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中国临床药理学与治疗学 ›› 2022, Vol. 27 ›› Issue (11): 1255-1263.doi: 10.12092/j.issn.1009-2501.2022.11.007

• 临床药理学 • 上一篇    下一篇

吗替麦考酚酯胶囊在中国健康男性受试者空腹及餐后状态下的完全重复交叉设计的生物等效性研究

史革鑫1,2,崇锐3,4,贺坤2,吴海棠5,周宇5,顿中军6,温清2,张继国1,2,张荣3,4   

  1. 1山东第一医科大学药学院,济南 250000,山东;2山东第一医科大学附属中心医院,济南 250000,山东;
    3江苏先声药业有限公司,南京 210000,江苏;4转化医学与创新药物国家重点实验室,南京 210000,江苏;
    5上海熙华检测技术服务股份有限公司,上海 200000;6北京信立达医药科技有限公司,北京 100000

  • 收稿日期:2022-03-29 修回日期:2022-05-17 出版日期:2022-11-26 发布日期:2022-12-12
  • 通讯作者: 张荣,男,博士,副主任药师,研究方向:临床药理。 E-mail: rong.zhang@cn.simcere.com
  • 作者简介:史革鑫,女,在读硕士研究生,研究方向:临床药学和药理学。 E-mail: shigx2018@163.com

A fully replicated crossover bioequivalence study of mycophenolate mofetil capsules in Chinese healthy male subjects under fasting and fed conditions

SHI Gexin1,2, CHONG Rui3,4, HE Kun2, WU Haitang5, ZHOU Yu5, DUN Zhongjun6, WEN Qing2, ZHANG Jiguo1,2, ZHANG Rong3,4   

  1. 1School of Pharmaceutical Sciences, Shandong First Medical University, Jinan 250000, Shandong, China; 2Central Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong, China; 3Jiangsu Simcere Pharmaceutical Co., Ltd., Nanjing 21000, Jiangsu, China; 4State Key Laboratory of Translational Medicine and Innovative Drug Development, Nanjing 210000, Jiangsu, China; 5Shanghai Xihua Scientific Co., Ltd., Shanghai 200000, China; 6Beijing Trust Medical Consulting Co., Ltd., Beijing 100000, China 
  • Received:2022-03-29 Revised:2022-05-17 Online:2022-11-26 Published:2022-12-12

摘要:

目的:评价吗替麦考酚酯胶囊受试制剂与参比制剂在中国健康男性受试者空腹及餐后状态下的生物等效性。方法:空腹试验和餐后试验各入组40例中国健康男性受试者,均采用两制剂、两序列、四周期、完全重复交叉设计。受试者于每周期单剂量口服0.25 g吗替麦考酚酯胶囊受试制剂或参比制剂。采用液相色谱-串联质谱(LC-MS/MS)法测定血浆中吗替麦考酚酯和代谢产物麦考酚酸的浓度。通过Phoenix WinNonlin 8.0软件采用非房室模型计算药动学参数,使用SAS 9.4软件进行统计分析。对于参比制剂的个体内标准差(SWR)<0.294的药动学参数采用平均生物等效性(ABE)方法进行生物等效性评价,对于SWR≥0.294的药动学参数采用参比制剂校正的平均生物等效性(RSABE)方法进行生物等效性评价。结果:在空腹试验中,吗替麦考酚酯Cmax、AUC0-t、AUC0-∞以及麦考酚酸Cmax的SWR大于0.294(分别为0.643 4、0.456 5、0.434 9和0.335 7),(YT-YR)2-θS2WR的单侧95%置信区间上限分别为-0.217 0、-0.118 8、-0.104 4和-0.043 7,几何均值比(T/R)的点估计值分别为91.73%、98.95%、98.13%和92.09%,结果均符合RSABE的生物等效性判定标准。在空腹试验中,麦考酚酸AUC0-t和AUC0-∞的SWR小于0.294(分别为0.090 9和0.108 4),几何均值比(T/R)的90%置信区间分别为95.49%~100.07%和95.10%~100.26%,结果均符合ABE的生物等效性判定标准。在餐后试验中,吗替麦考酚酯Cmax、AUC0-t和AUC0-∞的SWR大于0.294(分别为0.587 9、0.387 5和0.386 5),(YT-YR)2-θS2WR的单侧95%置信区间上限分别为-0.157 4、-0.085 2和-0.082 8,几何均值比(T/R)的点估计值分别为91.09%、99.58%和99.58%,结果均符合RSABE的生物等效性判定标准。在餐后试验中,麦考酚酸Cmax、AUC0-t和AUC0-∞的SWR小于0.294(分别为0.260 9、0.112 2和0.127 5),几何均值比(T/R)的90%置信区间分别为91.28%~107.63%、97.39%~103.70%和96.72%~103.34%,结果均符合ABE的生物等效性判定标准。结论:吗替麦考酚酯胶囊的受试制剂与参比制剂在空腹及餐后条件下均生物等效。

