全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Pharmacokinetic Comparison and Bioequivalence Evaluation of Two Empagliflozin/Metformin Fixed-Dose Combination Tablets in Healthy Subjects under Fed Conditions

DOI: 10.4236/ojemd.2025.153004, PP. 29-44

Keywords: Empagliflozin, Metformin, Bioequivalence, Pharmacokinetics

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background: Empagliflozin, an SGLT2 inhibitor, and Metformin, a biguanide, are commonly prescribed together for the management of type 2 diabetes. This study evaluates the bioequivalence of a fixed-dose combination of Empagliflozin and Metformin (12.5/1000 mg) in healthy subjects under fed conditions. The goal is to ensure that generic versions deliver the same therapeutic effect as the reference product. Materials and Methods: This study was a randomized, open-label, two-period, two-sequence, crossover trial aimed at evaluating the bioequivalence (BE) profiles of two fixed-dose combinations (FDCs) of Empagliflozin and Metformin. The assessment of bioequivalence focused on the maximum plasma concentration (Cmax), area under the concentration-time curve from time zero to time t (AUC0-t), and area under the concentration-time curve from time zero to infinity (AUC0-∞) for both the test and reference formulations. Out of 46 screened participants, 17 were enrolled, of whom 15 completed both treatment periods. In each period, serial blood samples were collected for a duration of up to 72 hours following the oral administration of the study medications. Plasma concentrations of Empagliflozin and Metformin were quantified using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) methodology. The drug products were deemed bioequivalent if the 90% confidence interval (CI) for the test/reference ratios was within the range of 80.00% to 125.00% for the natural logarithm-transformed Cmax, AUC0-t, and AUC0-∞. Tolerability and safety were continuously monitored throughout the study. Results: Based on the rate and extent of absorption, the pharmacokinetic (PK) parameters were similar between the test product (T) and reference product (R). The 90% CI of the test/reference ratios of log-transformed PK parameters point estimates for Empagliflozin were Cmax: 97.39% (87.80% - 108.02%), AUC0-t: 95.40% (90.67% - 100.37%), and AUC0-∞: 95.98% (90.93% - 101.32%) and Cmax: 96.72% (84.39% - 110.84%), AUC0-t: 98.30% (89.94% - 107.43%), and AUC0-∞: 97.69% (89.53% - 106.59%) for Metformin, respectively (90% CI for all PK parameters fell within 80.00% - 125.00%). Conclusion: Our findings confirmed in vivo bioequivalence between the test and reference formulations of Empagliflozin 12.5 mg/Metformin 1000 mg under fed conditions.

