Lee Sang Won, Park Sang-In, Lee SeungHwan, Chung Jae-Yong, Yu Kyung-Sang
Int J Clin Pharmacol Ther. 2019 Feb;57(2):117-124. doi: 10.5414/CP203289.
Metformin and dipeptidyl peptidase-4 (DPP-IV) inhibitors are commonly combined to treat patients with diabetes mellitus (DM). A new fixed-dose combination (FDC) drug containing gemigliptin, a DPP-IV inhibitor, and sustained-release metformin has been developed. This study aimed to compare the PKs and tolerability of FDC versus loose combination of gemigliptin 50 mg and metformin 500 mg.
A randomized, open-label, two-treatment, two-period, two-sequence, crossover study was conducted in 28 healthy subjects, who received a single oral dose of an FDC tablet of gemigliptin (50 mg) and sustained-release metformin (500 mg) or were coadministered gemigliptin (50 mg) and extended-release metformin (500 mg) with a 1-week washout. Serial blood samples were collected up to 48 hours after study drug administration, and the plasma concentrations of gemigliptin, LC15-0636 (active metabolite of gemigliptin), and metformin were determined using a validated LC-MS/MS method. Pharmacokinetic parameters were derived using a noncompartmental method. Safety and tolerability were evaluated based on vital signs, adverse events, clinical laboratory tests, and electrocardiography.
The concentration-time profiles of gemigliptin and metformin were similar when they were administered as FDC or were coadministered. The geometric mean ratio (GMR) and its 90% CIs of C for gemigliptin, LC15-0636, and metformin were 0.93 (0.85 - 1.02), 1.00 (0.94 - 1.06), and 1.03 (0.98 - 1.09), respectively. The corresponding values of AUC were 0.97 (0.93 - 1.01), 1.00 (0.97 - 1.04), and 1.00 (0.95 - 1.05), respectively. There were no clinically meaningful differences in safety and tolerability.
When comparing the AUC and C of gemigliptin, LC15-0636, and metformin, the 90% CIs were all within the range of 0.8 - 1.25, which is the commonly accepted range for evaluating bioequivalence.
二甲双胍和二肽基肽酶-4(DPP-IV)抑制剂常联合用于治疗糖尿病(DM)患者。一种含有DPP-IV抑制剂吉格列汀和缓释二甲双胍的新型固定剂量复方(FDC)药物已研发出来。本研究旨在比较FDC与吉格列汀50 mg和二甲双胍500 mg松散组合的药代动力学(PK)和耐受性。
对28名健康受试者进行了一项随机、开放标签、双治疗、双周期、双序列、交叉研究,受试者接受单次口服吉格列汀(50 mg)和缓释二甲双胍(500 mg)的FDC片剂,或联合服用吉格列汀(50 mg)和缓释二甲双胍(500 mg),洗脱期为1周。在研究药物给药后长达48小时内采集系列血样,采用经过验证的液相色谱-串联质谱(LC-MS/MS)法测定吉格列汀、LC15-0636(吉格列汀的活性代谢物)和二甲双胍的血浆浓度。使用非房室方法推导药代动力学参数。根据生命体征、不良事件、临床实验室检查和心电图评估安全性和耐受性。
吉格列汀和二甲双胍以FDC形式给药或联合给药时,其浓度-时间曲线相似。吉格列汀、LC15-0636和二甲双胍的C的几何平均比值(GMR)及其90%置信区间(CI)分别为0.93(0.85 - 1.02)、1.00(0.94 - 1.06)和1.03(0.98 - 1.09)。AUC的相应值分别为0.97(0.93 - 1.01)、1.00(0.97 - 1.04)和1.00(0.95 - 1.05)。安全性和耐受性方面无临床意义上的差异。
比较吉格列汀、LC15-0636和二甲双胍的AUC和C时,90%CI均在0.8 - 1.25范围内,这是评估生物等效性的公认范围。