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

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

Food Effects on the Pharmacokinetics of Doxylamine Hydrogen Succinate 25 mg Film-Coated Tablets: A Single-Dose,Randomized, Two-Period Crossover Study in Healthy Volunteers

Background

Doxylamine succinate, an ethanolamine-based antihistamine, is used in the short-term management of insomnia because of its sedative effects. The data available on the pharmacokinetic profile of doxylamine in humans are limited, notwithstanding that this drug has been marketed in European countries for more than 50 years. In fact, no data on the effect of food on the pharmacokinetic parameters of doxylamine are available.

Objective

The objective of this study was to evaluate the pharmacokinetic parameters of doxylamine following a single oral dose of doxylamine hydrogen succinate 25 mg in healthy human subjects under fed and fasting conditions.

Study Design

This was a single-center, randomized, single-dose, laboratory-blinded, two-period, two-sequence, crossover study.

Setting

The study was conducted in a phase I clinical unit.

Subjects and Methods

A single oral dose of doxylamine hydrogen succinate 25 mg (equivalent to 17.4 mg of doxylamine base) was administered to healthy volunteers under either fed conditions (high-fat, high-calorie food intake) or fasting conditions in each study period. The drug administrations were separated by a wash-out period of seven calendar days. Plasma samples were collected for up to 60 hours postdose, and plasma doxylamine concentrations were determined by a high-performance liquid chromatography method with tandem mass spectrometry detection. Pharmacokinetic parameters were calculated using noncompartmental analysis. Safety was evaluated through assessment of adverse events, standard laboratory evaluations, vital signs, and 12-lead electrocardiography.

Results

In total, 24 healthy subjects (12 male and 12 female) were included in the study. Doxylamine succinate 25 mg tablets exhibited similar oral bioavailability of doxylamine in the fasting state (mean maximum plasma drug concentration [C_max] 118.21 ng/mL, coefficient of variation [CV] 19.2%; mean area under the plasma concentration time curve from time zero to time t [AUC_t] 1746.97 ng · h/mL, CV 31.6%) and in the fed state (mean C_max 120.99 ng/mL, CV 15.0%; mean AUC_t 1712.20 ng · h/mL, CV 26.7%). No statistically significant between-treatment differences were observed for any of the pharmacokinetic parameters under study. The fed: fasting ratios of the geometric least squares means with corresponding 90% confidence intervals for C_max and AUC_t were within the range of 80–125%.

Conclusion

High-fat, high-calorie food intake does not affect the kinetics of doxylamine in healthy subjects. The drug was safe and well tolerated by the subjects in this study.     

别嘌呤醇对大鼠CYP450酶活性的影响

目的用Cocktail探针药物法研究别嘌呤醇对大鼠细胞色素P450（CYP450）同工酶的影响。方法将SD大鼠随机分为2组。别嘌呤醇组为实验组,生理盐水组为对照组,采用高效液相色谱-质谱联用技术测定连续给药14d后大鼠血浆中相应探针药物的浓度及其药动学参数。结果别嘌呤醇体内给药14d后,大鼠体内非那西丁的AUC（0-∞）（P〈0．01）、clnax（P〈0．05）和t1／2（P〈0．05）显著大于对照组,CL显著低于对照组（P〈0．01）;而甲苯磺丁脲、奥美拉唑和右美沙芬探针药物的药动学参数均无显著变化。结论别嘌呤醇抑制大鼠CYP1A2酶,对CYP2C9、CYP2C19和CYP2D6酶的影响不显著。     

Bioequivalence Study of Two Formulations of Ibandronic Acid 150-mg Film-Coated Tablets in Healthy Volunteers Under Fasting Conditions: A Randomized,Open-Label,Three-Way,Reference-Replicated Crossover Study

Aims

This bioequivalence study aimed to compare rate and extent of absorption of a generic medicinal product of ibandronic acid 150-mg film-coated tablet versus Bonviva^®.

