Cho H Y, Yoon H, Lim Y C, Lee Y B
Department of Pharmacological Research, NITR, KFDA, Seoul, Korea.
Int J Clin Pharmacol Ther. 2009 Dec;47(12):770-9. doi: 10.5414/cpp47770.
To evaluate the bioequivalence of a gliclazide/metformin combination tablet (at dose of 80/500 mg) with co-administration of metformin (500 mg) and gliclazide (80 mg) as individual tablets in healthy male Korean volunteers.
SUBJECTS, MATERIALS AND METHODS: The study was conducted as an open-label, randomized, 2-period crossover design in 32 healthy male Korean volunteers who received a combination tablet of gliclazide/metformin at a dose of 80/500 mg or co-administration of gliclazide and metformin as individual tablets in each study period. There was a 7-day washout period between doses. Serum concentrations of gliclazide and metformin up to 32 hours after administration were determined using a validated HPLC method with UV detection. The pharmacokinetic parameters such as AUC0-t (the area under the curve from zero to the time), AUC0- yen (the area under the curve from zero to infinity), Cmax (maximum serum concentration), tmax (time to reach Cmax) and t1/2 (terminal half-life), were analyzed by non-compartmental analysis. Analysis of variance (ANOVA) was carried out using logarithmically transformed AUC0-t, AUC0- yen and Cmax, and untransformed tmax. In addition, blood glucose concentration was also logarithmically transformed and analyzed. Tolerability and safety profiles were also investigated.
There were no significant differences between the single combination tablet and the individual tablets in AUC0-t, AUC0- yen, Cmax and blood glucose concentration. The point estimates (90% confidence intervals) for AUC0-t, AUC0- yen and Cmax were 1.0293 (0.9476 - 1.1178), 1.0253 (0.9185 - 1.1443) and 1.0425 (0.9986 - 1.0883) for gliclazide, and 0.9887 (0.9137 - 1.0697), 0.9915 (0.9189 - 1.0697) and 0.9882 (0.9295 - 1.0505) for metformin, respectively, satisfying the bioequivalence criteria of 80 - 125% as proposed by the US FDA and the Korean legislation. Significant F test values were found between the subjects and subject nested sequence (SEQ) for AUC0-t and Cmax, indicating substantial inter-subject variation in the pharmacokinetics of gliclazide and metformin. However, a SEQ effect in the two-way crossover design did not impair the bioequivalence conclusion. No statistically significant differences were found for tmax and blood glucose concentration between two treatments.
The combination tablet of gliclazide/metformin is bioequivalent to co-administration of individual tablets. As a result, the combination tablets are regarded therapeutically equivalent and exchangeable to the co-administration of individual tablets in clinical practice. Moreover, the combination tablets are expected to improve convenience and adherence to prescribed therapy and to contribute to better blood glucose control for patients with Type 2 diabetes.
在健康韩国男性志愿者中,评估格列齐特/二甲双胍复方片剂(剂量为80/500mg)与分别服用二甲双胍(500mg)和格列齐特(80mg)单片剂的生物等效性。
受试者、材料与方法:本研究采用开放标签、随机、两周期交叉设计,纳入32名健康韩国男性志愿者,他们在每个研究周期接受80/500mg剂量的格列齐特/二甲双胍复方片剂,或分别服用格列齐特和二甲双胍单片剂。两次给药之间有7天的洗脱期。采用经过验证的带紫外检测的高效液相色谱法测定给药后32小时内格列齐特和二甲双胍的血清浓度。通过非房室分析对药代动力学参数进行分析,如AUC0-t(从零到给药后某时间的曲线下面积)、AUC0-∞(从零到无穷大的曲线下面积)、Cmax(最大血清浓度)、tmax(达到Cmax的时间)和t1/2(末端半衰期)。使用对数转换后的AUC0-t、AUC0-∞和Cmax以及未转换的tmax进行方差分析(ANOVA)。此外,血糖浓度也进行对数转换并分析。同时研究了耐受性和安全性。
在AUC0-t、AUC0-∞、Cmax和血糖浓度方面,复方单片剂与分别服用的单片剂之间无显著差异。格列齐特的AUC0-t、AUC0-∞和Cmax的点估计值(90%置信区间)分别为1.0293(0.9476 - 1.1178)、1.0253(0.9185 - 1.1443)和1.0425(0.9986 - 1.0883),二甲双胍的分别为0.9887(0.9137 - 1.0697)、0.9915(0.9189 - 1.0697)和0.9882(0.9295 - 1.0505)均符合美国食品药品监督管理局(FDA)和韩国法规提出的80 - 125%的生物等效性标准。在AUC0-t和Cmax方面,受试者与受试者嵌套序列(SEQ)之间存在显著的F检验值,表明格列齐特和二甲双胍的药代动力学存在显著的个体间差异。然而,双向交叉设计中的SEQ效应并未影响生物等效性结论。两种治疗方法在tmax和血糖浓度方面未发现统计学上的显著差异。
格列齐特/二甲双胍复方片剂与分别服用单片剂具有生物等效性。因此,在临床实践中,复方片剂在治疗上被认为是等效的,并且可以与分别服用单片剂相互替换。此外,复方片剂有望提高用药便利性和对规定治疗的依从性,并有助于更好地控制2型糖尿病患者的血糖。