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Diezi L, Dao K, Jullien V, Roussel‐Maupetit C, Burton I, André P, Bardinet C, Rothuizen LE, Chtioui H, Manso‐Silvan MA, Guittet C, Brunner‐Ferber F, Vandenhende F, Chiron C, Granier L, Buclin T. An innovative ethosuximide granule formulation designed for pediatric use: Comparative pharmacokinetics, safety, tolerability, and palatability profile versus reference syrup. Pharmacol Res Perspect 2023; 11:e01032. [PMID: 36537292 PMCID: PMC9764106 DOI: 10.1002/prp2.1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/13/2022] [Indexed: 12/24/2022] Open
Abstract
Ethosuximide, the first-line therapy for childhood absence epilepsy, is currently formulated as a syrup (Zarontin®, Pfizer) with a bitter taste and high sugar content, poorly adapted to children, and a ketogenic diet. The collaborative European FP7 project KIEKIDS aimed at developing an innovative sugar-free, tasteless formulation convenient for pediatric use. This dual Phase-I study evaluated two granule formulations based on lipid multiparticulate (LMP) technology. Two panels of 6 healthy adult volunteers underwent a randomized, placebo-controlled, partly blinded, 3-way cross-over trial, comparing ethosuximide granules A or B with placebo granules and syrup at single 10 mg/kg doses. Corresponding plasma pharmacokinetic profiles of ethosuximide were compared, along with palatability, safety, and tolerability. The LMP granule A proved suboptimal due to bitterness and adherence to beaker walls, while the optimized granule B revealed excellent palatability, similar to placebo granules, and low adherence to glass. The relative bioavailability of granules A versus syrup, based on dose-normalized Cmax and AUC0-∞ was 93.7% [90% CI: 76.3-115.1] and 96.1% [91.0-101.5], respectively. For granules B it was 87.6% [81.6-94.0] and 92.5% [88.5-96.6], respectively, with slightly delayed tmax of 0.75 h [0.5-4.05] compared to syrup 0.5 h [0.3-0.8]. Tolerability visual analog scales revealed a trend for statistically non-significant improvement versus syrup at peak (30 min) for transient dizziness (both granules), fatigue (granules A), and anxiety (granules B). The innovative ethosuximide granule formulation B achieves a suitable profile for pediatric use, being sugar-free, tasteless, bioequivalent, and well-tolerated while enabling precise adjustment to body weight.
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Affiliation(s)
- Léonore Diezi
- Clinical PharmacologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Kim Dao
- Clinical PharmacologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | | | | | | | - Pascal André
- Clinical PharmacologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Carine Bardinet
- Clinical PharmacologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Laura E. Rothuizen
- Clinical PharmacologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Haithem Chtioui
- Clinical PharmacologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | | | | | | | | | | | | | - Thierry Buclin
- Clinical PharmacologyLausanne University Hospital and University of LausanneLausanneSwitzerland
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2
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Desfontaine V, Guinchard S, Marques S, Vocat A, Moulfi F, Versace F, Huser-Pitteloud J, Ivanyuk A, Bardinet C, Makarov V, Ryabova O, André P, Prod'Hom S, Chtioui H, Buclin T, Cole ST, Decosterd L. Optimized LC-MS/MS quantification of tuberculosis drug candidate macozinone (PBTZ169), its dearomatized Meisenheimer Complex and other metabolites, in human plasma and urine. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1215:123555. [PMID: 36563654 PMCID: PMC9883661 DOI: 10.1016/j.jchromb.2022.123555] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
Tuberculosis, and especially multidrug-resistant tuberculosis (MDR-TB), is a major global health threat which emphasizes the need to develop new agents to improve and shorten treatment of this difficult-to-manage infectious disease. Among the new agents, macozinone (PBTZ169) is one of the most promising candidates, showing extraordinary potency in vitro and in murine models against drug-susceptible and drug-resistant Mycobacterium tuberculosis. A previous analytical method using liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) was developed by our group to support phase I clinical trials of PBTZ169. These plasma sample analyses revealed the presence of several additional metabolites among which the most prominent was H2PBTZ, a reduced species obtained by dearomatization of macozinone, one of the first examples of Meisenheimer Complex (MC) metabolites identified in mammals. Identification of these new metabolites required the optimization of our original method for enhancing the selectivity between isobaric metabolites as well as for ensuring optimal stability for H2PBTZ analyses. Sample preparation methods were also developed for plasma and urine, followed by extensive quantitative validation in accordance with international bioanalytical method recommendations, which include selectivity, linearity, qualitative and quantitative matrix effect, trueness, precision and the establishment of accuracy profiles using β-expectation tolerance intervals for known and newer analytes. The newly optimized methods have been applied in a subsequent Phase Ib clinical trial conducted in our University Hospital with healthy subjects. H2PBTZ was found to be the most abundant species circulating in plasma, underscoring the importance of measuring accurately and precisely this unprecedented metabolite. Low concentrations were found in urine for all monitored analytes, suggesting extensive metabolism before renal excretion.