Methods

This was a single-centre, open-label, randomized, three-way, three-sequence, reference-replicated, crossover bioequivalence study, under fasting conditions. A single oral dose of ibandronic acid as one 150-mg film-coated tablet was administered in each study period. Each washout period lasted 14 days. Blood samples were collected according to a predefined sampling schedule and up to 48.0 hours after administraton in each period. Plasma concentrations of ibandronic acid were measured using a liquid chromatograph–mass spectrometry/mass spectrometry method. Bioequivalence between generic and reference medicinal products is acceptable if the 90 % confidence intervals (CI) of ratio of least-squares means between the test and the reference product of ln-transformed area under the serum concentration–time curve from time zero to time of last measurable concentration (AUC_0–t) is within the 80.00–125.00 % interval. Prospectively, a scaled average bioequivalence approach for maximum serum concentration (C_max) was established.

Results

153 healthy volunteers were enrolled and randomized. After the test formulation (T) and first and second Bonviva^® (R) dosing, the C_max was 96.71 ± 90.19 ng/mL, 92.67 ± 91.48 ng/mL and 87.94 ± 60.20 ng/mL and the AUC_0–t was 390.83 ± 287.27 ng·h/mL, 388.54 ± 356.76 ng·h/mL and 383.53 ± 246.72, respectively. Ratios of T/R and 90 % CI were 100.92 % (94.35–107.94) for AUC_0–t, 100.90 % (94.37–107.88) for AUC_0–inf and 102.56 % (95.05–110.67) for C_max.

Conclusions

Test formulation of ibandronic acid is bioequivalent in rate and extent of absorption to Bonviva^® following a 150-mg dose, under fasting conditions.     

Effects of Angelicae tenuissima radix,Angelicae dahuricae radix and Scutellariae radix Extracts on Cytochrome P450 Activities in Healthy Volunteers

Abstract: Three kinds of herbal medicines, commonly used in Korea, Angelicae tenuissima radix, Angelicae dahuricae radix and Scutellariae radix were studied to evaluate their effect on cytochrome P450 (CYP) activities in healthy volunteers. A total of 24 healthy male volunteers were assigned to one of three parallel herbal treatment groups, each consisting of eight volunteers. A cocktail of probe drugs for CYP enzymes was orally administered before and after multiple administrations of herbal medicines, three times a day for 13 days. Probe drugs used to measure CYP activities were caffeine (CYP1A2), losartan (CYP2C9), omeprazole (CYP2C19), dextromethorphan (CYP2D6), chlorzoxazone (CYP2E1) and midazolam (CYP3A4). The probe drugs and their metabolites were quantified in plasma or urine using HPLC or LC‐MS/MS. Changes in each CYP activity was evaluated by metabolic ratio of the probe drug (concentration ratio of metabolite to parent form at reference time point) following the herbal medication period, compared to the baseline values. A. dahuricae radix significantly decreased CYP1A2 activity to 10% of baseline activity (95% CI: 0.05–0.21). S. radix also showed significant changes in CYP2C9 and CYP2E1 activities. Compared to baseline values, the metabolic activities of losartan were decreased to 71% (0.54–0.94). In addition, S. radix showed a 1.42‐fold (1.03–1.97) increase in chlorzoxazone metabolic activity. However, CYP activities were not meaningfully influenced by A. tenuissima radix. Changes in certain CYP activities were observed after the administration of S. radix and A. dahuricae radix in healthy volunteers. Therefore, herbal medicines containing S. radix or A. dahuricae radix are candidates for further evaluation of clinically significant CYP‐mediated herb‐drug interactions in human beings.     

