ADVANTAGES AND LIMITATIONS OF

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ADVANTAGES AND LIMITATIONS OF AN IN-VITRO LIPOLYSIS MODEL AS A PREDICTIVE TOOL IN THE DEVELOPMENT OF LIPID BASED ORAL FORMULATIONS FOR LIPOPHILIC DRUGS Arik Dahan School of Pharmacy The Hebrew University of Jerusalem GPEN 26 In recent years, the discovery of new active lipophilic molecules has been enormously increased. However, major barriers facing the absorption of these lipophilic molecules following oral administration.

The barriers that a lipophilic molecule has to transverse along the intestinal absorption cascade In most cases, the solubilization in the intestinal milieu is the rate limiting step Dahan and Hoffman, in Enhancement in Drug Delivery, CRC Press 26 Lipid based vehicle has been shown to enhance bioavailability of lipophilic drug. Currently, the design of appropriate lipidic vehicles remains primarily empirical. A dynamic in vitro model was proposed before that mimics the lipolysis process in the intestine (Porter and Charman 21, Christensen et al 24).

In vitro dynamic lipolysis model (stage 1) 15mM NaCl 5mM CaCl 2 2H 2 O 5mM Tris maleate 5mM Na taurodeoxycholate 1.25mM phosphatidylcholine Continuously stirring Temp. 37ºc System representative of fasted state intestinal environment, with maximum pseudo-physiological conditions In vitro dynamic lipolysis model (stage 2) Drug in formulation is dispersed in the system Experiment initiated with the insertion of pancreatic juice Throughout lipolysis, free FA are released and ph is decreased and titrated immediately utilizing ph-stat titration unit and maintained at 7. At the end-point, ph remains steady without titration

In vitro dynamic lipolysis model (stage 3) Following the completion of the lipolysis, aliquots are taken from the system and ultracentrifuged: Oil phase Aqueous phase Drug soluble in oil Solubilized drug May participate in absorption Most readily available for absorption Sediment phase Drug in sediment Not available for absorption Purpose To investigate the IVIVC of the lipolysis model To assess the model as a predictive tool for the influences of different vehicles on the in-vivo oral absorption of lipophilic drugs The advantages and limitations were investigated using 4 model drugs: progesterone, vitamin D 3, dexamethasone and griseofulvin

4 model lipophilic drugs: Progesterone undergoes presystemic metabolism in the gut wall Vitamin D 3 undergoes lymphatic absorption Dexamethasone comparatively high water solubility (1 µg/ml) Griseofulvin practically insoluble in water Progesterone Log P = 4 Low oral bioavailability (less than 5%) 5% presystemic metabolism in the gut wall What is the effect of significant presystemic metabolism in the gut wall on the IVIVC of the lipolysis model?

In vitro dynamic lipolysis model Progesterone 1 Aqueous phase Sediment Lipid phase % of progesterone dose 8 6 4 2 LCT MCT SCT Performance rank order: MCT > LCT > SCT Dahan and Hoffman, Pharm Res 26 1 In vivo oral bioavailability Progesterone Plasma progesterone conc. (ng/ml) 8 6 4 2 LCT MCT SCT 5 1 15 2 25 Time (hr) Performance rank order: MCT > LCT > SCT Dahan and Hoffman, Pharm Res 26

In vitro - in vivo correlation (IVIVC) 9 Progesterone Progesterone in vivo AUC values (ng h/ml) 75 MCT 6 45 3 LCT 15 SCT 2 4 6 8 1 % of progesterone dose in the in vitro aqueous phase Good IVIVC (R 2 >.99) Dahan and Hoffman, Pharm Res 26 Vitamin D 3 Highly lipophilic, Log P = 9.1 Significant lymphatic absorption What is the effect of significant lymphatic absorption on the IVIVC of the lipolysis model?

In vitro dynamic lipolysis model 1 Vitamin D 3 Aqueous phase Sediment Lipid phase % of vitamin D3 dose 8 6 4 2 LCT MCT SCT Performance rank order: MCT > LCT > SCT Dahan and Hoffman, Pharm Res 26 Plasma vitamin D3 conc. (µg/ml) 3.5 3 2.5 2 1.5 1.5 In vivo oral bioavailability Vitamin D 3 LCT MCT SCT 4 8 12 16 2 24 Time (hr) Performance rank order: LCT > MCT > SCT No IVIVC Dahan and Hoffman, Pharm Res 26

Plasma vitamin D3 conc. (µg/ml) 1.6 1.2.8.4 Vitamin D 3 plasma and lymph profiles Cumulative vitamin D3 in lymph (% of dose) 4 35 3 25 2 15 1 Without lymphatic absorption 5 Cumulative lymph vitamin D 3 1 2 3 4 5 Time (hours) All absorption pathways 1 2 3 4 5 6 Time (hours) Lymphatic absorption stands for 75% of vitamin D 3 bioavailability Dahan and Hoffman, Eur J Pharm Sci 25 Pretreatment with cycloheximide eliminates the lymphatic transport, without affecting other absorption pathways Cycloheximide Dahan and Hoffman, Eur J Pharm Sci 25