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Affiliation(s)
- Vincent Desfontaine
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland
| | - Sylvie Guinchard
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland
| | - Sara Marques
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland
| | - Anthony Vocat
- Global Health Institute, School of Life Sciences, EPFL, Lausanne, Switzerland
| | - Farizade Moulfi
- Innovative Medicines for Tuberculosis (IM4TB), Lausanne, Switzerland
| | - François Versace
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland
| | - Jeff Huser-Pitteloud
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland
| | - Anton Ivanyuk
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland
| | - Carine Bardinet
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland
| | - Vadim Makarov
- Innovative Medicines for Tuberculosis (IM4TB), Lausanne, Switzerland,Federal Research Center “Fundamentals of Biotechnology RAS”, Moscow, Russia
| | - Olga Ryabova
- Federal Research Center “Fundamentals of Biotechnology RAS”, Moscow, Russia
| | - Pascal André
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland
| | - Sylvain Prod'Hom
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland
| | - Haithem Chtioui
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland
| | - Thierry Buclin
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland,Innovative Medicines for Tuberculosis (IM4TB), Lausanne, Switzerland
| | - Stewart T. Cole
- Global Health Institute, School of Life Sciences, EPFL, Lausanne, Switzerland,Innovative Medicines for Tuberculosis (IM4TB), Lausanne, Switzerland
| | - Laurent Decosterd
- Laboratory & Service of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, University Hospital of Lausanne and University of Lausanne, Switzerland,Corresponding author.
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Eugster PJ, Dunand M, Grund B, Ivanyuk A, Fogarasi Szabo N, Bardinet C, Abid K, Buclin T, Grouzmann E, Chtioui H. Quantification of serotonin and eight of its metabolites in plasma of healthy volunteers by mass spectrometry. Clin Chim Acta 2022; 535:19-26. [PMID: 35963304 DOI: 10.1016/j.cca.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/15/2022]
Abstract
Serotonin is transformed into melatonin under the control of the light/dark cycle, representing a cornerstone of circadian rhythmicity. Serotonin also undergoes extensive metabolism to produce 5-hydroxyindoleacetic acid (5-HIAA), a biomarker for the diagnosis and monitoring of serotonin secreting neuroendocrine tumors (NETs). While serotonin, melatonin and their metabolites are part of an integrated comprehensive system, human observations about their respective plasma concentrations are still limited. We report here for the first time a multiplex UHPLC-MS/MS assay for the quantification of serotonin, 5-HIAA, 5-hydroxytryptophol (5-HTPL), N-acetyl-serotonin (NAS), Mel, 6-OH-Mel, 5-methoxytryptamine (5-MT), 5-methoxytryptophol (5-MTPL), and 5-methoxyindoleacetic acid (5-MIAA) in human plasma. Analytes were extracted by protein precipitation and solid phase extraction. Plasma concentrations for these analytes were determined in 102 healthy volunteers. The LLOQ of the assay ranges from 2.2 nM for serotonin to 1.0 pM for 6-OH-Mel. This sensitivity enables the quantification of circulating serotonin, 5-HIAA, NAS, Mel, and 5-MIAA, even at their lowest diurnal concentrations. This assay will enable specific, precise and accurate measurement of serotonin, Mel and their metabolites to draw a detailed picture of this complex pineal metabolism, allowing a dynamic understanding of these pathways and providing promising biomarkers and a metabolic signature for serotonin-secreting NETs.