Evaluation of the Pharmacokinetics and Safety of AMG 986 Tablet and Capsule Formulations in Healthy Adult Subjects: A Phase I,Open-Label,Randomized Study

Background and objectiveAMG 986 is a first-in-class, novel apelin receptor small molecule agonist initially developed for the treatment of heart failure. The current phase I study was conducted to evaluate the pharmacokinetics and safety of a single-dose 200-mg capsule formulation of AMG 986 relative to the tablet formulation in 12 healthy subjects.MethodsIn a two-period, two-way crossover design, eligible subjects were randomized 1:1 to tablet/capsule or capsule/tablet treatment sequences; each treatment sequence lasted for approximately 6 days and comprised six subjects.ResultsFollowing a single oral dose of AMG 986, the geometric mean maximum observed concentration (C_max) values were 9670 ng/mL and 6920 ng/mL and the geometric mean area under the curve from time zero to 120 h (AUC_0–120h) values were 68,000 ng*h/mL and 59,900 ng*h/mL for the tablet and capsule, respectively. The geometric least squares means (90% confidence interval [90% CI]) for the ratios of capsule/tablet were 0.88 (90% CI 0.81–0.96) and 0.72 (90% CI 0.57–0.91) for AUC_0–120h and C_max, respectively. AMG 986 had an acceptable safety profile; all adverse events were grade 1 or 2 in severity.ConclusionThere was a modest 12% decrease in AUC_0–120h and a 28% decrease in C_max with the AMG 986 capsule versus the tablet. These differences are not considered to be clinically relevant, suggesting the capsule formulation can be used in subsequent clinical studies of AMG 986.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40268-022-00388-1.     

食物对细胞色素P450药物代谢酶的影响

细胞色素P450酶系在大多数内源性和外源性分子的生物氧化过程中发挥重要的作用,尤其在药物代谢方面。CYP450酶个体差异大,除了遗传因素的影响外,食物等外界因素也可能影响其活性或表达,从而影响经酶代谢药物的疗效和不良反应。故本文就食物因素对细胞色素P450酶影响的相关研究进行综述。     

葛根素对细胞色素P450酶活性的影响

目的研究葛根素体外对细胞色素P450酶 1A2（CYP1A2）、CYP2C9、CYP2C19、CYP2D6和CYP3A4活性的影响。方法 分别以咖啡因、甲苯磺丁脲、美芬妥因、美托洛尔和咪达唑仑为探针药, 利用高效液相色谱法测定探针药与相应代谢产物的浓度,采用重组酶研究葛根素对CYP1A2、CYP2C9、CYP2C19、CYP2D6和CYP3A4酶活性的影响。结果 在体外重组酶反应体系中,葛根素对CYP2C9、CYP2C19及CYP3A4酶活性无明显影响。但低浓度葛根素（0.1 mmol•L-1）使CYP1A2的活性降低（48±9）%（P＜0.05）,CYP2D6的活性降低 （61±8）%（P＜0.01）;高浓度（0.4 mmol•L-1） 使CYP1A2的活性降低（82±8）%（P＜0.01）,CYP2D6的活性降低（88±6）%（P＜0.01）。结论 葛根素（0.1 mmol•L-1）对CYP1A2和CYP2D6酶活性有较明显的体外抑制作用;且随着葛根素浓度的增高,对这两种酶活性的抑制作用也增强。为研究葛根素与其他药物的相互作用及作用机制等奠定了基础。     

细胞色素P450酶与药物代谢的研究进展与评价

目的：评价细胞色素P450酶与药物代谢的研究进展,以供临床医师合理用药参考。方法：查阅近年来国内、外的相关文献资料,进行归纳和分析。结果与结论：肝细胞色素P450酶系参与人体许多内、外源性物质（包括药物）的分解和代谢。P450酶系在体内的分布、结构和功能在药物代谢和临床疾病诊断过程中有着十分重要的药理作用和临床意义。     

