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Chinese Journal of Clinical Pharmacology and Therapeutics ›› 2022, Vol. 27 ›› Issue (11): 1255-1263.doi: 10.12092/j.issn.1009-2501.2022.11.007

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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

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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