Richter Wolfram, Erenmemisoglu Aydin, Van der Meer Mike John, Emritte Nizam, Tuncay Emine, Koytchev Rossen
Cooperative Clinical Drug Research and Development AG, Berlin, Germany.
Arzneimittelforschung. 2009;59(6):297-302. doi: 10.1055/s-0031-1296400.
The aim of the present study was to evaluate the bioequivalence of two oral clopidogrel (CAS 113665-84-2) formulations.
The study was conducted as a monocentric, open, randomized, single-dose, two-period crossover trial in 48 healthy volunteers with a duration of hospitalization of approximately 24 h after dosing on day 1 and with a real wash-out period of 7 days. Blood samples were collected for 24 h post dosing in each period. The plasma was separated and the concentrations of clopidogrel were determined by a LC-MS/MS method. AUC(0-tlast), Cmax, tmax, AUC(0-inf), MRT and t1/2 were calculated for both formulations.
The arithmetic means of AUC(0-tlast) and Cmax were 3,656.01 pg x h/ml and 1970.22 pg/ml for the test formulation and 3771.51 pg x h/ml and 1756.52 pg/ml, respectively, for the reference formulation. The mean tmax was 1.16 h for the test and 1.13 h for the reference formulation. The point estimators of the ratios of the test and reference formulations for AUC(0-tlast) and Cmax were 1.042 and 1.115, respectively. Furthermore, the 90% confidence intervals calculated by means of ANOVA-log for the first primary endpoint of the trial, the intra-individual ratio (T/R) of AUC(0-tlast) of clopidogrel was between 0.932 and 1.165. The 90% confidence interval calculated by means of ANOVA-log for Cmax of clopidogrel was between 0.973 and 1.277. The 90% confidence intervals for both parameters were within the predefined acceptance ranges (0.80-1.25 for AUC(0-tlast) and 0.75-1.33 for Cmax). The intraindividual coefficients of variation determined by means of ANOVA-log were 33.51% for AUC(0-tlast) and 41.29% for Cmax.
While both products were bioequivalent in terms of the rate and extent of absorption, the present study also confirmed a high variability for clopidogrel suggesting high volunteer numbers in bioequivalence trials.
本研究旨在评估两种口服氯吡格雷(CAS 113665-84-2)制剂的生物等效性。
本研究为单中心、开放、随机、单剂量、两周期交叉试验,纳入48名健康志愿者,第1天给药后住院约24小时,实际洗脱期为7天。每个周期给药后采集24小时血样。分离血浆,采用液相色谱-串联质谱法测定氯吡格雷浓度。计算两种制剂的AUC(0-tlast)、Cmax、tmax、AUC(0-inf)、MRT和t1/2。
受试制剂的AUC(0-tlast)和Cmax算术平均值分别为3656.01 pg·h/ml和1970.22 pg/ml,参比制剂分别为3771.51 pg·h/ml和1756.52 pg/ml。受试制剂的平均tmax为1.16小时,参比制剂为1.13小时。受试制剂与参比制剂AUC(0-tlast)和Cmax比值的点估计值分别为1.042和1.115。此外,通过方差分析对数法计算的试验首个主要终点(氯吡格雷AUC(0-tlast)的个体内比值(T/R))的90%置信区间为0.932至1.165。通过方差分析对数法计算的氯吡格雷Cmax的90%置信区间为0.973至1.277。两个参数的90%置信区间均在预定义的接受范围内(AUC(0-tlast)为0.80-1.25,Cmax为0.75-1.33)。通过方差分析对数法确定的个体内变异系数,AUC(0-tlast)为33.51%,Cmax为41.29%。
虽然两种产品在吸收速率和程度方面具有生物等效性,但本研究也证实氯吡格雷存在高度变异性,这表明生物等效性试验需要大量志愿者。