细胞色素P450酶的表观遗传学调控及研究进展

细胞色素P450（CYPs）家族是体内重要的药物代谢酶,其功能主要是代谢临床药物及外源性物质。长期以来,CYP450酶的个体间功能活性差异往往被认为是由基因多态性所导致。然而随着研究的日益深入,人们发现基因序列的改变并不能完全解释CYP450酶的个体间活性差异。表观遗传学作为研究DNA序列未发生变化而基因表达发生可遗传变异的学科,可作为重要研究手段进一步解释CYP450酶的个体差异。该学科主要研究内容包括DNA甲基化、组蛋白翻译后修饰和RNA编辑等。本文就各主要CYP450酶的表观遗传学调控研究进行综述并讨论其在药物代谢和临床应用中的意义。     

Pharmacokinetics,Tolerability, and Safety of the Single Oral Administration of AGSAV301 vs Exforge: A Randomized Crossover Study of Healthy Male Volunteers

Background and Objective

Valsartan, an angiotensin receptor blocker, is often used with calcium channel blockers (CCBs) such as amlodipine to control hypertension. Recently, the fixed-dose combination (FDC) of amlodipine 10 mg/valsartan 160 mg (Exforge) was approved. Amlodipine is a racemic mixture of CCB; S-amlodipine has higher activity than R-form. Therefore, AGSAV301, the FDC of S-amlodipine 5 mg/valsartan 160 mg was recently developed. The objective of this study was to compare the pharmacokinetic (PK) characteristics of S-amlodipine and valsartan when administered as one tablet each of Exforge and AGSAV301 to healthy male subjects.

Methods

This was a single-dose, randomized, open-label, two-way, two-period crossover study. Each subject received a single dose of AGSAV301 and Exforge, separated by a 3-week washout period. Plasma samples for the PK analysis of valsartan and S-amlodipine were collected at predose (0) and 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 16, 24, 36, 48, 72, 96, 120, and 168 h after administration. Tolerability was also evaluated.

Results

A total of 29 subjects were enrolled; 24 completed this study. The S-amlodipine maximum plasma concentration (C _max) geometric mean ratio (GMR) between AGSAV301 and Exforge was 0.951 (90 % CI 0.983–1.014), and area under the concentration–time curve from time 0 to last measured time point (AUC_last) was 0.917 (90 % CI 0.861–0.976). The GMR of valsartan C _max was 0.994 (90 % CI 0.918–1.076), and the AUC_last was 0.927 (90 % CI 0.821–1.047). All adverse events (AEs) were resolved without sequelae; no serious AEs were reported. Two drugs showed similar tendencies to lower blood pressure in healthy subjects.

Conclusions

The PK profiles of AGSAV301 and Exforge were bioequivalent. Both drugs were also well tolerated, with comparable AE profiles and similar blood pressure-lowering tendencies in healthy volunteers, suggesting equivalent therapeutic indications.     

呋喃二烯对肝脏细胞色素P450酶不同亚型的影响

目的 考察呋喃二烯(furanodiene,FDE)对肝脏微粒体主要的细胞色素P450(CYP)酶活性的影响。方法 采用探针底物法,考察FDE在体外孵育体系中对大鼠和人肝微粒体CYP1A、CYP2A、CYP3A、CYP2C、CYP2D、CYP2E1的抑制作用,并计算相应的IC50值;采用微粒体体外“鸡尾酒”孵育法(cocktail法),考察大鼠经低、高剂量FDE(40 mg·kg^-1和160 mg·kg^-1)连续灌胃7 d,其肝微粒体主要CYP酶活性的变化。结果 FDE对大鼠肝微粒体CYP2D1和CYP2C6/7有较弱的抑制作用,其IC50分别为15.8和23.8 μmol·L^-1;对人肝微粒体CYP2C9也有较弱的抑制作用,IC50为26.1 μmol·L^-1。与对照组比较,大鼠灌胃40 mg·kg^-1 FDE,肝微粒体主要CYP酶活性无显著变化;灌胃160 mg·kg^-1后,肝微粒体CYP2E1活性为对照组的164%。结论 FDE对大鼠和人肝微粒体CYP主要亚型的抑制作用较弱;40 mg·kg^-1 FDE对大鼠肝微粒体主要CYP酶未显示明显诱导作用,160 mg·kg^-1 FDE对肝微粒体CYP2E1有一定的诱导作用。     

