Recent Advances in BCS and Drug Product (BioPredictive) Dissolution Gordon L Amidon College of Pharmacy Charles Walgreen Jr. Professor of Pharmacy University of Michigan Ann Arbor, MI 48109-1065 Moscow, Oct 28, 2013 Major Considerations in Pharmaceutical Products • Must Insure Labeling • Must Insure Product Does What the Label States • Must Set Pharmaceutical Standards – Insure Therapeutic Interchangeability • World Market is Generic = Multi Source Products • Singular Fact: Patients Have (almost) No Choice Oral Drug Product Performance Predicting Absorption(Fabs) vs. Systemic Availability (Fsys) Pharmaceutical Standards • Identity • Purity – Safety and Efficacy • Potency Dose Bioavailability • BIOEQUIVALENCE! Bioequivalence: Orange Book Bioequivalent Drug Products. This term describes pharmaceutical equivalent or alternative products that display comparable bioavailability when studied under similar experimental conditions. Section 505 (j)(8)(B) of the Act describes one set of conditions under which a test and reference listed drug5 shall be considered bioequivalent: the rate and extent of absorption of the test drug do not show a significant difference from the rate and extent of absorption of the reference drug when administered at the same molar dose of the therapeutic ingredient under similar experimental conditions in either a single dose or multiple doses; or Bioavailability (21 CFR 320)* This term means the rate and extent to which the active ingredient or active moiety is absorbed from a drug product and becomes available at the site of action. * Code of Federal Regulations (US Government) Bioequivalence (BE): Today Bioequivalence (BE) Paradigm (Oral) • Similar Plasma Levels Similar Efficacy • Similar In Vivo Dissolution Similar Plasma Levels • Similar In Vitro Dissolution Similar In Vivo Dissolution Bioavailability (21 CFR 320)* This term means the rate and extent to which the active ingredient or active moiety is absorbed from a drug product and becomes available at the site of action. * Code of Federal Regulations (US Government) General BE Confidence Interval Test Transport View of BE Science BE connects the product in the bottle with the claims on the label! Label “BE” Product BE: Transport (Absorptive) View t M (t ) P C dAdt 0 A Transport Bioequivalence(BE) If Two Drug Products, Same Drug, present the drug to the absorbing membrane the same way, (C[x,y,z,t]), they will be bioequivalent (BE) Predicting Absorption M (t ) tres 0 P C dAdt A Absorption Rate dM / dt P m ( x, y, z )C m ( x, y, z )dA A • Same Absorption Rate • Same metabolism rate • Same Plasma Levels Oral BE and Dissolution Amidon et al., Clinical pharmacology and Therapeutics, 90, 467 (2011) The Case for ‘Dissolution’ Bioperformance Dissolution • Phase III Clinically tested Product • In Vivo Dissolution of Phase III Product = Bioperformance Dissolution • In Vitro Dissolution? Amidon, KS, et al. Clin. Pharmac. Therap., 90, 467, 2011 August 2000 FDA Guidance G.L. Amidon et. al., Pharmaceutical Research, 12, 413 (1995). Biopharmaceutical Classification High Permeability Low Solubility Class 1 Class 2 High Solubility High Permeability (Rapid Dissolution) Low Solubility High Permeability Low Permeability High Solubility Class 3 Class 4 High Solubility Low Permeability Low Solubility Low Permeability Amidon et al., Pharm Res 12: 413-420, 1995 BCS: Definitions • High Permeability Fraction Absorbed>90% (85%) – Permeability is Surrogate (Human/Animal/Caco2) • High Solubility->Highest Dose Soluble 250 ml – pH 1-7.5 (6.8), pKa High Permeability Drug: Fabs>90% Fabs High Solubility Drug FDA Glass of Water= 8 oz. (240 ml) • Vs = Volume of Solution <250 