Novartis Institutes for BioMedical Research, Cambridge, MA, USA.
Novartis Institutes for BioMedical Research, Shanghai, China.
Clin Pharmacol Drug Dev. 2016 Jan;5(1):40-51. doi: 10.1002/cpdd.191. Epub 2015 May 15.
Metformin is the first-line pharmacotherapy choice for treating type-2 diabetes mellitus, alone or in combination with other antidiabetic drugs. During the development of immediate-release (IR) metformin containing novel fixed-dose combination (FDC) products, several health-authorities require sponsors to demonstrate bioequivalence between FDC products and the country-sourced metformin for market approval. Eight bioequivalence studies that compared metformin/vildagliptin FDC product (test) to metformin IR tablet sourced from various countries (reference) were conducted. A population pharmacokinetic (PPK) analysis of pooled metformin concentration-time data was performed to evaluate whether country-sourced metformin is a significant covariate. The PPK analysis demonstrated that there was no clinically relevant effect of metformin source or race/ethnicity on metformin pharmacokinetics. Also, noncompartmental analysis conducted showed that 90%CI of geometric mean ratios of test to reference metformin formulations, calculated for maximum-concentration and exposure parameters, were within the 80%-125% criteria, indicating comparable metformin exposure regardless of the country-sourced metformin IR formulation. These results are consistent with the biopharmaceutics properties of metformin and provide scientific evidence that after assessing in vitro dissolution of novel FDC formulation, additional bioequivalence studies with multiple countries' reference products may not be required once bioequivalence is established with 1 country-sourced IR metformin formulation.
二甲双胍是治疗 2 型糖尿病的一线药物治疗选择,可单独使用或与其他抗糖尿病药物联合使用。在开发含有新型固定剂量组合(FDC)的速释(IR)二甲双胍产品时,一些卫生当局要求赞助商证明 FDC 产品与源自本国的二甲双胍在市场批准方面具有生物等效性。进行了 8 项生物等效性研究,比较了二甲双胍/维格列汀 FDC 产品(测试)与源自不同国家的二甲双胍 IR 片剂(参比)。对汇集的二甲双胍浓度-时间数据进行群体药代动力学(PPK)分析,以评估源自本国的二甲双胍是否为重要协变量。PPK 分析表明,二甲双胍的来源或种族/民族对二甲双胍药代动力学没有临床相关影响。此外,进行的非房室分析表明,测试与参比二甲双胍制剂的最大浓度和暴露参数的几何均数比值的 90%置信区间在 80%-125%标准范围内,表明无论源自本国的 IR 二甲双胍制剂如何,二甲双胍的暴露情况均可比较。这些结果与二甲双胍的生物药剂学特性一致,并提供了科学证据,即在评估新型 FDC 制剂的体外溶出度后,一旦与源自 1 个国家的 IR 二甲双胍制剂建立了生物等效性,可能不需要使用多个国家的参比产品进行额外的生物等效性研究。