Investigation of bioequivalence of a new fixed-dose combination of acarbose and metformin with the corresponding loose combination as well as the drug-drug interaction potential between both drugs in healthy adult male subjects.

What is known and objective Both metformin and acarbose are recommended monotherapy and add-on therapy in type 2 diabetes mellitus ( T2 DM). A fixed-dose combination ( FDC) of acarbose and metformin has been developed to reduce pill burden and potentially improve compliance. The current study invest...

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Publicado en:Journal of Clinical Pharmacy & Therapeutics Vol. 39; no. 4; pp. 424 - 432
Autores principales: Kim, S., Jang, I.-J., Shin, D., Shin, D. S., Yoon, S., Lim, K. S., Yu, K.-S., Li, J., Zhang, H., Liu, Y., Brendel, E., Blode, H., Wang, Y.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Aug2014
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2014
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/jcpt.12166
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        atl: Investigation of bioequivalence of a new fixed-dose combination of acarbose and metformin with the corresponding loose combination as well as the drug-drug interaction potential between both drugs in healthy adult male subjects.
      aug:
        au:
          Kim, S.
          Jang, I.-J.
          Shin, D.
          Shin, D. S.
          Yoon, S.
          Lim, K. S.
          Yu, K.-S.
          Li, J.
          Zhang, H.
          Liu, Y.
          Brendel, E.
          Blode, H.
          Wang, Y.
        affil: Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital
      sug:
        subj:
          Diabetes Mellitus, Type 2 Drug Therapy
          Acarbose Pharmacokinetics
          Metformin Pharmacokinetics
          Acarbose Pharmacodynamics
          Metformin Pharmacodynamics
          Drug Combinations
          Biological Availability
          Drug Therapy, Combination
          Human
          Drug Tolerance
          Patient Safety
          Drug Interactions
          Crossover Design
          Male
          Koreans
          Acarbose Administration and Dosage
          Metformin Administration and Dosage
          Descriptive Statistics
          Confidence Intervals
          Adverse Drug Event
          Chromatography, High Pressure Liquid
          Data Analysis Software
          Blood Chemical Analysis
          Analysis of Variance
          Blood Glucose
          Funding Source
          Adolescence
          Young Adult
          Adult
          Middle Age
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
      ab: What is known and objective Both metformin and acarbose are recommended monotherapy and add-on therapy in type 2 diabetes mellitus ( T2 DM). A fixed-dose combination ( FDC) of acarbose and metformin has been developed to reduce pill burden and potentially improve compliance. The current study investigated the bioequivalence of the acarbose/metformin FDC compared with the individual agents administered simultaneously (loose combination). Secondary endpoints were the safety and tolerability of the FDC and the potential for drug-drug interactions between acarbose and metformin. Methods A single-centre, randomized, open-label, four-period crossover study was conducted in healthy male Korean subjects aged 18-45 years. Following one-period balanced Williams design, participants were randomized to receive four single oral treatments on different study days separated by ≥7 days' washout. Treatments were as follows: (i) acarbose/metformin 50/500 mg FDC (test); (ii) acarbose 50 mg and metformin 500 mg as loose combination (reference); (iii) acarbose 50 mg; and (iv) metformin 500 mg. Serial blood samples were taken for glucose and insulin levels for 4 h after a sucrose load on the day before and day of study drug administration. Additionally, serial blood samples were taken for analysis of metformin levels for 24 h after each drug containing metformin. The area under the curve for 4 h post-test ( AUC0-4 h) and the maximal serum concentration ( Cmax) of plasma glucose and serum insulin were primary pharmacodynamic ( PD) parameters, and Cmax, AUC0-last and AUC for metformin levels were primary pharmacokinetic ( PK) parameters. The bioequivalence of the FDC to the loose combination was considered established if the 90% confidence intervals ( CIs) of the baseline-adjusted PD parameter ratios (test vs. reference) for plasma glucose and the PK parameter ratios for metformin fell completely within current acceptance limits (0·8-1·25). Results and discussion Thirty-three of 40 randomized subjects completed the study; five withdrew consent and two discontinued because of adverse events ( AEs). The 24-h plasma concentration-time curves of metformin and the 4-h plasma glucose-time curves after acarbose/metformin FDC (test) and acarbose + metformin loose combination (reference) were almost superimposable. The geometric least squares ( LS) mean of the Ratio AUC and
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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