ml, • pH=1-7.5 (6.8) • Highest Dose Strength • Do=Dose/250/C s <1 BCS of Worlds Drugs Drug database of oral immediate-release (IR) drugs on 200 top-selling US, GB, ES, JP, and KR drug products • US: 113 oral IR drugs (56.5%) • GB: 102 oral drugs (51.0%) • ES: 106 oral drugs (53.0%) • JP: 113 oral drugs (56.5%) • KR: 87 oral drugs (43.5%) • Based on 200 top-selling drug products in 5 countries, and WHO Essential drugs (EML), drug databases of Combined List (346 drugs), Western List (147 drugs), Eastern List (163 drugs) was made and analyzed on molecular properties and BCS classification. Comparison of the percentage of oral IR drugs of permeability class on the Combined, Western, Eastern, US, GB, ES, JP, KR, and WHO lists 0 Combined Western Eastern US GB ES JP (150mL) JP (250mL) KR (240mL) KR (250mL) WHO Combined Western Eastern US GB ES JP (150mL) JP (250mL) KR (240mL) KR (250mL) WHO Combined Western Eastern US GB ES JP (150mL) JP (250mL) KR (240mL) KR (250mL) WHO Percentage of oral IR drugs Comparison of the percentage of oral IR drugs of solubility class in the Combined, Western, Eastern, US, GB, ES, JP, KR, and WHO lists 60 50 40 30 20 10 High-solubility Low -solubility Unavailable BCS Worlds Drugs Bioperformance Dissolution (Definition) • An in vitro dissolution methodology that is predictive of in vivo dissolution • This methodology is not a QC methodology • It is not a regulatory methodology • It IS a drug product development methodology Bioperformance Dissolution Sub-Classification Proposal BCS Class I Drug Solubility pH 1.2 Drug Solubility pH 6.8 Drug Permeability High High High Preferred Procedure >85% Dissolution in 15 min; 30 min, f2., pH = 6.8. 15 min at pH=1.2, then 85% Dissolution in 30 min., pH = 6.8; F2>50; 5 points minimum; not more than one point > 85%. II-A Low High High II-B High Low High >85% Dissolution in 15 min., pH = 1.2. II-C Low Low High 15 min at pH=1.2; then 85% Dissolution in 30 min., pH = 6.8 plus surfactant*; F2>50; 5 points minimum, not more than one point > 85%. III High High Low >85% Dissolution in 15 min., pH = 1.2, 4.5, 6.8. IV-A Low High Low 15 min. at pH = 1.2; then 85% Dissolution in 30 min., pH = 6.8,; F2>50; 5 points minimum.; not more than one point > 85%. IV-B High Low Low >85% Dissolution in 15 min., pH = 1.2. IV-C Low Low Low 15 min at pH=1.2; then 85% Dissolution in 30 min., pH = 6.8 plus surfactant*; F2>50; 5 points minimum, not more than one point > 85%. Bioperformance Dissolution: One Consideration • • • • • GI Physiology pH Buffer Transit Fasted/Fed Human In Vivo Buffer: Bicarbonate Human GI Bicarbonate Pharmaceutical buffers 10mM Stomach 4-21mM, Average= 15mM 30mM pH 1.2, 0.1N HCl 1. USP 2. FaSSIF 3. Others 70mM J.G. Hardman, et al., eds., Goodman and Gilman’s The pharmacological basis for therapeutics, 10th ed., Chapter 39, p1038. N.W. Tietz, et al., eds., Clinical guide to laboratory tests., 3rd ed., p 84. W. G. Karr, et al., Intubation Studies Of The Human Small Intestine. Iv. Chemical Characteristics Of The Intestinal Contents In The Fasting State And As Influenced By The Administration Of Acids, Of Alkalies And Of Water. J Clin Invest 14: 893-900 (1935). A Pharmaceutical Product with CO2 2012 Sales 16 14 12 10 8 6 4 2 0 Coke Cola Pfizer CO2 in the Environment Pharmaceutical Buffers • United State Pharmacopeias (USP) buffer – 50 mM pH 6.8 phosphate buffer Fasted State Simulated Small Intestinal Fluids (FaSSIF1) Other buffers covering pH 1.2-7.5 1: 29 mM NaH2PO4 q.s. to pH 6.5 with NaOH 3 mM Na taurocholate 0.75 mM lecithin 106 mM NaCl Simulated gastric fluids (SGF): pH 1.2 HCl FeSSIF (Fed State Simulated Small Intestine fluids) pH 5.0 acetate buffer pH 7.5 