References

[1]  Jayawardena, R., Ranasinghe, P., Byrne, N.M., Soares, M.J., Katulanda, P. and Hills, A.P. (2012) Prevalence and Trends of the Diabetes Epidemic in South Asia: A Systematic Review and Meta-Analysis. BMC Public Health, 12, Article No. 380.
https://doi.org/10.1186/1471-2458-12-380
[2]  Zhou, B., Lu, Y., Hajifathalian, K., Bentham, J., Cesare, M.D., Danaei, G., Bixby, H., Cowan, M.J., Ali, M.K., Taddei, C. and Lo, W.C. (2016) Worldwide Trends in Diabetes since 1980: A Pooled Analysis of 751 Population-Based Studies with 4.4 Million Participants. The Lancet, 387, 1513-1530.
[3]  Kanaya, A.M., Wassel, C.L., Mathur, D., Stewart, A., Herrington, D., Budoff, M.J., et al. (2010) Prevalence and Correlates of Diabetes in South Asian Indians in the United States: Findings from the Metabolic Syndrome and Atherosclerosis in South Asians Living in America Study and the Multi-Ethnic Study of Atherosclerosis. Metabolic Syndrome and Related Disorders, 8, 157-164.
https://doi.org/10.1089/met.2009.0062
[4]  Karter, A.J., Schillinger, D., Adams, A.S., Moffet, H.H., Liu, J., Adler, N.E., et al. (2013) Elevated Rates of Diabetes in Pacific Islanders and Asian Subgroups. Diabetes Care, 36, 574-579.
https://doi.org/10.2337/dc12-0722
[5]  Wild, S., Roglic, G., Green, A., Sicree, R. and King, H. (2004) Global Prevalence of Diabetes. Diabetes Care, 27, 1047-1053.
https://doi.org/10.2337/diacare.27.5.1047
[6]  DeMarsilis, A., Reddy, N., Boutari, C., Filippaios, A., Sternthal, E., Katsiki, N., et al. (2022) Pharmacotherapy of Type 2 Diabetes: An Update and Future Directions. Metabolism, 137, Article 155332.
https://doi.org/10.1016/j.metabol.2022.155332
[7]  Avignon, A., Radauceanu, A. and Monnier, L. (1997) Nonfasting Plasma Glucose Is a Better Marker of Diabetic Control than Fasting Plasma Glucose in Type 2 Diabetes. Diabetes Care, 20, 1822-1826.
https://doi.org/10.2337/diacare.20.12.1822
[8]  Scheen, A.J. (1996) Clinical Pharmacokinetics of Metformin. Clinical Pharmacokinetics, 30, 359-371.
https://doi.org/10.2165/00003088-199630050-00003
[9]  Tucker, G., Casey, C., Phillips, P., Connor, H., Ward, J. and Woods, H. (1981) Metformin Kinetics in Healthy Subjects and in Patients with Diabetes Mellitus. British Journal of Clinical Pharmacology, 12, 235-246.
https://doi.org/10.1111/j.1365-2125.1981.tb01206.x
[10]  Graham, G.G., Punt, J., Arora, M., Day, R.O., Doogue, M.P., Duong, J.K., et al. (2011) Clinical Pharmacokinetics of Metformin. Clinical Pharmacokinetics, 50, 81-98.
https://doi.org/10.2165/11534750-000000000-00000
[11]  Jahagirdar, V. and Barnett, A.H. (2014) Empagliflozin for the Treatment of Type 2 Diabetes. Expert Opinion on Pharmacotherapy, 15, 2429-2441.
https://doi.org/10.1517/14656566.2014.966078
[12]  Neumiller, J.J. (2014) Empagliflozin: A New Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitor for the Treatment of Type 2 Diabetes. Drugs in Context, 3, Article 212262.
[13]  Synjardy (2025) Inn-Empagliflozin + Metformin. Boehringer Ingelheim International GmbH.
https://www.ema.europa.eu/en/documents/product-information/synjardy-epar-product-information_en.pdf
[14]  Frampton, J.E. (2018) Empagliflozin: A Review in Type 2 Diabetes. Drugs, 78, 1037-1048.
https://doi.org/10.1007/s40265-018-0937-z
[15]  Pena, E., Inatti, A., Taly, A., Chacón, J.G. and Serrano-Martin, X. (2023) Bioequivalence Assessment of Two Formulations of Empagliflozin in Healthy Adult Subjects. American Journal of Pharmacotherapy and Pharmaceutical Sciences, 2, Article 19.
https://doi.org/10.25259/ajpps_2023_019
[16]  Heise, T., Seewaldt‐Becker, E., Macha, S., Hantel, S., Pinnetti, S., Seman, L., et al. (2013) Safety, Tolerability, Pharmacokinetics and Pharmacodynamics Following 4 Weeks’ Treatment with Empagliflozin Once Daily in Patients with Type 2 Diabetes. Diabetes, Obesity and Metabolism, 15, 613-621.