葛根素对人肝微粒体中细胞色素P450酶活性的影响

目的:研究葛根素对人肝微粒体中细胞色素P450 1A2(CYP1A2)、CYP3A4、CYP2C9、CYP2C19、CYP2D6、CYP2E1酶活性的影响.方法:分别以咖啡因、咪达唑仑、甲苯磺丁脲、氯唑沙宗、美托洛尔、美芬妥因为探针药,利用HPLC方法测定探针药与相应代谢产物的浓度,研究葛根素在人肝微粒体孵化体系中对CYP1A2、CYP3A4、CYP2C9、CYP2E1、CYP2D6、CYP2C19酶活性的影响.结果:在人肝微粒体反应体系中,0.1,0.2,0.4,0.8mmol·L-1葛根素使咖啡因的代谢产物的生成分别降低了(31±15)%(P＜0.01),(43±8)%(P＜0.05),(48±6)%(P＜0.05),(49±4)%(P＜0.05),0.05,0.1,0.2,0.4,0.8mmol·L-1葛根素使美托洛尔的代谢产物生成分别降低了(25±7)%(P＜0.01),(33±4)%(P＜0.05),(40±9)%(P＜0.01),(46±5)%(P<0.01),(72±9)%(P＜0.01);而对甲苯磺丁脲、美芬妥因、咪达唑仑和氯唑沙宗的代谢产物没有明显影响.结论:在人肝微粒体反应体系中,葛根素(0.1 mmol·L-1)对CYP1A2和CYP2D6酶活性有较明显的抑制作用;且随着葛根素浓度的增高,对这两种酶活性的抑制作用也随之增强,而对CYP2C9、CYP2C19、CYP3A4和CYP2E1酶活性没有影响.     

葛根素对5种细胞色素P450酶体外活性影响研究

目的 研究葛根素体外对细胞色素P450酶亚型 CYP1A2、CYP2C9、CYP2C19、CYP2D6和CYP3A4等活性的影响。方法分别以咖啡因、甲苯磺丁脲、美芬妥因、美托洛尔和咪哒唑仑为探针药，采用高效液相色谱法测定探针药与相应代谢产物的浓度，采用重组酶研究葛根素对CYP1A2、CYP2C9、CYP2C19、CYP2D6和CYP3A4酶体外活性的影响。结果在体外重组酶反应体系中，葛根素对CYP2C9、CYP2C19及CYP3A4酶活性无明显影响。但低浓度(0.1 mmol·L 1)下可使CYP1A2活性降低 (48±9)%(P＜0.05)，使CYP2D6活性降低(61±8)%(P＜0.01)；高浓度(0.4 mmol·L 1)下使CYP1A2活性降低（82 ±8）%(P＜0.01)，使CYP2D6活性降低（88 ± 6）%(P＜ 0.01)。结论葛根素对CYP1A2和CYP2D6酶体外活性有较明显的抑制作用；随着葛根素浓度的增高，抑制作用也相应增强。     

评价HPPH对细胞色素P450酶体外代谢活性的影响

目的:评价HPPH在体外对大鼠及人肝微粒CYP450酶的6种亚型酶活性的影响,预测使用HPPH可能出现的药物相互作用。方法:将注射用HPPH与CYP450酶的6种亚型的特异性探针底物非那西汀(CYP1A2)、甲苯磺丁脲(CYP2C9)、S-美芬妥因(CYP2C19)、右美沙芬(CYP2D6)、氯唑沙宗(CYP2E1)、咪达唑仑(CYP3A4)和睾酮(CYP3A4)与大鼠及人肝微粒进行孵育反应,采用HPLC-MS/MS法测定对应的7种代谢产物(对乙酰氨基酚、羟基甲苯磺丁脲、4-羟基美芬妥因、O-去甲基右美沙芬、6-羟基氯唑沙宗、1′-羟基咪达唑仑、6β-羟基睾酮)的浓度。结果:在本实验条件下,HPPH浓度为1.00~50.00μmol·L-1时,未发现其对大鼠的CYP1A2、CYP2C9、CYP2D6、CYP2E1、CYP3A4产生抑制作用。在本实验条件下,HPPH浓度为0.50~10.00μmol·L-1时,未发现其对人CYP1A2产生抑制作用;但对人CYP2C9、CYP2C19、CYP2D6、CYP2E1均存在抑制作用;对人CYP3A4,对底物咪达唑仑存在抑制作用,对底物睾酮未发现抑制作用。结论:HPPH对CYP450酶的抑制作用存在种属差异,在人体内HPPH与CYP450酶作用有待体内实验进一步证明。     

