Pharmacokinetics, Safety, and Tolerability of Single and Multiple Doses of Relebactam, a ß-Lactamase Inhibitor, in Combination with Imipenem and Cilastatin in Healthy Participants.

Relebactam is a novel class A and C ß-lactamase inhibitor that is being developed in combination with imipenem-cilastatin for the treatment of serious infections with Gram-negative bacteria. Here we report on two phase 1 randomized, double-blind, placebo-controlled pharmacokinetics, safety, and tolerability studies of relebactam administered with or without imipenem-cilastatin to healthy participants: (i) a single-dose (25 to 1,150 mg) and multiple-dose (50 to 625 mg every 6 h [q6h] for 7 to 14 days) escalation study with men and (ii) a single-dose (125 mg) study with women and elderly individuals. Following single- or multiple-dose intravenous administration over 30 min, plasma relebactam concentrations declined biexponentially, with a terminal half-life (t1/2) ranging from 1.35 to 1.85 h independently of the dose. Exposures increased in a dose-proportional manner across the dose range. No clinically significant differences in pharmacokinetics between men and women, or between adult and elderly participants, were observed. Urine pharmacokinetics demonstrated that urinary excretion is the major route of relebactam elimination. No drug-drug interaction between relebactam and imipenem-cilastatin was observed, and the observed t1/2 values for relebactam, imipenem, and cilastatin were comparable, thus supporting coadministration. Relebactam administered alone or in combination with imipenem-cilastatin was well tolerated across the dose ranges studied. No serious adverse events or deaths were reported. The pharmacokinetic profile and favorable safety results supported q6h dosing of relebactam with imipenem-cilastatin in clinical treatment trials.

Artifacts Generated During Azoalkane Peroxy Radical Oxidative Stress Testing of Pharmaceuticals Containing Primary and Secondary Amines.

We report artifactual degradation of pharmaceutical compounds containing primary and secondary amines during peroxy radical-mediated oxidative stress carried out using azoalkane initiators. Two degradation products were detected when model drug compounds dissolved in methanol/water were heated to 40°C with radical initiators such as 2,2'-azobis(2-methylpropionitrile) (AIBN). The primary artifact was identified as an α-aminonitrile generated from the reaction of the amine group of the model drug with formaldehyde and hydrogen cyanide, generated as byproducts of the stress reaction. A minor artifact was generated from the reaction between the amine group and isocyanic acid, also a byproduct of the stress reaction. We report the effects of pH, initiator/drug molar ratio, and type of azoalkane initiator on the formation of these artifacts. Mass spectrometry and nuclear magnetic resonance were used for structure elucidation, whereas mechanistic studies, including stable isotope labeling experiments, cyanide analysis, and experiments exploring the effects of butylated hydroxyanisole addition, were employed to support the degradation pathways.

In silico prediction of pharmaceutical degradation pathways: a benchmarking study.

Zeneth is a new software application capable of predicting degradation products derived from small molecule active pharmaceutical ingredients. This study was aimed at understanding the current status of Zeneth's predictive capabilities and assessing gaps in predictivity. Using data from 27 small molecule drug substances from five pharmaceutical companies, the evolution of Zeneth predictions through knowledge base development since 2009 was evaluated. The experimentally observed degradation products from forced degradation, accelerated, and long-term stability studies were compared to Zeneth predictions. Steady progress in predictive performance was observed as the knowledge bases grew and were refined. Over the course of the development covered within this evaluation, the ability of Zeneth to predict experimentally observed degradants increased from 31% to 54%. In particular, gaps in predictivity were noted in the areas of epimerizations, N-dealkylation of N-alkylheteroaromatic compounds, photochemical decarboxylations, and electrocyclic reactions. The results of this study show that knowledge base development efforts have increased the ability of Zeneth to predict relevant degradation products and aid pharmaceutical research. This study has also provided valuable information to help guide further improvements to Zeneth and its knowledge base.

Ambient analysis of saturated hydrocarbons using discharge-induced oxidation in desorption electrospray ionization.

Saturated nonfunctionalized hydrocarbons can be oxidized in situ by initiating an electrical discharge during desorption electrospray ionization (DESI) to generate the corresponding alcohols and ketones. This form of reactive DESI experiment can be utilized as an in situ derivatization method for rapid and direct analysis of alkanes at atmospheric pressure without sample preparation. Betaine aldehyde was incorporated into the DESI spray solution to improve the sensitivity of detecting the long-chain alcohol oxidation products. The limit of detection for alkanes (C(15)H(32) to C(30)H(62)) from pure samples is approximately 20 ng. Multiple oxidations and dehydrogenations occurred during the DESI discharge, but no hydrocarbon fragmentation was observed, even for highly branched squalane. Using exact mass measurements, the technique was successfully implemented for analysis of petroleum distillates containing saturated hydrocarbons.

