College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea.
Dong-A Pharmaceutical Co. Ltd., Giheung-gu, Yongin, Gyeonggi 446-905, Republic of Korea.
Int J Pharm. 2018 May 30;543(1-2):52-59. doi: 10.1016/j.ijpharm.2018.03.042. Epub 2018 Mar 26.
Entecavir (EV), an anti-viral agent for hepatitis B infection, should be administered under fasted state, as intestinal absorption of this hydrophilic compound is markedly decreased under post-prandial conditions. Herein, in order to improve therapeutic adherence, a parenteral sustained delivery system was constructed, by synthesizing water-insoluble ester prodrugs of the nucleotide analogous with fatty acids. EV-3-palmitate (named EV-P), exhibited the lowest solubility in phosphate buffered saline (pH 7.4, 1.1 μg/ml), with extended release profile compared with EV, EV-3-myristate, and EV-3-stearate, was selected as a candidate to formulate drug suspension. The crystalline suspension was fabricated using anti-solvent crystallization technique, with a mean particle size of 7.7 μm. After subcutaneous (SC) injection in beagle dogs (0.43 mg/kg as EV), the plasma concentrations of EV were markedly protracted with lowered maximum plasma concentration (C, 4.7 ng/ml), extended time required to reach C (T, 9.0 days), and lengthened elimination half-life (T 129.3 h) compared with those after oral administration (0.0154 mg/kg, C, 15.4 ng/ml; T, 0.01 days; T, 4.1 h). The systemic exposure of the lipidic prodrug was below 0.1% compared with that of EV following SC injection, denoting that EV-P was rapidly converted into the parent compound in blood. Therefore, SC delivery of EV-P microsuspension can be an alternative to oral EV therapy, offering prolonged pharmacokinetic profile after single injection.
恩替卡韦(EV)是一种用于乙型肝炎感染的抗病毒药物,应在空腹状态下给药,因为这种亲水性化合物在餐后条件下的肠道吸收明显减少。在此,为了提高治疗的依从性,通过合成核苷酸类似物的与脂肪酸的水不溶性酯前药,构建了一种肠外持续释放给药系统。EV-3-棕榈酸酯(命名为 EV-P)在磷酸盐缓冲盐水(pH 7.4,1.1μg/ml)中的溶解度最低,与 EV、EV-3-肉豆蔻酸酯和 EV-3-硬脂酸酯相比,具有延长的释放曲线,被选为制备药物混悬剂的候选物。采用抗溶剂结晶技术制备结晶混悬剂,平均粒径为 7.7μm。在比格犬(0.43mg/kg 作为 EV)中皮下(SC)注射后,EV 的血浆浓度明显延长,最大血浆浓度(C)降低(4.7ng/ml),达到 C 的时间(T)延长(9.0 天),消除半衰期(T 129.3 h)延长,与口服(0.0154mg/kg,C 为 15.4ng/ml;T 为 0.01 天;T 为 4.1h)相比。与 SC 注射后 EV 相比,脂质前药的全身暴露低于 0.1%,这表明 EV-P 在血液中迅速转化为母体化合物。因此,SC 给予 EV-P 微混悬剂可替代口服 EV 治疗,单次注射后可提供延长的药代动力学特征。