Analysis of anti-epileptic drugs in human serum using an Agilent Ultivo LC/TQ

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Application Note Clinical Research Analysis of anti-epileptic drugs in human serum using an Agilent Ultivo LC/TQ Authors Jennifer Hitchcock 1, Lauren Frick 2, Peter Stone 1, and Vaughn Miller 2 1 Agilent Technologies, Inc. Santa Clara, CA 2 Agilent Technologies, Inc. Lexington, MA Abstract Analyzing anti-epileptic drugs can be challenging in clinical research due to the disparate concentrations at which these drugs may be present in human serum. Therefore, a quality assay must be able to analyze many compounds simultaneously, over several orders of magnitude. A highly sensitive and specific analytical method for the quantitation of 15 anti-epileptic drugs in human serum was tested on the Agilent Ultivo triple quadrupole LC/MS (LC/TQ). Samples were prepared through a simple protein precipitation/dilution protocol. Analytes could be quantified over a wide dynamic range; accuracy and reproducibility metrics, as well as R 2 values, were acceptable.

Introduction Liquid chromatography-tandem mass spectrometry (LC/MS/MS) has long demonstrated its value in analytical research laboratories due to its analytical specificity and sensitivity when analyzing multiple compounds in a single injection. Despite this convenience, many large clinical research laboratories find physical instrumentation space to be at a premium, sometimes driving the need for creative solutions. Minimizing the instrument footprint while maintaining the power of a traditionally sized mass spectrometer may provide an answer for such laboratories. In this context, the analytical capabilities of a miniature Agilent Ultivo LC/TQ was evaluated using a panel of anti epileptic drugs in human serum. This panel was compared to an identical sample set analyzed on a larger Agilent 647 LC/TQ MS. Compounds comprising the analytical panel were acetylretigabine, carbamazepine 1,11 epoxide, carbamazepine, 1,11-dihydro 1-hydroxy-carbamazepine, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, retigabine, rufinamide, tiagabine, and vigabatrin. The analytical method tested the ability of the instruments to detect compounds over numerous concentration ranges simultaneously, at calibration concentrations ranging from.59 ng/ml to 2, ng/ml for individual analytes. Top concentrations could range between.15 and 2 µg/ml. Samples were created by spiking drug standards into clean human serum. To prepare samples and controls for analysis, a simple protein precipitation protocol was performed, followed by dilution into water to reduce the sample organic content. The injection-to-injection cycle time was less than 1 minutes, and two transitions were monitored for each of the 15 target compounds. A transition meant to detect phospholipids was also included in the analytical method to verify any minimal interference or suppression from these endogenous molecules. Calibration curve accuracies were within 2 % of the expected concentration at the lowest calibration level, and reproducibility across all levels was acceptable, with CVs less than 15 %. R 2 values were all