Imaging of lipids in atheroma by desorption electrospray ionization mass spectrometry.

One of the hallmarks of atherosclerosis is the accumulation of lipoproteins within the wall of blood vessels. The lipid composition can vary among atheroma, even within a single individual, and is also dynamic, changing as the lesion progresses. One desirable characteristic of atheroma is their stability, as the rupture of unstable plaques can interfere with normal blood flow to the brain or heart, leading to stroke or heart attack. Desorption electrospray ionization mass spectrometry (DESI-MS) was used in this study for the profiling and imaging of arterial plaques. DESI-MS is an ambient ionization method in which a charged, nebulized solvent spray is directed a surface. In the positive and negative ion modes, sodium and chloride adducts, respectively, of diacyl glycerophosphocholines (GPChos), sphingomyelins (SMs), and hydrolyzed GPChos were detected. Also, cholesteryl esters were detected via adduct formation with ammonium cations. Finally, cholesterol was imaged in the atheroma by doping the charge labeling reagent betaine aldehyde directly into the DESI solvent spray, leading to in situ chemical derivatization of the otherwise nonionic cholesterol. DESI imaging experiments, in which the spatial distribution of the various chemical species is determined by scanning the DESI probe across an entire sample surface, revealed that there are lipid rich regions within the arterial walls, and the lipid rich regions seem to have one of two different lipid profiles. These lipid rich regions likely correspond to the areas of the tissue where lipoprotein particles have accumulated. It is also possible that the different lipid distributions may correlate with the stability or vulnerability of that particular region of the plaque.

Internal energy distributions in desorption electrospray ionization (DESI).

The internal energy distributions of typical ions generated by desorption electrospray ionization (DESI) were measured using the "survival yield" method, and compared with corresponding data for electrospray ionization (ESI) and electrosonic spray ionization (ESSI). The results show that the three ionization methods produce populations of ions having internal energy distributions of similar shapes and mean values (1.7-1.9 eV) suggesting similar phenomena, at least in the later stages of the process leading from solvated droplets to gas-phase ions. These data on energetics are consistent with the view that DESI involves "droplet pick-up" (liquid-liquid extraction) followed by ESI-like desolvation and gas-phase ion formation. The effects of various experimental parameters on the degree of fragmentation of p-methoxy-benzylpyridinium ions were compared between DESI and ESSI. The results show similar trends in the survival yields as a function of the nebulizing gas pressure, solvent flow rate, and distance from the sprayer tip to the MS inlet. These observations are consistent with the mechanism noted above and they also enable the user to exercise control over the energetics of the DESI ionization process, through manipulation of external and internal ion source parameters.

Serine sublimes with spontaneous chiral amplification.

Sublimation of near-racemic samples of serine yields a sublimate which is highly enriched in the major enantiomer; this simple one-step process occurs under relatively mild conditions, and represents a possible mechanism for the chiral amplification step in homochirogenesis.

Enhanced desorption ionization using oxidizing electrosprays.

A signal enhancement of two orders of magnitude was achieved when reactive desorption electrospray ionization (DESI) was used to investigate copper(II) dibutyl dithiocarbamate, Cu(II)(bu2dtc)2, found in a specialized polymer. Cu(II) was oxidized to Cu(III) during the DESI experiment by oxidants in the spray solvent. Such oxidants could be present or formed during electrospray (e.g., O2) or deliberately added to the spray solvent (this approach is called reactive DESI). When a strong oxidizing agent (e.g., iodine) was added to the spray solvent, the signal increased by two orders of magnitude relative to the pure solvent spray. The correlation between the standard reduction potential of the oxidant and the signal intensity and signal to noise ratio of the product ion for various reagents, was tested and discussed. The observed DESI enhancements in rates of oxidation are not observed in homogeneous solution. The major peaks in the collision induced dissociation (CID) spectrum of the complex ion Cu(III)(bu2dtc)2]+ were identified using isotopic distributions and MS3 data.

Desorption electrospray ionization and electrosonic spray ionization for solid- and solution-phase analysis of industrial polymers.

Desorption electrospray ionization (DESI) and electrosonic spray ionization (ESSI), two new techniques, are used to measure average molecular weights and molecular weight distributions of solid-phase and solution-phase samples of the same polymers.