1
|
Gobetti C, Dissanayake S, Shur J, Ganley W, Silva L, Salem I, Najib O, Harb U. Bioequivalence of Two Tiotropium Dry Powder Inhalers and the Utility of Realistic Impactor Testing. J Aerosol Med Pulm Drug Deliv 2023; 36:257-267. [PMID: 37358626 DOI: 10.1089/jamp.2022.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Introduction: Inhaled antimuscarinics are a cornerstone of the management of chronic obstructive pulmonary disease. This article details a series of five pharmacokinetic (PK) studies comparing a generic tiotropium dry powder inhaler (DPI) to Spiriva HandiHaler, the realistic in vitro methods used to support those studies, and the related in vitro-in vivo correlations (IVIVCs). Methods: All five PK studies were of open-label, single-dose, crossover design with test and reference treatments administered to healthy subjects. Following unexpected results in the first three PK studies, a realistic impactor method was developed comprising an Oropharyngeal Consortium (OPC) mouth-throat and simulated inspiratory profiles in conjunction with a Next Generation Impactor (NGI). Mass fractions and the in vitro whole lung dose were estimated for the test product and Spiriva® HandiHaler® using this method, and IVIVCs derived. Results: Bioequivalence could not be demonstrated for Cmax in the first three PK studies (test/reference ratios ranging from 83.1% to 131.8%), although was observed for AUCt. Reanalysis of the corresponding biobatches with the realistic NGI method revealed in vitro ratios aligned with these PK data (in contrast to the compendial NGI data) and thus inadvertent selection of "mismatched" biobatches. Two further PK studies were undertaken, supported by the realistic NGI method. With the comparison of test and reference products similarly positioned within their respective product performance distributions, bioequivalence was confirmed in both studies. IVIVCs based on mass fractions as per the realistic NGI method were robust and highly predictive of PK outcomes. Conclusions: The test tiotropium DPI and Spiriva HandiHaler were bioequivalent when equitable biobatch comparisons, based on realistic NGI testing, were performed. The observations from this program support the utility of realistic test methods for inhaled product development.
Collapse
Affiliation(s)
| | | | - Jag Shur
- Nanopharm Ltd., An Aptar Pharma Company, Newport, United Kingdom
| | - William Ganley
- Nanopharm Ltd., An Aptar Pharma Company, Newport, United Kingdom
| | - Lucas Silva
- Nanopharm Ltd., An Aptar Pharma Company, Newport, United Kingdom
| | - Isam Salem
- International Pharmaceutical Research Center, Amman, Jordan
| | - Omaima Najib
- International Pharmaceutical Research Center, Amman, Jordan
| | - Usama Harb
- International Pharmaceutical Research Center, Amman, Jordan
| |
Collapse
|
2
|
Zhang J, Wu K, Liu B, Hou S, Li X, Ye X, Liu J, He Q. Bioequivalence study of ipratropium bromide inhalation aerosol using PBPK modelling. Front Med (Lausanne) 2023; 10:1056318. [PMID: 36824609 PMCID: PMC9941642 DOI: 10.3389/fmed.2023.1056318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/17/2023] [Indexed: 02/10/2023] Open
Abstract
Aims Systemic pharmacokinetic (PK) studies can reflect the overall exposure of orally inhaled drug Products (OIDPs) in the blood after inhalation into the lung and can be used to evaluate the bioequivalence of test and reference products. The aim of this article is: (1) to study the PK characteristics and bioequivalence of ipratropium bromide (IB) inhalation aerosol, reference and test products in healthy Chinese subjects; (2) to establish a physiologically based pharmacokinetic (PBPK) model and verify the accuracy of the model in predicting bioequivalence; (3) attempt to use the model to predict the regional distribution of particles in the lung after inhalation, and discuss the effect of gastrointestinal drug absorption of IB on systemic exposure. Methods The study involved two clinical studies. Clinical study-1 (registration number: CTR20201284) was used with non-clinical data to construct and validate a PBPK model in the B2O simulator, a web-based virtual drug development platform. This model assessed different test and reference products' bioequivalence. Results were compared to a second clinical study (Clinical study-2: registration number CTR20202291). The particles' regional distribution in the lung and the gastrointestinal absorption effect on systemic exposure were discussed based on the simulation results. Results The established PBPK model successfully simulated the in vivo PK characteristics of IB inhalation aerosol, with r 2 close to 1. Gastrointestinal absorption had a negligible effect on systemic exposure. Particles accumulated in the alveolar area were cleared within an hour, followed by particles in the bronchioles and bronchi. Conclusion This model provided a reliable method for exploring the correlation between in vitro and in vivo PK studies of IB inhalation aerosols. According to the simulation results, the test and reference products were bioequivalent.