https://doi.org/10.1111/dom.12073
[17]  American Diabetes Association (2017) 8. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes2018. Diabetes Care, 41, S73-S85.
https://doi.org/10.2337/dc18-s008
[18]  Evans, A.J. and Krentz, A.J. (2001) Insulin Resistance and Β‐Cell Dysfunction as Therapeutic Targets in Type 2 Diabetes. Diabetes, Obesity and Metabolism, 3, 219-229.
https://doi.org/10.1046/j.1463-1326.2001.00101.x
[19]  Kahn, S.E., Haffner, S.M., Heise, M.A., Herman, W.H., Holman, R.R., Jones, N.P., et al. (2006) Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy. New England Journal of Medicine, 355, 2427-2443.
https://doi.org/10.1056/nejmoa066224
[20]  US Food and Drug Administration (2025) SYNJARDY® (Empagliflozin and Metformin) Label.
http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/206111lbl.pdf
[21]  Dailey, G. (2015) Empagliflozin for the Treatment of Type 2 Diabetes Mellitus: An Overview of Safety and Efficacy Based on Phase 3 Trials. Journal of Diabetes, 7, 448-461.
https://doi.org/10.1111/1753-0407.12278
[22]  Hundal, R.S., Krssak, M., Dufour, S., Laurent, D., Lebon, V., Chandramouli, V., et al. (2000) Mechanism by Which Metformin Reduces Glucose Production in Type 2 Diabetes. Diabetes, 49, 2063-2069.
https://doi.org/10.2337/diabetes.49.12.2063
[23]  Goldman, J.D. (2018) Combination of Empagliflozin and Metformin Therapy: A Consideration of Its Place in Type 2 Diabetes Therapy. Clinical Medicine Insights: Endocrinology and Diabetes, 11, 1-11.
https://doi.org/10.1177/1179551418786258
[24]  Macha, S., Dieterich, S., Mattheus, M., Seman, L.J., Broedl, U.C. and Woerle, H.J. (2013) Pharmacokinetics of Empagliflozin, a Sodium Glucose Cotransporter-2 (SGLT2) Inhibitor, and Metformin Following Co-Administration in Healthy Volunteers. International Journal of Clinical Pharmacology and Therapeutics, 51, 132-140.
https://doi.org/10.5414/cp201794
[25]  Böhm, A., Schneider, U., Aberle, J. and Stargardt, T. (2021) Regimen Simplification and Medication Adherence: Fixed-Dose versus Loose-Dose Combination Therapy for Type 2 Diabetes. PLOS ONE, 16, e0250993.
https://doi.org/10.1371/journal.pone.0250993
[26]  Scheen, A.J. (2018) The Safety of Empagliflozin Plus Metformin for the Treatment of Type 2 Diabetes. Expert Opinion on Drug Safety, 17, 837-848.
https://doi.org/10.1080/14740338.2018.1497159
[27]  Rojas, C., Link, J., Meinicke, T. and Macha, S. (2016) Pharmacokinetics of Fixed-Dose Combinations of Empagliflozin/Metformin Compared with Individual Tablets in Healthy Subjects. International Journal of Clinical Pharmacology and Therapeutics, 54, 282-292.
https://doi.org/10.5414/cp202425
[28]  Benford, M., Milligan, G., Pike, J., Anderson, P., Piercy, J. and Fermer, S. (2012) Fixed-Dose Combination Antidiabetic Therapy: Real-World Factors Associated with Prescribing Choices and Relationship with Patient Satisfaction and Compliance. Advances in Therapy, 29, 26-40.
https://doi.org/10.1007/s12325-011-0096-z
[29]  Bangladesh Medical Research Council (2025) Ethical Guidelines for Conducting Research Studies Involving Human Subjects
https://bmrcbd.org/application_form/EthicalGuidelines.pdf
[30]  (2025) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products Bangladesh (2023).
https://dgdagov.info/index.php/information-center/good-clinical-practice-gcp
[31]  The World Medical Association, INC. Declaration of Helsinki. Ethical principles for Medical Research Involving Human Subjects. Adopted by the 18th WMA General Assembly, Helsinki, Finland, June 1964, and amended by the: 64th WMA General Assembly, Fortaleza, Brazil, October 2013.
[32]  European Medicines Agency (2016) Committee for Human Medicinal Products. International Council for Harmonization Guideline for Good Clinical Practice E6(R2).

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133