greater than.994, and two-thirds of the compounds displayed linear responses throughout the concentration range, while the remaining one third required quadratic fits. Experimental LC configuration and parameters Table 1. UHPLC configuration and settings. Parameter Instruments Needle wash Autosampler temperature Value Agilent 129 Infinity II high speed pump (G712A) Agilent 129 Infinity autosampler (G4226A) Agilent 129 Infinity autosampler thermostat (G133B) Agilent 129 Infinity II multicolumn thermostat (G7116B) 1 % Methanol 4 C Injection volume 4 µl Guard column Analytical column Column temperature 5 C Mobile phase A Mobile phase B Flow rate Gradient Stop time Post time Agilent Poroshell 12 EC-C18, 2.1 5 mm, 2.7 µm, guard column (p/n 821725-911) Agilent Poroshell 12 EC-C18, 2.1 1 mm, 2.7 µm, LC column (p/n 695775-92) 2 mm Ammonium acetate in water 2 mm Ammonium acetate in methanol.4 ml/min Time (min) %B. 1 1. 1 5. 5 6.2 6 6.3 95 7.5 95 7.51 1 8 minutes 1 minute Triple quadrupole mass spectrometer configuration and parameters Table 2. Mass spectrometer instrument configuration and source settings. Instrument Parameter MS/MS mode Ion mode Value Agilent Ultivo Triple Quadrupole Mass Spectrometer Dynamic MRM Positive Drying gas temperature 35 C Drying gas flow Nebulizer pressure 12 L/min 5 psi Sheath gas temperature 35 C Sheath gas flow Nozzle voltage Capillary voltage, positive Delta EMV, positive MS1/MS2 resolution Dwell time 11 L/min V 3,5 V V.7/.7 Unit Variable 2

MS/MS compound information for analytes and internal standards Table 3. Detailed MRM settings in dynamic MRM Mode. Compound ISTD Precursor ion (m/z) Product ion (m/z) Retention time (min) Retention window (min) Fragmentor (V) CAV (V) Collision energy (V) 1,11-Dihydro-1-hydroxycarbamazepine 255.1 237. 5.7 1.1 8 9 4 + 1,11-Dihydro-1-hydroxycarbamazepine 255.1 194. 5.7 1.1 8 9 16 + Carbamazepine 237.1 194.1 6.85 1.12 146 9 12 + Carbamazepine 237.1 193.3 6.85 1.12 146 9 32 + Carbamazepine D1 247.2 24.1 6.85 1. 152 9 14 + Carbamazepine 1,11 epoxide 253.1 21. 5.84.87 94 9 8 + Carbamazepine 1,11 epoxide 253.1 18.1 5.84.87 94 9 24 + Carbamazepine 1,11 epoxide 13 C6 259.1 186.1 5.84 1. 97 9 28 + Felbamate 178.1 117.1 4.81 1.7 71 9 11 + Felbamate 178.1 91.1 4.81 1.7 71 9 25 + Gabapentin 172.1 154.1 2.36 1.39 16 9 8 + Gabapentin 172.1 137.1 2.36 1.39 16 9 12 + Gabapentin D1 182.2 164.1 2.28 1. 91 9 8 + Lacosamide 251.1 18 4.71 1.21 8 9 + Lacosamide 251.1 91.1 4.71 1.21 8 9 16 + Lacosamide 13 C D3 255.3 18 4.82 1. 88 9 2 + Lamotrigine 256. 21.9 5.11 1.22 154 9 24 + Lamotrigine 256. 43. 5.11 1.22 154 9 44 + Lamotrigine 13 C 15 N4 261. 46. 5.1 1. 157 9 46 + Levetiracetam 171.1 154. 2.85 1.21 71 9 + Levetiracetam 171.1 126. 2.85 1.21 71 9 8 + Levetiracetam D6 177.1 132.1 2.83 1. 71 9 1 + N-Acetyleretigabine 274.1 256.1 6. 1.25 12 9 8 + N-Acetyleretigabine 274.1 19. 6. 1.25 12 9 32 + Oxcarbazepine 253.1 28. 6.13 1.21 12 9 12 + Oxcarbazepine 253.1 18. 6.13 1.21 12 9 28 + Oxcarbazepine 13 C6 259.1 214. 6.13 1. 12 9 12 + Pregabalin 16.1 142.1 2.26 1.39 89 9 4 + Pregabalin 16.1 55.1 2.26 1.39 89 9 2 + Pregabalin D6 166.2 148.1 2.21 1. 88 9 4 + Retigabine 34.2 23. 7.5.87 123 9 12 + Retigabine 34.2 19. 7.5.87 123 9 32 + Retigabine D4 38.2 113. 7.5 1. 126 9 32 + Rufinamide 239.1 127. 4.73 1.21 1 9 2 + Rufinamide 239.1 11. 4.73 1.21 1 9 54 + Tiagabine 376.1 247. 7.33.75 143 9 12 + Tiagabine 376.1 111. 7.33.75 143 9 28 + Tiagabine D6 382.2 253.1 7.33 1. 149 9 12 + Vigabatrin 13.1 113..67 1.19 71 9 4 + Vigabatrin 13.1 71.1.67 1.19 71 9 12 + Polarity 3