phosphate buffer Buffer choice of analytical chemists with addition of SLS, Tween, and CTAB. Vertzoni M. et al., Dissolution media simulating the intralumenal composition of the small intestine: physiological issues and practical aspects. J. Pharmacy & Pharmacology, 2004, 56:453-462. Equilibrium (?) In the Intestine CO2 (g) • Bicarbonate Equilibrium • • • H2CO3 HCO3− + H+ Ka1 = 2.5×10−4 ; pKa1 = 3.60 at 25 °C. HCO3− CO32− + H+ Ka2 = 5.61×10−11 ; pKa2 = 10.33 at 25 °C • • Gas Phase Equilibrium • – • • • • • • • CO2(gas) = CO2(dissolved) where kH=29.76 atm/(mol/L) at 25°C (Henry constant) CO2(aq) + H2O = H2CO3 (aq) Then of course we have CO2 transport in the Intestine Transporters, Exchangers, intracellular equilibrium PCO2 (Intestine)~200 mmHg CO2 (aq) + H2O = H2CO3 Bicarbonate Buffer Physiological Relevance • Bicarbonate is secreted by the cells throughout the GI tract. • Bicarbonate in the lumen of the GI tract modulates luminal pH. GI Lumen 𝑪𝑶𝟐 + 𝑯𝟐 𝑶 ⇌ 𝑯+ + 𝑯𝑪𝑶𝟑− 𝑪𝑶𝟐 + 𝑯𝟐 𝑶 ⇌ 𝑯+ + 𝑯𝑪𝑶𝟑− GI Epithelial Cell Blood Bicarbonate Buffer: Reactions and Rates 𝑲𝟎 𝑲𝟏 CO2 𝒂𝒒 + 𝑯𝟐 𝑶 ⇌ 𝑯𝟐 𝑪𝑶𝟑 ⇌ 𝑯+ + 𝑯𝑪𝑶𝟑− 𝑯𝟐 𝑪𝑶𝟑 𝑲𝟎 = 𝑪𝑶𝟐 𝒂𝒒 𝑯 + 𝑯𝑪𝑶− 𝟑 𝑲𝟏 = 𝑯𝟐 𝑪𝑶𝟑 𝑲𝒉 𝑲𝟎 = 𝑲𝒅 𝑲𝒇 𝑲𝟏 = 𝑲𝒓 𝑲𝒉 = ~𝟎. 𝟏 𝒔−𝟏 𝑲𝒇 = 𝟖 × 𝟏𝟎𝟔 𝒔−𝟏 Th=1/.1=10 ses 𝑲𝒅 = ~𝟓𝟎 𝒔 −𝟏 Td=1/50=0.02 sec 𝑲𝒂 = 𝑲𝟎 ∙ 𝑲𝟏 = 𝟏𝟎−𝟐.𝟔 ∙ 𝑲𝒓 = 𝟒. 𝟕 × 𝟏𝟎𝟏𝟎 𝒔−𝟏 + 𝑯𝑪𝑶− 𝑯 𝟑 𝟏𝟎−𝟑.𝟕 𝑪𝑶𝟐 𝒂𝒒 = 10-6.3 Film Model Flux and Flux using Cussler’s Reaction Enhancement Factor Flux with Reaction Enhancement Factor Film Model Flux 𝑘 0 𝐻2 𝐶𝑂3 0 − 𝐻2 𝐶𝑂3 𝑘 𝐻2 𝐶𝑂3 ℎ 𝐷𝐻2 𝐶𝑂3 𝑘 = ℎ 𝑘= 0 𝐷𝐻2 𝐶𝑂3 𝐻2 𝐶𝑂3 0 − 𝐻2 𝐶𝑂3 ℎ 𝑘0 50 100 250 500 10,000 2.384 x 10−3 3.372 x 10−3 5.331 x 10−3 7.54 x 10−3 3.38 x 10−2 − 𝐻2 𝐶𝑂3 ℎ 𝐷𝐻2 𝐶𝑂3 𝑘𝑑 𝐷𝐻2 𝐶𝑂3 𝑘𝑑 𝐻2 𝐶𝑂3 0 − 𝐻2 𝐶𝑂3 ℎ RPM 0 𝑘 3.42 3.42 3.42 3.42 3.42 x x x x x 10−2 10−2 10−2 10−2 10−2 EL Cussler, “Diffusion and Mass Transport”, 2009, Wiley 𝑘 𝑘0 14.344 10.143 6.415 4.536 1.013 ℎ Ф (Best Fit) 17 14 5.6 2.8 nd Predicted and Experimental Flux in Bicarbonate Buffer at pH 6.5: Ibuprofen Solubility=3.3x10-4 M, pKa=4.43, Diffusion Coefficient =7.93x10-6 cm2/s 0.4 Experimental in Bicarbonate Buffer 0.35 Predicted in Bicarbonate Buffer (pKa = 6.3) Flux (mg/cm^2/min) 0.3 Predicted in Bicarbonate (Based on Reaction Enhancement Factor phi) 0.25 Predicted in Bicarbonate Buffer (pKa = 3.7) 0.2 0.15 0.1 0.05 0 0 5 10 15 Bicarbonate Buffer Concentration (mM) 20 25 BABE 1960-Present • Mainly Empirical: Cmax and AUC – Regulatory Dominated • Little Biopharmaceutical Mechanism – ADME very complex-> Empirical • Pharmacokinetics Dominated the Science – Analytical and Computational Technology • Regulatory Standards from the ~1970’s – BA & BE Bioequivalence (BE) Today: Oral • Historically a Relative Bioavailability (BA) Based View – Misses the underlying scientific issues • IN Vivo Dissolution • BE Testing is Same Drug – Once Absorbed PK is the Same • The Science of BE is at the Absorption Site – For Oral Dosage Form in the GI Tract • The Question is: What is the Best BE Test BioPredictive Dissolution (BPD) • BCS Class I, IIa, III – Rapid Dissolution • BCS Class IIb,c – More Complex • Modified Release – -Move Complex 天獄 地獄の辺土(天国と地獄の間) 煉獄(苦行) 地獄 Predicting Absorption M (t ) tres 0 P C dAdt A Time Dependent Absorption M (t ) tres P C dAdt 0 A dC / dt k a C ( dM / dt )1 / V dC / dt ka C (dM / dt )1/ V ka C ka C ka (t ) 1/ sec k a C k a C k a ( t ) 1 / sec Diffusion vs. Pharmacokinetic Views of Absorption: A Simpler Well Mixed View Diffusion J (dM / dt )1/ A P C P C Pharmacokinetic dC / dt (dM / dt )1/ V ka C ka C ka 1/ sec P cm / sec. ka ( S / V ) Peff Software e.g. GastroPlus® Predicting Absorption(Fabs) vs. Systemic Availability (Fsys) Predicting Absorption M (t ) tres 0 P C dAdt A Transport View Of Oral Absorption