Bioequivalence Study Comparing Fixed-Dose Combination of Clopidogrel and Aspirin with Coadministration of Individual For

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ORIGINAL RESEARCH

Bioequivalence Study Comparing Fixed-Dose Combination of Clopidogrel and Aspirin with Coadministration of Individual Formulations in Chinese Subjects Under Fed Conditions: A Phase I, Open-Label, Randomized, Crossover Study Yan Li . Jeffrey E. Ming . Fangyuan Kong . Huiqiu Yin . Linlin Zhang . Haihong Bai . Huijuan Liu . Lu Qi . Yu Wang . Fang Xie . Na Yang . Chuan Ping . Yi Li . Liu Chen . Chunyu Han . Ju Liu . Xinghe Wang Received: August 1, 2020 Ó The Author(s) 2020

ABSTRACT Introduction: Simultaneous administration of acetylsalicylic acid (ASA) and clopidogrel has demonstrated efficacy in the treatment of acute coronary syndrome. Clopidogrel ? ASA in a fixed-dose combination (FDC) provides a pharmaceutical option to enhance adherence to the coadministration of dual antiplatelet therapy (DAPT). Herein, we evaluate the bioequivalence of enteric ASA and clopidogrel in an FDC Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12859856. Electronic Supplementary Material The online version of this article (https://doi.org/10.1007/s12325020-01486-9) contains supplementary material, which is available to authorized users. Y. Li  H. Bai  H. Liu  L. Qi  L. Chen  C. Han  J. Liu  X. Wang (&) Phase I Clinical Trial Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China e-mail: [email protected] J. E. Ming Research and Development, Sanofi, New York, USA F. Kong  N. Yang  C. Ping  Y. Li Research and Development, Sanofi, Beijing, China L. Zhang Medical, Sanofi, Beijing, China H. Yin  F. Xie Medical, Sanofi, Shanghai, China

compared with simultaneous administration of the individual formulations. Methods: This study is a randomized, single-center, open-label, three-sequence, three-period, twotreatment, crossover study conducted in healthy Chinese male and female subjects under fed conditions. Subjects were randomized to receive, in each period, a single dose of (1) a combination tablet containing 75-mg clopidogrel and 100-mg enteric ASA (test formulation) or (2) coadministration of one 75-mg clopidogrel tablet and one 100-mg enteric-coated ASA tablet (reference formulations) under fed conditions. Plasma samples were analyzed for ASA, salicylic acid, clopidogrel, and the clopidogrel metabolite SR26334. For ASA, the reference-scaled average bioequivalence (RSABE) analysis was conducted for Cmax of ASA because within-subject standard deviation (SDW) was C 0.294 for log-transformed Cmax. Results: The point estimate (test/reference geometric mean ratio) was between 0.80 and 1.25, and the upper one-sided 95% confidence interval (CI) for the scaled average bioequivalence metric was B 0 (-0.08). AUC of ASA as SDW was \ 0.294 for log-transformed AUClast and AUC. Estimates of 90% CIs for log-transformed AUClast and AUC ratios were within the bioequivalence range of 0.80 to 1.25 (0.98–1.08 and 1.00–1.10, respectively). For clopidogrel, the 90% CIs for the ratios comparing log-transformed Cmax, AUClast, and AUC ratios of clopidogre