Collapse
Affiliation(s)
- Jisheng Zhang
- Wuxi People’s Hospital Affiliated with Nanjing Medical University, Wuxi, Jiangsu, China
| | - Keheng Wu
- Yinghan Pharmaceutical Technology (Shanghai) Co., Ltd., Shanghai, China
| | - Bo Liu
- School of Chemical Engineering and Pharmacy, Wuhan Institute of Technology, Wuhan, China
| | - Shuguang Hou
- Sichuan Purity Medical Technology Co., Ltd., Sichuan, China
| | - Xue Li
- Yinghan Pharmaceutical Technology (Shanghai) Co., Ltd., Shanghai, China
| | - Xiang Ye
- Yinghan Pharmaceutical Technology (Shanghai) Co., Ltd., Shanghai, China
| | - Jack Liu
- Yinghan Pharmaceutical Technology (Shanghai) Co., Ltd., Shanghai, China
| | - Qing He
- Wuxi People’s Hospital Affiliated with Nanjing Medical University, Wuxi, Jiangsu, China,*Correspondence: Qing He, ✉
| |
Collapse
|
3
|
The history, current state and perspectives of aerosol therapy. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2022; 72:225-243. [PMID: 36651510 DOI: 10.2478/acph-2022-0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 01/20/2023]
Abstract
Nebulization is a very effective method of drug administration. This technique has been popular since ancient times when inhalation of plants rich in tropane alkaloids with spasmolytic and analgesic effects was widely used. Undoubtedly, the invention of anasthesia in the 19th century had an influence on the development of this technique. It resulted in the search for devices that facilitated anasthesia such as pulveriser or hydronium. From the second half of the 21st century, when the first DPI and MDI inhalers were launched, the constant development of aerosol therapy has been noticed. This is due to the fact that nebulization, compared with other means of medicinal substance application (such as oral and intravenous routes of administration), is safer and it exhibits a positive dose/efficacy ratio connected to the reduction of the dose. It enables drugs administration through the lung and possesses very fast onset action. Therefore, various drugs prescribed in respiratory diseases (such as corticosteroids, β-agonists, anticholinergics) are present on the market in a form of an aerosol.
Collapse
|
4
|
Eriksson J, Thörn H, Lennernäs H, Sjögren E. Pulmonary drug absorption and systemic exposure in human: Predictions using physiologically based biopharmaceutics modeling. Eur J Pharm Biopharm 2020; 156:191-202. [DOI: 10.1016/j.ejpb.2020.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 11/26/2022]
|
5
|
Hava DL, Tan L, Johnson P, Curran AK, Perry J, Kramer S, Kane K, Bedwell P, Layton G, Swann C, Henderson D, Khan N, Connor L, McKenzie L, Singh D, Roach J. A phase 1/1b study of PUR1900, an inhaled formulation of itraconazole, in healthy volunteers and asthmatics to study safety, tolerability and pharmacokinetics. Br J Clin Pharmacol 2020; 86:723-733. [PMID: 31696544 DOI: 10.1111/bcp.14166] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 09/30/2019] [Accepted: 10/17/2019] [Indexed: 01/21/2023] Open
Abstract
AIMS Oral itraconazole has variable pharmacokinetics and risks of adverse events associated with high plasma exposure. An inhalation formulation of itraconazole (PUR1900) is being developed to treat allergic bronchopulmonary aspergillosis, an allergic inflammatory disease occurring in asthmatics and patients with cystic fibrosis. METHODS A 3-part, open-label Phase 1 study was conducted to evaluate safety, tolerability and pharmacokinetics of PUR1900. Healthy volunteers (n = 5-6/cohort) received either single (Part 1) or multiple (Part 2) ascending doses of PUR1900 for up to 14 days. In Part 3 stable, adult asthmatics received a single dose of 20 mg PUR1900 or 200 mg of oral Sporanox (itraconazole oral solution) in a 2-period randomized cross-over design. Itraconazole plasma and sputum concentrations were evaluated. RESULTS None of the adverse events considered as at least possibly related to study treatment were moderate or severe, and none were classed as serious. The most common was the infrequent occurrence of mild cough. Itraconazole plasma exposure increased with increasing doses of PUR1900. After 14 days, PUR1900 resulted in plasma exposure (area under the concentration-time curve up to 24 h) 106- to 400-fold lower across doses tested (10-35 mg) than steady-state exposure reported for oral Sporanox 200 mg. In asthmatics, PUR1900 geometric mean maximum sputum concentrations were 70-fold higher and geometric mean plasma concentrations were 66-fold lower than with oral Sporanox. CONCLUSION PUR1900 was safe and well-tolerated under the study conditions. Compared to oral dosing, PUR1900 achieved higher lung and lower plasma exposure. The pharmacokinetic profile of PUR1900 suggests the potential to improve upon the efficacy and safety profile observed with oral itraconazole.
