Use of pharmacogenetics in bioequivalence studies to reduce sample size: an example with mirtazapine and CYP2D6
doi: 10.1038/tpj.2012.29
pmid: 22733239
Use of pharmacogenetics in bioequivalence studies to reduce sample size: an example with mirtazapine and CYP2D6
In bioequivalence studies, intra-individual variability (CV(w)) is critical in determining sample size. In particular, highly variable drugs may require enrollment of a greater number of subjects. We hypothesize that a strategy to reduce pharmacokinetic CV(w), and hence sample size and costs, would be to include subjects with decreased metabolic enzyme capacity for the drug under study. Therefore, two mirtazapine studies, two-way, two-period crossover design (n=68) were re-analysed to calculate the total CV(w) and the CV(w)s in three different CYP2D6 genotype groups (0, 1 and ≥ 2 active genes). The results showed that a 29.2 or 15.3% sample size reduction would have been possible if the recruitment had been of individuals carrying just 0 or 0 plus 1 CYP2D6 active genes, due to the lower CV(w). This suggests that there may be a role for pharmacogenetics in the design of bioequivalence studies to reduce sample size and costs, thus introducing a new paradigm for the biopharmaceutical evaluation of drug products.
- Autonomous University of Madrid Spain
- Comunidad de Madrid Spain
- Hospital Universitario La Paz Spain
- Hospital Universitario de La Princesa Spain
- University of Montevideo Uruguay
Male, Cross-Over Studies, Genotype, Mirtazapine, Mianserin, Antidepressive Agents, Tricyclic, Healthy Volunteers, Cytochrome P-450 CYP2D6, Therapeutic Equivalency, Pharmacogenetics, Sample Size, Humans, Female
Male, Cross-Over Studies, Genotype, Mirtazapine, Mianserin, Antidepressive Agents, Tricyclic, Healthy Volunteers, Cytochrome P-450 CYP2D6, Therapeutic Equivalency, Pharmacogenetics, Sample Size, Humans, Female
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