In vivo oral bioavailability of Vitamin D 3 1 in cycloheximide treated animals.8 Vitamin D3 conc. (µg/ml).6.4 LCT MCT.2 4 8 12 16 2 24 Time (hr) Performance rank order: MCT > LCT Good IVIVC Dahan and Hoffman, Pharm Res 26 Interim Conclusions The in-vitro lipolysis model managed to predict the performance of different lipidic vehicles in-vivo Presystemic metabolism in the gut wall did not influence this IVIVC Lymphatic absorption of the drug may interfere with this IVIVC, since LCT oil is necessary for chylomicron production The potential of a lipophilic drug to undergo lymphatic absorption has to be examined (see poster PS-4)

The correlation between in-vitro lipolysis, intestinal permeability and in vivo absorption Lipid based formulation has direct influence on the permeation of the drug through the gut wall To assess the IVIVC of the lipolysis model in light of the influence of different vehicles on the intestinal permeability 2 Model Drugs sharing the same Log P (~2) but differ in their water solubility characteristics: Dexamethasone - Relatively good water solubility Griseofulvin - Practically insoluble in water Dexamethasone Log P = 2 Relatively good water solubility (1 µg/ml) What is the effect of gut wall permeation abilities on the IVIVC of the lipolysis model?

1 In vitro dynamic lipolysis model Dexamethasone Aqueous phase Sediment phase Lipid phase % of dexamethasone dose 8 6 4 2 LCT MCT SCT Performance rank order: MCT = LCT = SCT 2 Ex vivo intestinal permeation model Dexamethasone Dexamethasone amount in the serosal side (ng 15 1 5 P app (cm/sec) 7.E-5 6.E-5 5.E-5 4.E-5 3.E-5 2.E-5 1.E-5.E+ LCT MCT SCT.5 1 1.5 2 2.5 Time (hr) Performance rank order: SCT > MCT LCT LCT MCT SCT

Dexamethasone conc. (µg/ml) 7 6 5 4 3 2 1 In vivo oral bioavailability Dexametasone LCT MCT SCT 1 2 3 4 5 6 Time (hr) Performance rank order: MCT = LCT = SCT IVIVC with lipolysis and not with permeation Griseofulvin Log P = 2 Practically insoluble in water What is the effect of gut wall permeation abilities on the IVIVC of the lipolysis model?

1 In vitro dynamic lipolysis model Griseofulvin Aqueous phase Sediment phase Lipid phase 8 % of griseofulvin dose 6 4 2 MCT LCT SCT H2O Performance rank order: MCT>LCT>SCT>H 2 O 4 Ex vivo intestinal permeation model Griseofulvin Griseofulvin amount in the serosal side (ng 3 2 1 P app (cm/sec) 1.E-4 8.E-5 6.E-5 4.E-5 2.E-5.E+ LCT MCT SCT.5 1 1.5 2 2.5 Time (hr) Performance rank order: SCT > MCT > LCT LCT MCT SCT

2 In vivo oral bioavailability Griseofulvin Griseofulvin conc. (µg/ml) 1.6 1.2.8.4 LCT MCT SCT H2O 6 12 18 24 Time (hr) Performance rank order: MCT>LCT>SCT>H 2 O Griseofulvin in vivo AUC values (µg h/ml) In vitro - in vivo correlation (IVIVC) 2 Griseofulvin 16 12 8 4 H 2O SCT LCT 2 4 6 8 1 % of griseofulvin dose in the in vitro aqueous phase Good IVIVC (R 2 >.98) with the lipolysis model No correlation with the permeation studies MCT

Conclusions (1) The in-vitro lipolysis model managed to predict the performance of different lipidic vehicles in-vivo Valuable information can be obtained from the in-vitro lipolysis model, leading to the intelligent selection of lipidic vehicles Conclusions (2) For class 2 drugs, permeation studies may not predict actual in-vivo performance The influence of the vehicle on the permeability does not affect in-vivo bioavailability of class 2 drugs, hence does not damage the prediction of the lipolysis model SCT vehicle shown to be a potential intestinal permeability enhancer The differences between solubilization abilities of the various vehicles are less profound with the increase in the drug water solubility

Conclusions (3) Significant presystemic metabolism in the gut wall does not affect the ability of the model to predict in-vivo performance For drugs that undergo lymphatic absorption the model may not be able to predict in-vivo performance Acknowledgments Prof. Amnon Hoffman School of Pharmacy The Hebrew University of Jerusalem The study was supported by the israeli consortium of Pharmalogica