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Affiliation(s)
- Philippe J Eugster
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland.
| | - Marielle Dunand
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Baptiste Grund
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Anton Ivanyuk
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Nathalie Fogarasi Szabo
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Carine Bardinet
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Karim Abid
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Thierry Buclin
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Eric Grouzmann
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Haithem Chtioui
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
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Gallay J, Prod'hom S, Mercier T, Bardinet C, Spaggiari D, Pothin E, Buclin T, Genton B, Decosterd LA. Corrigendum to "LC-MS/MS method for the simultaneous analysis of seven antimalarials and two active metabolites in dried blood spots for applications in field trials: Analytical and clinical validation" [J. Pharm. Biomed. Anal. 154 (2018) 263-277]. J Pharm Biomed Anal 2020; 182:112759. [PMID: 32063409 DOI: 10.1016/j.jpba.2019.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Joanna Gallay
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Sylvain Prod'hom
- Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Thomas Mercier
- Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Carine Bardinet
- Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Dany Spaggiari
- Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Emilie Pothin
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Thierry Buclin
- Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Blaise Genton
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Department of Community Medicine, University Hospital, Lausanne, Switzerland
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Dao K, Thoueille P, Decosterd LA, Mercier T, Guidi M, Bardinet C, Lebon S, Choong E, Castang A, Guittet C, Granier LA, Buclin T. Sultiame pharmacokinetic profile in plasma and erythrocytes after single oral doses: A pilot study in healthy volunteers. Pharmacol Res Perspect 2020; 8:e00558. [PMID: 31990440 PMCID: PMC6986439 DOI: 10.1002/prp2.558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 12/13/2019] [Indexed: 12/02/2022] Open
Abstract
A pilot study was conducted aiming at specifying sultiame's pharmacokinetic profile, completed by in vitro assays evaluating the intraerythrocytic transfer of sultiame and by a pharmacokinetic model assessing its distribution. Single oral doses of sultiame (Ospolot® 50, 100, and 200 mg) were administered in open‐label to four healthy volunteers. Serial plasma, whole blood, and urine samples were collected. A spiking experiment was also performed to characterize sultiame's exchanges between plasma and erythrocytes in vitro. Pharmacokinetic parameters were evaluated using standard noncompartmental calculations and nonlinear mixed‐effect modeling. The plasma maximal concentrations (Cmax) showed striking nonlinear disposition of sultiame, with a 10‐fold increase while doses were doubled. Conversely, whole blood Cmax increased less than dose proportionally while staying much higher than in plasma. Quick uptake of sultiame into erythrocytes observed in vivo was confirmed in vitro, with minimal efflux. A two‐compartment model with first‐order absorption, incorporating a saturable ligand to receptor binding, described the data remarkably well, indicating apparent plasma clearance of 10.0 L/h (BSV: 29%) and distribution volume of 64.8 L; saturable uptake into an intracellular compartment of 3.3 L with a maximum binding capacity of 111 mg accounted for nonlinearities observed in plasma and whole blood concentrations. Pharmacokinetic characteristics of sultiame are reported, including estimates of clearance and volume of distribution that were so far unpublished. The noticeable nonlinearity in sultiame disposition should be taken into account for the design of future studies and the interpretation of therapeutic drug monitoring results.