Chemicals and reagents Human serum, used for matrix-matched calibrators, was sourced from Golden West Biologicals (Temecula, CA). Standards and internal standards were bought from Sigma Aldrich (St. Louis, MO) and Cerilliant Corporation (Round Rock, TX). Sample preparation and LC solvents were from Sigma-Aldrich (St. Louis, MO) and Honeywell Riedel de Haën (Seelze, Germany). Sample preparation To achieve the top concentration, clean human serum was spiked with drug standards of the 15 compounds. Eight lower concentrations were created by a serial dilution into clean serum. Each sample was combined with an internal standard solution and extracted by protein precipitation using methanol. Samples were vortexed and centrifuged, and an aliquot of supernatant was diluted 1-fold with water before introduction into the LC system. Counts Figure 1. Overlaid dmrm chromatograms, showing elution of the 15 compounds. Data analysis Data were acquired and analyzed using Agilent MassHunter software suite B.8. for data collection from the 647 LC/TQ MS, or C.1. for data collection from the Ultivo. MS/MS transitions were obtained for both instruments using Agilent MassHunter Acquisition Optimizer software to determine optimal precursor and product ions, fragmentor voltages, and collision energies upon injection of a neat solution of each individual compound or internal standard at a concentration level of 1, ng/ml, 2 µl injection volume in flow injection mode. Results and discussion Linearity The calibration concentrations ranged from.59 ng/ml to 2, ng/ml for some individual analytes. Other analyte concentrations ranged from.15 to 2 µg/ml. R 2 values were greater than.994 for all analytes, with 1 of the compounds displaying linear responses throughout the concentration range, and five requiring quadratic fits to cover the complete concentration range. 1 5 3.1 3. 2.9 2.8 2.7 2.6 2.5 2.4 2.3 2.2 2.1 2. 1.9 1.8 1.7 1.6 1.5 1.4 1.3 1.2 1.1 1..9.8.7.6.5.4.3.2.1.2.4.6.8 1. 1.2 1.4 1.6 1.8 2. 2.2 2.4 2.6 2.8 3. 3.2 3.4 3.6 3.8 4. 4.2 4.4 4.6 4.8 5. 5.2 5.4 5.6 5.8 6. 6.2 6.4 6.6 6.8 7. 7.2 7.4 7.6 Acquisition time (min) 4

Table 4. Results summary comparing the Agilent Ultivo TQ and Agilent 647 TQ. Data include signal-to-noise (S/N), calculated LOQ on-column, coefficient of determination, and calibration curve fit. Data were calculated from calibration standard 1, except for concentrations denoted with a * or **, which used calibration standards 3 and 2, respectively. All compounds used a 1/x weighted calibration curve. Agilent Ultivo TQ Agilent 647 TQ Compound Cal 1 (ng/ml) Cal 1 S/N Calc. LOQ on col (pg) R 2 Cal. curve Cal 1 (ng/ml) Cal 1 S/N Calc. LOQ on col (pg) R 2 Cal. curve Vigabatrin 293.11* 3. 