Relative bioavailability and pharmacokinetic properties of two different enteric formulations of esomeprazole in healthy bangladeshi male volunteers: An open-label, single-dose, randomized-sequence, two-way crossover study

Abstract

Background: In Bangladesh, a number of generic oral formulations of esomeprazole are marketed. Study of the relative bioavailability of these generic formulations has yet to be conducted in a Bangladeshi population. Objectives: The aims of this study were to assess the relative bioavailability and pharmacokinetic properties of 2 formulations (test and reference) of esomeprazole 40 mg. Methods: This open-label, randomized, 2-way crossover study was conducted in healthy Bangladeshi male subjects in compliance with the Declaration of Helsinki and International Conference on Harmonisation guidelines. Subjects were randomly assigned to receive the test formulation followed by the reference formulation or vice versa, as a single dose of esomeprazole 40 mg after a 12-hour overnight fast. A washout period of 1 week was maintained between treatments. Following oral administration, blood samples were collected at 0, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.25, 2.5, 2.75, 3, 3.5, 4, 5, 7, 9, and 12 hour(s) after dosing and analyzed for esomeprazole concentrations using a validated HPLC method. Pharmacokinetic parameters, including C max, AUC 0–12, and AUC 0−∞, were determined with a non-compartmental method. The formulations were to be considered bioequivalent if the natural log (ln)-transformed ratios of the pharmacokinetic parameters were within the predetermined bioequivalence range of 80% to 125%, according to the US Food and Drug Administration (FDA) requirement. The within- and between-group differences were examined using ANOVA. Tolerability was assessed by monitoring vital signs and conducting subject interviews regarding adverse events. Interviewers were not blinded to study design. Results: A total of 24 nonsmoking, healthy, Bangladeshi male subjects (mean [SD] age, 22.8 [2.22] years [range, 20–29 years]; weight, 64.7 [6.9] kg [range, 55–79 kg]; height, 1.69 [0.05] m [range, 1.63–1.82 m]; and body mass index, 22.39 [2.16] kg/m 2 [range, 18.99–27.34 kg/m 2]) were enrolled. From serum data, the mean (SD) values for the test and reference products were as follows: 5.26 (1.57) and 5.54 (2.94) μmol/L for C max; 2.53 (0.67) and 2.07 (0.65) hours for T max; 15.74 (6.50) and 16.68 (6.77) μmol/L/h for AUC 0–12; and 17.15 (7.58) and 18.26 (7.31) μmol/L/h for AUC 0−∞, respectively. The mean T max was found to be significantly different between the test and reference formulations (2.53 [0.67] vs 2.07 [0.65] hours, respectively; P < 0.05). The point estimates (90% CI) for the test/reference ratios of the In-transformed AUC 0−∞ and C max were 92.92% (84.02%–102.76%) and 102.36% (85.96%–121.90%), respectively, which were within the FDA-accepted limits for assuming bioequivalence. No adverse events were reported by the volunteers during the study. Conclusion: This single-dose study found that the test and reference formulations of esomeprazole 40 mg met the FDA regulatory criteria for assuming bioequivalence in these healthy, fasting Bangladeshi male volunteers. A significant difference was found in T max between the 2 formulations. Both formulations were well tolerated in the studied population.