kataoka M, Tanno FK, Kokubo H, Yamashita S. Correlation between in vitro dissolution profiles from enteric-coated dosage forms and in vivo absorption in rats for high-solubility and high-permeability model drugs. J Pharm Sci 2009; 98:4141-52. [DOI: 10.1002/jps.21716] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Becker C, Dressman JB, Junginger HE, Kopp S, Midha KK, Shah VP, Stavchansky S, Barends DM. Biowaiver monographs for immediate release solid oral dosage forms: rifampicin. J Pharm Sci 2009; 98:2252-67. [PMID: 19160441 DOI: 10.1002/jps.21624] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Literature data relevant to the decision to allow a waiver of in vivo bioequivalence (BE) testing for the approval of new multisource and reformulated immediate release (IR) solid oral dosage forms containing rifampicin as the only Active Pharmaceutical Ingredient (API) are reviewed. Rifampicin's solubility and permeability, its therapeutic use and index, pharmacokinetics, excipient interactions and reported BE/bioavailability (BA) problems were taken into consideration. Solubility and absolute BA data indicate that rifampicin is a BCS Class II drug. Of special concern for biowaiving is that many reports of failure of IR solid oral dosage forms of rifampicin to meet BE have been published and the reasons for these failures are yet insufficiently understood. Moreover, no reports were identified in which in vitro dissolution was shown to be predictive of nonequivalence among products. Therefore, a biowaiver based approval of rifampicin containing IR solid oral dosage forms cannot be recommended for either new multisource drug products or for major scale-up and postapproval changes (variations) to existing drug products.
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Affiliation(s)
- C Becker
- Institute of Pharmaceutical Technology, J.W. Goethe University, Frankfurt am Main, Germany
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Chuasuwan B, Binjesoh V, Polli JE, Zhang H, Amidon GL, Junginger HE, Midha KK, Shah VP, Stavchansky S, Dressman JB, Barends DM. Biowaiver monographs for immediate release solid oral dosage forms: diclofenac sodium and diclofenac potassium. J Pharm Sci 2009; 98:1206-19. [PMID: 18752289 DOI: 10.1002/jps.21525] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Literature data are reviewed regarding the scientific advisability of allowing a waiver of in vivo bioequivalence (BE) testing for the approval of immediate release (IR) solid oral dosage forms containing either diclofenac potassium and diclofenac sodium. Within the biopharmaceutics classification system (BCS), diclofenac potassium and diclofenac sodium are each BCS class II active pharmaceutical ingredients (APIs). However, a biowaiver can be recommended for IR drug products of each salt form, due to their therapeutic use, therapeutic index, pharmacokinetic properties, potential for excipient interactions, and performance in reported BE/bioavailability (BA) studies, provided: (a) test and comparator contain the same diclofenac salt; (b) the dosage form of the test and comparator is identical; (c) the test product contains only excipients present in diclofenac drug products approved in ICH or associated countries in the same dosage form, for instance as presented in this paper; (d) test drug product and comparator dissolve 85% in 30 min or less in 900 mL buffer pH 6.8, using the paddle apparatus at 75 rpm or the basket apparatus at 100 rpm; and (e) test product and comparator show dissolution profile similarity in pH 1.2, 4.5, and 6.8.
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Affiliation(s)
- B Chuasuwan
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, Maryland, USA
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Grube S, Langguth P, Junginger H, Kopp S, Midha K, Shah V, Stavchansky S, Dressman J, Barends D. Biowaiver monographs for immediate release solid oral dosage forms: Quinidine sulfate. J Pharm Sci 2009; 98:2238-51. [DOI: 10.1002/jps.21606] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Biowaiver Monographs for Immediate Release Solid Oral Dosage Forms: Aciclovir. J Pharm Sci 2008; 97:5061-73. [DOI: 10.1002/jps.21392] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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