Abstract :
Background- Among the gliptins, vildagliptin is the only therapy requiring twice-daily dosing and thus adversely impacts patient adherence. To reduce dosing frequency, we developed a once-daily sustained-release (SR) vildagliptin 100 mg tablet formulation with potential to furnish comparable dipeptidyl peptidase-4 (DPP-4) inhibition coverage to the conventional twice-daily regimen.
Objective- The current study compares the pharmacokinetic (PK) and pharmacodynamic (PD) characteristics of investigational once-daily SR vildagliptin 100 mg tablet formulation with the twice-daily dosage of marketed product, Galvus® in healthy Indian adult males after single and multiple-dose administration.
Methods- Single and multiple-dose PK-PD assessment was conducted in separate clinical studies enrolling thirty-six healthy subjects under fed-condition. Each study was a randomized, open-label, two treatment, two-period, crossover design. Drug plasma concentrations were quantified by validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. DPP-4 inhibition was estimated in the fluorescence-based assay. PK parameters were calculated from the plasma concentration-time curve employing Phoenix® WinNonlin® software. Formulation safety was evaluated by monitoring adverse events.
Results- SR vildagliptin 100 mg tablet resulted in peak-less, nearly steady drug concentration-time profile. Thus, its mean PK characteristics after single [Cmax (147.7), AUC(0-24) (1645.04), Tmax (5.29 hr), t1/2 (4.61 hr)] and multiple-dose [Cmaxss (163.59), AUCss (0-24) (1815.36), and Tmaxss (4.65 hrs), t1/2ss (3.71 hr)] administrations were significantly distinct from the Galvus® twice-daily regimen. SR vildagliptin 100 mg tablet demonstrated more than 80% DPP-4 inhibition profile for approximately 23 hrs in both the studies which was comparable to Galvus® twice-daily regimen.
Conclusions- Investigational SR vildagliptin 100 mg tablet formulation was found to be safe and well-tolerated. Its ability to provide nearly 80% DPP-4 inhibition coverage over 23 hrs post-dose may reduce the additional pill burden in patients on conventional twice-daily regimen.
Keywords :
Healthy Volunteers, Once-Daily, Pharmacodynamics, Pharmacokinetics, SR Vildagliptin 100 mgReferences :
1. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et all., Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract 157 (2019) 107843.
2. Gerich JE. Contributions of insulin-resistance and insulin-secretory defects to the pathogenesis of type 2 diabetes mellitus. Mayo Clin Proc 78 (2003) 447-456.
3. Nauck MA and Meier JJ. Incretin hormones: Their role in health and disease, Diabetes Obes Metab 20 (2018) 5-21.
4. Hui H, Farilla L, Merkel P, Perfetti R. The short half-life of glucagon-like peptide-1 in plasma does not reflect its long-lasting beneficial effects. Eur J Endocrinol 146 (2002) 863-869.
5. Gallwitz B. Clinical use of DPP-4 inhibitors. Front Endocrinol (Lausanne). 10 (2019) 1-10.
6. Rameshrad M, Razavi BM, Ferns GAA, Hosseinzadeh H. Pharmacology of dipeptidyl peptidase-4 inhibitors and its use in the management of metabolic syndrome: a comprehensive review on drug repositioning. Daru J Pharm Sci 27 (2019) 341-360.
7. Deacon CF. Dipeptidyl peptidase 4 inhibitors in the treatment of type 2 diabetes mellitus. Nat Rev Endocrinol 16 (2020) 642-653.
8. Prato SD. Ten years of Vildagliptin. Eur Endocrinol 13 (2017) 54-55.
9. Foley JE and Ahrén B. The vildagliptin experience-25 years since the initiation of the Novartis glucagon-like peptide-1 based therapy programme and 10 years since the first vildagliptin registration. Eur Endocrinol 13 (2017) 56-61.
