Glutathione-PEGylated liposomal methylprednisolone in comparison to free methylprednisolone: slow release characteristics and prolonged lymphocyte depression in a first-in-human study.

AIMS: Intravenous high-dose free methylprednisolone (MP) hemisuccinate is the primary treatment for an acute relapse in relapsing-remitting multiple sclerosis. However, it is inconvenient and its side effects are undesirable. Both dose and dosing frequency can be reduced by incorporating free MP in glutathione-PEGylated liposomes, creating a slow-release formulation with reduced toxicity and prolonged peripheral efficacy. This first-in-human study was designed to assess the safety, pharmacokinetics and pharmacodynamics of glutathione-PEGylated liposomes containing MP (2B3-201). METHODS: The first part was a double-blind, three-way cross over study in 18 healthy male subjects, receiving ascending doses of 2B3-201, active comparator (free MP) or placebo. Part 2 of the study was an open-label infusion of 2B3-201 (different doses), exploring pretreatment with antihistamines and different infusion schedules in another 18 healthy male subjects, and a cross-over study in six healthy female subjects. MP plasma concentrations, lymphocyte counts, adrenocorticotropic hormone, osteocalcin and fasting glucose were determined. Safety and tolerability profiles were assessed based on adverse events, safety measurements and central nervous system tests. RESULTS: The most frequent recorded AE related to 2B3-201 was an infusion related reaction (89%). 2B3-201 was shown to have a plasma half-life between 24 and 37 h and caused a prolonged decrease in the lymphocyte count, adrenocorticotropic hormone and osteocalcin, and a rise in fasting glucose. CONCLUSION: 2B3-201 is considered safe, with no clinically relevant changes in central nervous system safety parameters and no serious adverse events. In addition, 2B3-201 shows a long plasma half-life and prolonged immunosuppressive effects.

The perception and pharmacokinetics of a 20-mg dose of escitalopram orodispersible tablets in a relative bioavailability study in healthy men.

BACKGROUND: Rapidly dissolving oral (orodispersible) drug formulations have been developed to overcome problems related to swallowing. OBJECTIVE: The aim of this study was to compare the bioavailability of orodispersible and conventional immediate-release (IR) escitalopram tablets. METHODS: This was a randomized, open-label, 3-way crossover trial in which healthy men received single doses of orodispersible escitalopram formulations (2 ×10 mg and 1 × 20 mg) and conventional (2 × 10 mg) oral escitalopram tablets. Blood samples for pharmacokinetic analysis were obtained during a 168-hour period after dosing. The safety profile and tolerability were assessed by monitoring of adverse events, physical examinations, ECGs, and clinical laboratory and vital signs assessments. A questionnaire was used to assess the perception of the orodispersible tablet (ODT). RESULTS: The assumed bioequivalence assessment was based on pharmacokinetic and statistical analysis of data from the 29 men who completed the 3 treatments. The serum concentration-time profiles of escitalopram were similar after intake of the 3 treatments. The 90% CI for the mean treatment ratios of the log-transformed C(max), AUC(0-t), and AUC(0-∞) were all within the predefined equivalence range of 80% to 125%. Most subjects (87%) thought that the ODT was pleasant to take, and 85% of subjects thought that it was convenient to take the tablet without water. Most subjects (67%-90%) reported adverse events, with a similar incidence for all treatments. Most adverse events were mild, with somnolence and nausea being the most frequently reported. No clinically relevant changes were observed in physical, biochemical, hematologic, or urinalysis variables during the study. CONCLUSIONS: In this small study population of fasting healthy male volunteers, 2 × 10-mg ODTs or 1 × 20-mg ODT and 2 × 10-mg conventional IR escitalopram tablets met the regulatory criteria for assumed bioequivalence. CLINICALTRIALS.GOV IDENTIFIER: NCT 01395433.