关键词: 吗替麦考酚酯, 麦考酚酸, 药代动力学, 高变异, 生物等效性, 平均生物等效性, 参比制剂校正的平均生物等效性

Abstract:

AIM: To evaluate the bioequivalence of the test and reference formulations of mycophenolate mofetil capsule in Chinese healthy male subjects under fasting and fed conditions.  METHODS: This was a 2-treatment, 2-sequence, 4-period, fully replicated crossover study that included 80 Chinese healthy male subjects (40 subjects in the fasting group and 40 subjects in the fed group, respectively). Subjects were assigned to receive a single oral administration of the test or reference formulation at a dose of 0.25 g in each period. The plasma concentration of mycophenolate mofetil (MMF) and metabolite mycophenolic acid (MPA) were analyzed by LC-MS/MS. The major pharmacokinetic parameters of MMF and MPA were calculated using non-compartmental analysis  by WinNonlin 8.0. The statistical analysis was performed by SAS 9.4. Average bioequivalence (ABE) analysis was applied where it has been demonstrated that the within-subject standard deviation of the reference formulation (SWR) for the PK parameter in the study is<0.294, while reference-scaled average bioequivalence (RSABE) analysis was applied where it has been demonstrated that the SWR for the PK parameter in the study is ≥0.294. RESULTS: Under fasting conditions, the SWR values for the Cmax, AUC0-t and AUC0-∞ of MMF and the Cmax of MPA were >0.294 (0.643 4, 0.456 5, 0.434 9, and 0.335 7, respectively). The 95%upper confidence bounds of (YT-YR)2-θS2WR for these PK parameters were -0.217 0, -0.118 8, -0.104 4, and -0.043 7, respectively, and the point estimates of the test/reference geometric mean ratios for these PK parameters were 91.73%, 98.95%, 98.13%, and 92.09%, respectively. These results met the acceptance criteria of RSABE. Under fasting conditions, the SWR values for the AUC0-t and AUC0-∞ of MPA were <0.294 (0.090 9 and 0.108 4, respectively). The 90%CIs of the test/reference geometric mean ratios for these PK parameters were 95.49%-100.07% and 95.10%-100.26%, respectively, which fell within the ABE acceptance range of 80.00% to 125.00%. Under fed conditions, the SWR values for the Cmax, AUC0-t and AUC0-∞ of MMF were >0.294 (0.587 9, 0.387 5, and 0.386 5, respectively). The 95%upper confidence bounds of (YT-YR)2-θS2WR for these PK parameters were -0.157 4, -0.085 2, and -0.082 8, respectively, and the point estimates of the test/reference geometric mean ratios for these PK parameters were 91.09%, 99.58%, and 99.58%, respectively. These results met the acceptance criteria of RSABE. Under fed conditions, the SWR values for the Cmax, AUC0-t and AUC0-∞ of MPA were <0.294 (0.260 9, 0.112 2, and 0.127 5, respectively). The 90%CIs of the test/reference geometric mean ratios for these PK parameters were 91.28%-107.63%, 97.39%-103.70%, and 96.72%-103.34%, respectively, which fell within the ABE acceptance range of 80.00%to 125.00%. CONCLUSION: The test and reference formulations of mycophenolate mofetil capsule are bioequivalent under fasting and fed conditions.

Key words: mycophenolate mofetil, mycophenolic acid, pharmacokinetics, high variability, bioequivalence, average bioequivalence, reference-scaled average bioequivalence

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