Publications by Year: 2019

2019
Macheras P. On an Unphysical Hypothesis of Bateman Equation and its Implications for Pharmacokinetics. PHARMACEUTICAL RESEARCH. 2019;36.
Mavroudis PD, Kosmidis K, Macheras P. On the unphysical hypotheses in pharmacokinetics and oral drug absorption: Time to utilize instantaneous rate coefficients instead of rate constants. EUROPEAN JOURNAL OF PHARMACEUTICAL SCIENCES. 2019;130:137-146.Abstract
This work aims to explore the unphysical assumptions associated with i) the homogeneity of the well mixed compartments of pharmacokinetics and ii) the diffusion limited model of drug dissolution. To this end, we i) tested the homogeneity hypothesis using Monte Carlo simulations for a reaction and a diffusional process that take place in Euclidean and fractal media, ii) re-considered the flip-flop kinetics assuming that the absorption rate for a one-compartment model is governed by an instantaneous rate coefficient instead of a rate constant, and, iii) re-considered the extent of drug absorption as a function of dose using an in vivo reaction limited model of drug dissolution with integer and non-integer stoichiometry values. We found that drug diffusional processes and reactions are slowed down in heterogeneous media and the environmental heterogeneity leads to increased fluctuations of the measurable quantities. Highly variable experimental literature data with measurements in intrathecal space and gastrointestinal fluids were explained accordingly. Next, by applying power law and Weibull input functions to a one-compartment model of disposition we show that the shape of concentration-time curves is highly dependent on the time exponent of the input functions. Realistic examples based on PK data of three compounds known to exhibit flip-flop kinetics are analyzed. The need to use time dependent coefficients instead of rate constants in PBPK modeling and virtual bioequivalence is underlined. Finally, the shape of the fraction absorbed as a function of dose plots, using an in vivo reaction limited model of drug dissolution were found to be dependent on the stoichiometry value and the solubility of drug. Ascending and descending limbs were observed for the higher stoichiometries (2.0 and 1.5) with the low solubility drug. In contrast, for the more soluble drug, a continuous increase of fraction absorbed as a function of dose is observed when the higher stoichiometries are used (2.0 and 1.5). For both drugs, the fraction absorbed for the lower values of stoichiometry (0.7 and 1.0) exhibit a non-dependency on dose profile. Our results give an insight into the complex picture of in vivo drug dissolution since diffusion-limited and reaction-limited processes seem to operate under in vivo conditions concurrently.
Charalabidis A, Sfouni M, Bergstrom C, Macheras P. The Biopharmaceutics Classification System (BCS) and the Biopharmaceutics Drug Disposition Classification System (BDDCS): Beyond guidelines. INTERNATIONAL JOURNAL OF PHARMACEUTICS. 2019;566:264-281.Abstract
The recent impact of the Biopharmaceutics Classification System (BCS) and the Biopharmaceutics Drug Disposition Classification System (BDDCS) on relevant scientific advancements is discussed. The major advances associated with the BCS concern the extensive work on dissolution of poorly absorbed BCS class II drugs in nutritional liquids (e.g. milk, peanut oil) and biorelevant media for the accurate prediction of the rate and the extent of oral absorption. The use of physiologically based pharmacokinetic (PBPK) modeling as predictive tool for bioavailability is also presented. Since recent dissolution studies demonstrate that the two mechanisms (diffusion- and reaction-limited dissolution) take place simultaneously, the neglected reaction-limited dissolution models are discussed, regarding the biopharmaceutical classification of drugs. Solubility- and dissolution-enhancing formulation strategies based on the supersaturation principle to enhance the extent of drug absorption, along with the applications of the BDDCS to the understanding of disposition phenomena are reviewed. Finally, recent classification systems relevant either to the BCS or the BDDCS are presented. These include: i) a model independent approach based on %metabolism and the fulfilment (or not) of the current regulatory dissolution criteria, ii) the so called AB Gamma system, a continuous version of the BCS, and iii) the so-called Extended Clearance Classification System (ECCS). ECCS uses clearance concepts (physicochemical properties and membrane permeability) to classify compounds and differentiates from BDDCS by bypassing the measure of solubility (based on the assumption that since it inter-correlates with lipophilicity, it is not directly relevant to clearance mechanisms or elimination).