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Affiliation(s)
- Kim Dao
- Service of Clinical Pharmacology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Paul Thoueille
- Service of Clinical Pharmacology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Laurent A Decosterd
- Service of Clinical Pharmacology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Thomas Mercier
- Service of Clinical Pharmacology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Monia Guidi
- Service of Clinical Pharmacology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.,School of Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of western Switzerland, Geneva, Switzerland
| | - Carine Bardinet
- Service of Clinical Pharmacology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Sébastien Lebon
- Unit of Paediatric Neurology and Neurorehabilitation, Department Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Eva Choong
- Service of Clinical Pharmacology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | | | | | | | - Thierry Buclin
- Service of Clinical Pharmacology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Spaggiari D, Desfontaine V, Cruchon S, Guinchard S, Vocat A, Blattes E, Pitteloud J, Ciullini L, Bardinet C, Ivanyuk A, Makarov V, Ryabova O, Buclin T, Cole ST, Decosterd LA. Development and validation of a multiplex UHPLC-MS/MS method for the determination of the investigational antibiotic against multi-resistant tuberculosis macozinone (PBTZ169) and five active metabolites in human plasma. PLoS One 2019; 14:e0217139. [PMID: 31150423 PMCID: PMC6544242 DOI: 10.1371/journal.pone.0217139] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 05/07/2019] [Indexed: 12/31/2022] Open
Abstract
The emergence of Mycobacterium tuberculosis strains resistant to current first-line antibiotic regimens constitutes a major global health threat. New treatments against multidrug-resistant tuberculosis (MDR-TB) are thus eagerly needed in particular in countries with a high MDR-TB prevalence. In this context, macozinone (PBTZ169), a promising drug candidate with an unique mode of action and highly potent in vitro tuberculocidal properties against MDR Mycobacterium strains, has now reached the clinical phase and has been notably tested in healthy male volunteers in Switzerland. To that endeavor, a multiplex UHPLC-MS/MS method has been developed for the sensitive and accurate human plasma levels determination of PBTZ169 along with five metabolites retaining in vitro anti-TB activity. Plasma protein precipitation with methanol was carried out as a simplified sample clean-up procedure followed by direct injection of the undiluted supernatant for the bioanalysis of the six analytes within 5 min, using 1.8 μm reversed-phase chromatography coupled to triple quadrupole mass spectrometry employing electrospray ionization in the positive mode. Stable isotopically-labelled PBTZ169 was used as internal standard (ISTD), while metabolites could be reliably quantified using two unlabeled chemical analogues selected as ISTD from a large in-house analogous compounds library. The overall methodology was fully validated according to current recommendations (FDA, EMEA) for bioanalytical methods, which include selectivity, carryover, qualitative and quantitative matrix effect, extraction recovery, process efficiency, trueness, precision, accuracy profiles, method and instrument detection limits, integrity to dilution, anticoagulant comparison and short- and long-term stabilities. Stability studies on the reduced metabolite H2-PBTZ169 have shown no significant impact on the actual PBTZ169 concentrations determined with the proposed assay. This simplified, rapid, sensitive and robust methodology has been applied to the bioanalysis of human plasma samples collected within the frame of a phase I clinical study in healthy volunteers receiving PBTZ169.