23.44.9977 Linear 84.14 17.57 6.73.9974 Linear Pregabalin 6.83 4.32.55.9977 Linear 6.84 28.4.55.9971 Linear Gabapentin 9.75 58.5.78.9971 Linear 1.63 98.49.85.9978 Linear Levetiracetam 4.42 687.31 3.23.9997 Quadratic 4.59 1,84.66 3.25.9997 Quadratic Lacosamide 6.92 261.91.55.9976 Linear 7.75 343.6.62.9989 Linear Rufinamide 13.88 35.73 1.11.9995 Quadratic 3.5** 856.41 2.44.9948 Quadratic Felbamate 26.44 67.59 2.11.999 Quadratic 24.16 824.9 1.93.9977 Quadratic Lamotrigine 7.7 3.81.57.9937 Linear 8.12 224.1.65.9993 Linear 1,11-Dihydro-1-hydroxycarbamazepine 13.69 372.73 1.1.9993 Quadratic 12.88 1,2.54 1.3.9986 Quadratic Carbamazepine 1,11 epoxide 9.92 632.8.79.9992 Linear 9.98 318.23.8.9995 Linear N-Acetylretigabine 1.14 5.4.9.9987 Quadratic 1.2 28.44.1.9994 Quadratic Oxcarbazepine 2.2 2.68.16.9991 Linear 1.98 7.23.16.9982 Linear Carbamazepine 16.37 14.18 1.31.9969 Linear 16.34 782.22 1.31.9963 Linear Retigabine 1.81 4.27.14.9944 Linear 2.14 4.44.17.996 Linear Tiagabine.61 126.86.5.9973 Linear.59 28.77.5.9986 Linear Accuracy and reproducibility Calibration curves for each of the 15 compounds demonstrated accuracies within 2 % of each expected concentration at the lowest calibration level, and reproducibility across all other levels exhibited CVs less than 15 %. Tables 5 and 6, respectively show a detailed comparison of accuracies and reproducibility between the Ultivo and 647 instruments. 5

Relative response 1 1 Tiagabine 1.6 y =.812545 * x + 3.569196E-4 1.4 R 2 =.9973 1.2 1..8.6.4.2 Responses Relative response Responses 1 4 4.8 4.4 4. 3.6 3.2 2.8 2.4 2. 1.6 1.2.8.4 -.4 1 2 1.1 1..9.8.7.6.5.4.3.2.1 -.1 1 3 6.5 6. 5.5 5. 4.5 4. 3.5 3. 2.5 2. 1.5 1..5 -.5-1 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 18 19 2 21 Relative concentration Vigabatrin y = 2.449531 * x 199.519328 R 2 =.9977 2, 4, 6, 8, 1, 12, 14, 16, 18, Concentration (ng/ml) Levetiracetam y = -.46742 * x 2 + 6.37593 * x.8399 R 2 =.9997-1 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 18 19 2 21 Relative concentration N-Acetylretigabine y = -.3218 * x 2 + 19.378146 * x + 6.3375 R 2 =.9987-2 2 4 6 8 1 12 14 16 18 2 22 24 26 28 3 32 34 36 Concentration (ng/ml) Figure 2. Example calibration curves for compounds dispersed throughout the chromatogram. All calibration curves used a 1/x weighting factor. 6

Table 5. Accuracy and reproducibility for curves analyzed on the Agilent Ultivo TQ (n = 3). 1,11-Dihydro-1-hydroxy carbamazepine Acetylretigabine Carbamazepine Carbamazepine 1,11 epoxide Felbamate Gabapentin Lacosamide Lamotrigine Level Avg CV Avg CV Avg CV Avg CV Avg CV Avg CV Avg CV Avg CV 1 87.6 4.2 96.2 6.7 83.8 1.6 11.6 1.7 84.6 2.5 83.2 8. 88.6 2.4 2 1.4 3.1 14.1 13.3 95.1 1.4 98.8 3.9 1. 1.3 98.6 4.2 93.9 1.4 99.9 6.3 3 12.5 1.2 13.1 3.1 99.8.7 99..4 13.4 2.1 11.8 3.2 11.8 1.8 92.4 1.9 4 14.9 3. 19.3 1.8 15. 1.6 98.6 1.4 18.1 1.3 14.1 2.1 12.8 1.7 11.9 7.5 5 14. 1.2 12.7 4.5 14.2 1.5 98.4 1.3 15.4 1.7 12.9 3.7 11.3 2. 11.3 7. 6 14.3 3.2 12.1 2.2 19.2 2.3 12.8 1.1 12..8 16.5 1.5 19.1 1.4 12.1 1.4 7 97.7 1.9 93.8 3. 12..5 99.1 1.1 97.3 1.8 11.5 5.5 12. 1.6 1.7 2.4 8 97.9 1. 