Sitagliptin and metformin – novel combination therapy

Pharmacokinetics and Bioequivalence of Sitagliptin Phosphate/Metformin Hydrochloride Tablets in Healthy Chinese Subjects: A Randomized, Open-Label, Crossover Study

OBJECTIVE

Our objective was to evaluate the pharmacokinetics and bioequivalence of test and reference (JANUMET^®) formulations of sitagliptin phosphate/metformin hydrochloride tablets at a single dose of 50 mg/850 mg.

METHODS

The study was a randomized, open-label, two-period, double-crossover trial. Volunteers under fasting (n = 24) and fed (n = 24) conditions were given a single oral dose of test or reference formulations of sitagliptin phosphate/metformin hydrochloride tablets 50 mg/850 mg. We used the liquid chromatography tandem mass spectrometry method to determine the concentrations of sitagliptin and metformin in the plasma of subjects. Pharmacokinetic metrics were calculated using the WinNonlin 7.0 program, and bioequivalence was evaluated using SAS 9.4.

RESULTS

Under the fasting condition, the 90% confidence intervals (CIs) of geometric mean ratio for maximum plasma drug concentration (C_max), area under the plasma concentration-time curve from time zero to time t (AUC_0-t), and AUC from time zero to infinity (AUC_0-∞) of sitagliptin between the test and reference groups were 101.70-120.62%, 99.81-105.61%, and 100.27-106.12%, respectively; for metformin, they were 90.39-111.48%, 94.76-109.12%, and 95.76-110.38%, respectively. Under the fed condition, they were 102.12-117.31%, 100.80-107.81%, and 100.82-107.78%, respectively, for sitagliptin and 95.53-105.22%, 92.76-103.07%, and 93.40-104.14%, respectively, for metformin. Both were generally well-tolerated.

CONCLUSION

The two formulations of sitagliptin phosphate/metformin hydrochloride tablets were bioequivalent under fasting and fed conditions in healthy Chinese subjects.

Determination of sitagliptin in human plasma using a smart electrochemical sensor based on electroactive molecularly imprinted nanoparticles

Sitagliptin is a hypoglycaemic agent used to reduce blood sugar levels in patients with type 2 diabetes mellitus (T2DM). Real time monitoring of sitagliptin levels is crucial to prevent overdose, which might cause liver, kidney and pancreatic diseases. As an alternative solution, a sitagliptin voltammetric sensor was fabricated using artificial receptors called electroactive molecularly imprinted polymer nanoparticles (nanoMIPs). The nanoMIP tagged with a redox probe (ferrocene) combines both the recognition and reporting functions. Traditional electrochemical sensors determine the redox activity of an analyte. Thus, they are influenced by interfering molecules and the nature of the sample. These innovative nanoMIPs allow us to easily design and customise sensors, increase their sensitivity and minimise the cross reactivity in biological samples. The present technology replaces the traditional enzyme-mediator pairs used in traditional biosensors. The polymer composition was optimized "in silico" using docking and screening methods. Nanoparticles were synthesized via free radical polymerization and a solid phase method and then characterized by infrared spectroscopy (FTIR), transmission electron microscopy (TEM) and dynamic light scattering (DLS). The specific sitagliptin nanoparticles were covalently immobilized on platinum electrodes via silane and carbodiimide chemistry. The determination of sitagliptin in human plasma by a nanoMIP sensor was assessed by differential pulse voltammetry (DPV). The sensor current response was directly related to the change in nanoMIP conformation triggered by the analyte. The optimisation of the sensor response was made by adjusting (i) the silane concentration, (ii) nanoMIP concentration, and (iii) immobilization time. The sensor measurements in plasma revealed high selectivity and a sensitivity of 32.5 ± 0.6 nA pM-1 towards sitagliptin, and the limit of detection of the fabricated sensor was found to be 0.06 pM. The sensor displayed a satisfactory performance for the determination of sitagliptin in spiked human plasma, demonstrating the potential of this technology for drug monitoring and clinical diagnosis.

LC-tandem mass spectrometry method for the simultaneous determination of metformin and sitagliptin in human plasma after ion-pair solid phase extraction

A reversed-phase liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) method was established for simultaneous determination of two oral hypoglycemic drugs metformin (MET) and sitagliptin (STG) in human plasma. The analytes were extracted from 50μL human plasma by ion-pair solid phase extraction using sodium lauryl sulphate on Phenomenex Strata-X (30mg/1mL) cartridges. The chromatographic separation was accomplished on XSelect HSS CN (150×4.6mm, 5μm) column using mobile phase consisting of methanol-8.0mM ammonium formate in water, pH 4.5 (80:20, v/v) under isocratic condition. Tandem MS detection was performed on a triple quadrupole spectrometer equipped with an electrospray ionization source, operated in the positive mode. Multiple reaction monitoring (MRM) was used to quantify the analytes following transitions, m/z 130.1→60.1 and m/z 408.3→235.1 for MET and STG respectively. The method displayed acceptable linearity in the concentration range of 4.00-3200ng/mL for MET and 1.00-800ng/mL for STG. The intra-batch and inter-batch precisions were ≤5.1% and accuracy ranged from 96.5 to 103.3% for both the drugs. The mean recovery of MET and STG obtained from spiked plasma samples was 82.5% and 90.4% respectively with minimal matrix interference. Both the drugs were found to be stable under all mandatory storage conditions. The validated method was successfully applied to a clinical pharmacokinetic study for a fixed-dose tablet formulation containing 500mg MET and 50mg STG in 16 healthy volunteers.