Effects of P450 2C9 Genetic Polymorphisms on Pharmacokinetics of Glimepiride and Glucose Response in Chinese Healthy Volunteers

AIM ： To study the relationship of P450 2C9 genetic polymorphisms and the pharmacokinetics of glimepiride in Chinese. METHODS： P450 2C9 genotype was determined by oligonucleotide microarray. We evaluated P4502C9 phenotype in 19 healthy individuals expressing theP4502 C9＊1/＊1 （n=9）, ＊1/＊3 （n=9） and ＊3/＊3 （n=1） genotypes. Subjects received 4 mg of glimepiride, with plasma and urine collected over a 48 - hour period. Plasma glimepiride and urinary carboxyglimepiride and hydroxyglimepiride concentrations were determined by an HPLC method. RESULTS： Glimepiride AUCinf significantly increased 28% and 54% and T1/2 increased 63% and 235%, respectively,     

Effects of Short-Term Varenicline Administration on Emotional and Cognitive Processing in Healthy,Non-Smoking Adults: A Randomized,Double-Blind,Study

Varenicline is an effective and increasingly prescribed drug for smoking cessation, but has been associated with depressive symptoms and suicidal behavior. However, it remains unclear whether those changes in mood and behavior are directly related to varenicline use, or caused by smoking cessation itself or reflects depression and suicidality rates in smokers, independent of treatment. To investigate the influence of varenicline on mood and behavior independent of smoking and smoking cessation, we assessed the effects of varenicline on emotional processing (a biomarker of depressogenic effects), emotion-potentiated startle reactivity, impulsivity (linked with suicidal behavior), and cognitive performance in non-smoking subjects. We used a randomized, double-blind design, in which we administered varenicline or placebo to healthy subjects over 7 days (0.5 mg/day first 3 days, then 1 mg/day). Cognitive and emotional processing was assessed by a battery of computerized tasks and recording of emotion-potentiated startle response. A total of 41 subjects were randomized, with 38 subjects included in the analysis. The varenicline group did not differ from placebo in terms of negative biases in emotional processing or mood. However, compared with placebo, the varenicline group scored higher on working and declarative memory. In conclusion, short-term varenicline use did not influence negative biases in emotional processing or impulsivity in non-smoking subjects, thereby not supporting direct depressogenic or suicidal risk behavior-inducing effects. In contrast, varenicline may have cognitive-enhancing effects.     

肠道细胞色素P450和P-糖蛋白对口服药物生物利用度的影响

目的综述肠道细胞色素P450和P-糖蛋白(P-gp)对口服药物生物利用度的影响,包括CYP450、Pgp的作用及CYP与Pgp的联合作用。方法收集、阅读并分析近十年来关于肠道细胞CYP450和Pgp影响口服药物生物利用度的文献。结果 CYP450和Pgp在胃肠道均具有高表达,且两者的底物具有显著的重叠性,所以肠道细胞CYP450对已吸收药物的生物转化作用和肠道细胞中Pgp对已吸收药物的主动外排作用是影响口服药物生物利用度的重要因素。结论肠道细胞CYP450和Pgp对药物的口服生物利用度具有重要影响。