11.9 1.7 15.6 1.6 13.5.2 98.4 2.2 15.6 1.2 14.4 1.9 99.9.8 9 1.7.9 99.8.6 95.2 1.1 98.3.8 1.9 2.6 95.8 2.1 96.1 1.6 99.5 1.9 Levetiracetam Oxcarbazepine Pregabalin Retigabine Rufinamide Tiagabine Vigabatrin Level Average CV Average CV Average CV Average CV Average CV Average CV Average CV 1 13.5 1.5 13.2 5.5 87.4 11.8 92.5 7.4 88.8 1.8 13.9 13.5 2 99.6 1.4 97.2 1.3 95.9 8.8 94.5 9.8 11.2 2.2 92.4 6.2 3 98.7 1.6 95.9 1.1 99.8.3 98.2 1.2 13.3 2.4 98.1 13.1 14.2 8.5 4 1.6 1.2 98.5 3.5 12.4 1.4 14.3 6.9 16..2 98.4 5.8 1.6 4.7 5 96.7.8 11. 3.2 12.9 1.1 17.2 3.8 12.2 1.9 98.7 5.6 14. 8.2 6 11.8 1.7 14. 2.2 18.7.8 15.4 5.9 11.2.7 17.9 1.8 97.7 5.9 7 97.5 1. 1.1.5 12.4 1.2 96.1 3.3 96.7 1. 99.6 2.6 93.3 1.3 8 12. 1.8 11. 1. 14.5 1.1 14.2 3. 1.5 2.3 13.3 3.5 97.1 1.6 9 99.6 1.5 99. 1.6 95.9 1.4 97.7 4. 1.1 1.2 97.7 5.7 13.1 2.3 Table 6. Accuracy and reproducibility for curves analyzed on the Agilent 647 TQ (n = 3). 1,11-Dihydro-1-hydroxy carbamazepine Acetylretigabine Carbamazepine Carbamazepine 1,11 epoxide Felbamate Gabapentin Lacosamide Lamotrigine Level Average CV Average CV Average CV Average CV Average CV Average CV Average CV Average CV 1 82.4 3.6 87.8 6.7 83.7 1.9 12.2 3.4 77.3 2.5 9.7 1.2 99.2 3.3 13.9 6.3 2 94.4 1.4 1. 3.5 91.3.5 96.9 1.5 94.3 1.2 92.9 1.4 94.5.4 96.5 6.8 3 17.1.9 14.2 3.6 99.7.4 97.9 1.7 18. 1.6 99.3.6 98..8 99.6 4.5 4 11.3 2.2 15.8 1.8 14.7.9 1.3 1.3 113.3 1.8 13.5 2. 11.2 1.5 97.1 2.2 5 17.3 1.6 14. 1.6 15.7.8 98.7.8 19.4.7 12.3 1.2 1.3.7 98.5 3.2 6 13.1.8 1.8 3.9 11.9.7 13.7 1.1 13.6 1.5 18.5 1.4 15.3.9 13.4 1.4 7 97.4 1.3 97.3 2.2 14..9 99..9 96.9 1.2 12.3 1. 1.1.6 1. 1.6 8 96.5 1.7 99.8 1.5 15.5.7 12.9 1. 95.3 1.4 14.7 1.2 14.2 1. 12.7 2.2 9 11.8 1.6 1.2 1.9 94.5 1.2 98.5 1.8 12.9 2.5 95.9 2.6 97.2 1.1 98.4 1.2 Levetiracetam Oxcarbazepine Pregabalin Retigabine Rufinamide Tiagabine Vigabatrin Level Average CV Average CV Average CV Average CV Average CV Average CV Average CV 1 13.9 1.3 11.2 2.7 87.6 4.7 19.5.7 1.8 2.6 119.7 14.4 2 97.6 1.3 97. 5.8 91.8.8 11.4 12.5 97.6.5 97.8 3. 15.3 12.1 3 98.9.3 99.9 5. 1. 2.7 87.6 2.7 12.4 2.2 96.8 4. 96.8 3.2 4 1.3 1.4 98.6 2.5 14.4 2.6 86.4 8.9 122.2 3.9 12.7 2.4 95.1 6.7 5 98.2.4 98.3 1.8 13. 1.4 99.2 14.9 111.6 3.5 97.8.8 92.5 6.3 6 12.5 1.4 13.3 1.7 19.7 2. 11. 6.6 13. 3.3 12.5 1.1 96.5.1 7 97.2 1.2 98.5 1.9 13. 1.5 97.8 6.7 94.9 2.1 98.9.4 92.3 3.8 8 11.6.9 16. 2. 15.2 1.4 14.1 5.5 94.6 2.4 15.3.8 97.6.7 9 99.7 1.7 97.1 1.9 95.2 2.1 98.8 5.6 13.6 3. 97.4.7 14.1 1.2 7

Conclusion The miniature Agilent Ultivo LC/TQ delivers comparable results to those achieved on the Agilent 647 LC/TQ. This demonstrates that downsizing the instrument has not compromised any analytical sensitivity or dynamic range, as determined from a head-to-head comparison under identical analytical conditions. Future work is required to assess potential matrix interferences to potentially include additional anti-epileptic drugs, creating a more comprehensive or inclusive analytical research method. Reference 1. Frick, L. E.; Miller, V. P. Simultaneous LC/MS/MS Quantitation of 2 Anti-epileptic Drugs in Human Serum. Poster presented at MSACL, January 217, 23-26, Palm Springs, CA. www.agilent.com/chem For Research Use Only. Not for use in diagnostic procedures. This information is subject to change without notice. Agilent Technologies, Inc. 218 Printed in the USA, January 17, 218 5991-8848EN