Collapse
Affiliation(s)
| | - Lisa Tan
- Lisa Tan Pharma Consulting, Kingston, Cambridge, UK
| | | | | | | | | | | | | | | | | | | | - Naimat Khan
- Medicines Evaluation Unit, The Langley Building, Wythenshawe Hospital, Wythenshawe, UK, England
| | - Lucy Connor
- Medicines Evaluation Unit, The Langley Building, Wythenshawe Hospital, Wythenshawe, UK, England
| | | | - Dave Singh
- Medicines Evaluation Unit, The Langley Building, Wythenshawe Hospital, Wythenshawe, UK, England.,University of Manchester, Manchester University NHS Hospital Trust, Manchester, UK
| | | |
Collapse
|
6
|
Perry J, Trautman B, Takher-Smith J, Kramer S, Kane K, Silverman M, Tan L, Haughie S, Richter W, Kirkov V, Arsova S, Ward J, Hava DL. Particle size and gastrointestinal absorption influence tiotropium pharmacokinetics: a pilot bioequivalence study of PUR0200 and Spiriva HandiHaler. Br J Clin Pharmacol 2019; 85:580-589. [PMID: 30521129 DOI: 10.1111/bcp.13831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/16/2018] [Accepted: 11/29/2018] [Indexed: 12/23/2022] Open
Abstract
AIMS Plasma pharmacokinetics permit the assessment of efficacy and safety of inhaled drugs, and possibly their bioequivalence to other inhaled products. Correlating drug product attributes to lung deposited dose is important to achieving equivalence. PUR0200 is a spray-dried formulation of tiotropium that enables more efficient lung delivery than Spiriva® HandiHaler® (HH). The ratio of tiotropium lung-to-oral deposition in PUR0200 was varied to investigate the impact of particle size on tiotropium pharmacokinetics, and the contribution of oral absorption to tiotropium exposure was assessed using charcoal block. METHODS A seven-period, single-dose, crossover study was performed in healthy subjects. PUR0200 formulations differing in dose and aerodynamic particle size were administered in five periods and Spiriva HH in two periods. In one period, Spiriva HH gastrointestinal absorption was blocked with oral charcoal. Tiotropium plasma concentrations were assessed over 8 h after inhalation. RESULTS PUR0200 pharmacokinetics were influenced by aerodynamic particle size and the ratio of lung-to-oral deposition, with impactor sized mass (ISM) correlating most strongly with exposure. Formulation PUR0217a (3 μg tiotropium) lung deposition was similar to Spiriva HH (18 μg) with and without charcoal block, but total PUR0200 exposure was lower without charcoal. The Cmax and AUC0-0.5h of Spiriva HH with and without charcoal block were bioequivalent; however, Spiriva HH AUC0-8h was lower when gastrointestinal absorption was inhibited with oral charcoal administration. CONCLUSIONS Pharmacokinetic bioequivalence indicative of lung deposition and efficacy can be achieved by matching the reference product ISM. Due to reduced oral deposition and more efficient lung delivery, PUR0200 results in a lower AUC0-t than Spiriva HH due to reduced absorption of drug from the gastrointestinal tract.
Collapse
Affiliation(s)
- Jason Perry
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
| | - Brian Trautman
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
| | | | - Steve Kramer
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
| | - Katie Kane
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
| | | | - Lisa Tan
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
| | - Scott Haughie
- Mylan Global Respiratory Group, Discovery Park, Sandwich, UK
| | - Wolfram Richter
- Cooperative Clinical Drug Research and Development, Hoppegarten, Germany
| | - Valentin Kirkov
- Clinic for Internal Diseases, MHAT Tokuda Hospital, Sofia, Bulgaria
| | - Sacha Arsova
- Cooperative Clinical Drug Research and Development, Hoppegarten, Germany
| | - Jonathan Ward
- Mylan Global Respiratory Group, Discovery Park, Sandwich, UK
| | - David L Hava
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
| |
Collapse
|