10. Mathieu C, Kozlovski P, Paldánius PM, Foley JE, Modgill V, Evans M, Serban C. Clinical safety and tolerability of vildagliptin-insights from randomised trials, observational studies and post-marketing surveillance. Eur Endocrinol 13 (2017) 68-72.
11. Galvus – Summary of product characteristics (EMA Annex I) (2013). Available online on https://www.ema.europa.eu/en/documents/product-information/galvus-epar-product-information_en.pdf (accessed on March 31, 2021).
12. He YL, Wang Y, Bullock JM, Deacon CF, Holst JJ, Dunning BE, et all. Pharmacodynamics of vildagliptin in patients with type 2 diabetes during OGTT. J Clin Pharmacol. 47 (2007) 633-641.
13. Hu P, Yin Q, Deckert F, Jiang J, Liu D, Kjems L, et all. Pharmacokinetics and pharmacodynamics of vildagliptin in healthy Chinese volunteers, J Clin Pharmacol 49 (2009) 39-49.
14. Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther 23 (2001) 1296-1310.
15. Srivastava K, Arora A, Kataria A, Cappelleri JC, Sadosky A, Peterson AM. Impact of reducing dosing frequency on adherence to oral therapies : a literature review and meta-analysis. Patient Prefer Adherence 7 (2013) 419-434.
16. Conley R, Gupta SK, Sathyan G. Clinical spectrum of the osmotic-controlled release oral delivery system (OROS), an advanced oral delivery form. Curr Med Res Opin 22 (2006) 1879-1892.
17. Tatosian DA, Guo Y, Schaeffer AK, Gaibu N, Popa S, Stoch A, Langdon RB, Kauh EA. Dipeptidyl peptidase-4 inhibition in patients with type 2 diabetes treated with saxagliptin, sitagliptin, or vildagliptin. Diabetes Ther 4 (2013) 431-442.
18. Sangle GV, Patil M, Deshmukh NJ, Shengule SA, Kamble S, Vuppalavanchu KK et all., Evaluation of pharmacokinetic and pharmacodynamic parameters following single dose of sitagliptin in healthy Indian males. Eur J Clin Pharmacol 74 (2018) 561-569.
19. Pote A, Ravisankar S, Sangle G, Agarwal S, Patil M, Deshmukh N et all., Clinical pharmacokinetics and pharmacodynamics of vildagliptin 50 mg sustained release tablet formulation in healthy Indian males after single and multiple-dose. Int J Res Med Sci 9 (2021) 510-517.
20. Keraliya RA, Patel C, Patel P, Keraliya V, Soni TG, Patel RC, Patel MM. Osmotic Drug Delivery System as a Part of Modified Release Dosage Form. ISRN Pharm 2012 (2012) 1-9.
21. Verma RK, Krishna DM, Garg S. Formulation aspects in the development of osmotically controlled oral drug delivery systems. J Control Release 79 (2002) 7-27.
22. Sahoo CK, Sahoo NK, Rao SRM, Sudhakar M, Satyanarayana K. A review on controlled porosity osmotic pump tablets and its evaluation. Bull Fac Pharmacy Cairo Univ 53 (2015) 195-205.
23. He YL. Clinical Pharmacokinetics and Pharmacodynamics of Vildagliptin. Clin Pharmacokinet 51 (2012) 147-162.
24. He YL, Serra D, Wang Y, Campestrini J, Riviere GJ, Deacon CF et all., Pharmacokinetics and Pharmacodynamics of Vildagliptin in Patients with Type 2 Diabetes Mellitus. Clin Pharmacokinet 46 (2007) 577-588.
25. Scheen AJ. A review of gliptins for 2014. Expert Opin Pharmacother (2015) 43-62.
26. Herman GA, Bergman A, Stevens C, Kotey P, Yi B, Zhao P, et all., Effect of single oral doses of sitagliptin, a dipeptidyl peptidase-4 inhibitor, on incretin and plasma glucose levels after an oral glucose tolerance test in patients with type 2 diabetes. J Clin Endocrinol Metab 91 (2006) 4612-4619.