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Affiliation(s)
- Dany Spaggiari
- Laboratory & Service of Clinical Pharmacology, Department of Laboratories, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Vincent Desfontaine
- Laboratory & Service of Clinical Pharmacology, Department of Laboratories, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Sandra Cruchon
- Laboratory & Service of Clinical Pharmacology, Department of Laboratories, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Sylvie Guinchard
- Laboratory & Service of Clinical Pharmacology, Department of Laboratories, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Anthony Vocat
- Global Health Institute, School of Life Sciences, EPFL, Lausanne, Switzerland
| | - Emilyne Blattes
- Innovative Medicines for Tuberculosis (IM4TB), Lausanne, Switzerland
| | - Jeff Pitteloud
- Laboratory & Service of Clinical Pharmacology, Department of Laboratories, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Lorenzo Ciullini
- Laboratory & Service of Clinical Pharmacology, Department of Laboratories, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Carine Bardinet
- Laboratory & Service of Clinical Pharmacology, Department of Laboratories, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Anton Ivanyuk
- Laboratory & Service of Clinical Pharmacology, Department of Laboratories, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Vadim Makarov
- Innovative Medicines for Tuberculosis (IM4TB), Lausanne, Switzerland
- Federal Research Center “Fundamentals of Biotechnology RAS”, Moscow, Russia
| | - Olga Ryabova
- Federal Research Center “Fundamentals of Biotechnology RAS”, Moscow, Russia
| | - Thierry Buclin
- Laboratory & Service of Clinical Pharmacology, Department of Laboratories, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Stewart T. Cole
- Global Health Institute, School of Life Sciences, EPFL, Lausanne, Switzerland
- Innovative Medicines for Tuberculosis (IM4TB), Lausanne, Switzerland
| | - Laurent A. Decosterd
- Laboratory & Service of Clinical Pharmacology, Department of Laboratories, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
- * E-mail:
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Gallay J, Prod'hom S, Mercier T, Bardinet C, Spaggiari D, Pothin E, Buclin T, Genton B, Decosterd LA. LC-MS/MS method for the simultaneous analysis of seven antimalarials and two active metabolites in dried blood spots for applications in field trials: Analytical and clinical validation. J Pharm Biomed Anal 2018; 154:263-277. [PMID: 29579633 DOI: 10.1016/j.jpba.2018.01.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/08/2018] [Accepted: 01/09/2018] [Indexed: 02/04/2023]
Abstract
In epidemiological studies, antimalarials measurements in blood represent the best available marker of drugs exposure at population level, an important driver for the emergence of drug resistance. We have developed a liquid chromatography-tandem mass spectrometry method (LC-MS/MS) for the simultaneous quantification of 7 frequently used antimalarials (amodiaquine, chloroquine, quinine, sulfadoxine, pyrimethamine, mefloquine, lumefantrine) and 2 active metabolites (N-desethyl-amodiaquine, desbutyl-lumefantrine) in 10-μl dried blood spots (DBS). This sampling approach is suitable for field studies wherein blood samples processing, transportation and storage are problematic. Sample preparation included extraction from a 3 mm-disk punched out of the DBS with 100-μl of methanol + 1% formic acid containing deuterated internal standards for all drugs. Good performances were achieved in terms of trueness (-12.1 to +11.1%), precision (1.4-15.0%) and sensitivity, with lower limits of quantification comprised between 2 ng/ml (sulfadoxine) and 20 ng/ml (chloroquine, quinine, pyrimethamine, mefloquine, lumefantrine and desbutyl-lumefantrine). All analytes were stable in DBS kept for 24 h at room temperature and at 37 °C. The developed assay was applied within the frame of a pharmacokinetic study including 16 healthy volunteers who received a single dose of artemether-lumefantrine. Lumefantrine concentrations in plasma and in DBS were highly correlated (R = 0.97) at all time points, confirming the assumption that lumefantrine concentrations determined in DBS confidently reflect blood concentrations. The blood/plasma ratio of 0.56 obtained using the Bland-Altman approach (and corresponding to the slope of the linear regression) is in line with very low penetration of lumefantrine into red blood cells. This sensitive multiplex LC-MS/MS assay enabling the simultaneous analysis of antimalarials in DBS is suitable for epidemiological studies in field conditions.
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Affiliation(s)
- Joanna Gallay
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Sylvain Prod'hom
- Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Thomas Mercier
- Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Carine Bardinet
- Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Dany Spaggiari
- Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Emilie Pothin
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Thierry Buclin
- Service and Laboratory of Clinical Pharmacology, University Hospital, Lausanne, Switzerland
| | - Blaise Genton
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Department of Community Medicine, University Hospital, Lausanne, Switzerland
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8
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Dunand M, Grund B, Eugster P, Ivanyuk A, Fogarasi-Szabo N, Bardinet C, Grouzmann E, Buclin T, Chtioui H. Serotonin, Melatonin and Their Metabolites Measured in Plasma by a New LC-MS/MS Assay In Healthy Volunteers. Clin Ther 2017. [DOI: 10.1016/j.clinthera.2017.05.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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