throbber

`
`ELSEVIER
`
`Vctcrinary Parasitology 86 (1999) 2037215 —
`www.elsevier.com/locate/vetpar
`
`veterinary
`parasitology
`
`Ivermectin disposition kinetics after subcutaneous and
`
`intramuscular administration of an oil-based formulation
`
`to cattle
`
`A. Lifschitza, G. Virkel 3, A. Pis 3, F. Imperialea, S. Sanchez 3, L. Alvareza,
`R. Kujanek b, C. Lanusse M
`a Laboratorio de Farniacologi’a, Departamento de Fisiopatoiogi’a, Facultad de Ciencias Veterinarias,
`Universidad Naciona] del Centm, Campus Universitario, (7000) Tandi], Argentina
`1’ Bayer Argentina SA, Buenos Aires, Argentina
`Received 8 March 1999; accepted 7 June 1999
`
`
`
`Abstract
`
`
`
`Slight differences in formulation may change the plasma kinetics and ecto—endoparasiticide
`activity of endectocide compounds. This work reports on the disposition kinetics and plasma avail-
`ability of ivermectin (IVM) after subcutaneous (SC) and intramuscular (1M) administration as an
`oil-based formulation to cattle. Parasite-free Aberdeen Angus calves (n=24', 240—280 kg) were
`divided into three groups (n= 8) and treated (200 ug/kg) with either an IVM oil-based pharmaceu-
`tical preparation (IVM-TEST formulation) (Bayer Argentina S.A.) given by subcutaneous (Group
`A) and intramuscular (Group B) injections or the IVM-CONTROL (non-aqueous formulation)
`(lvomec®, MSD Agvet) subcutaneously administered (Group C). Blood samples were taken over
`35 days post-treatment a1 (1 the recovered plasma was extracted and analyzed by HPLC using fluo-
`rescence detection. IVM was detected in plasma between 12 h and 35 days po st—administration of
`IVM-TEST (SC and 1M injections) andIVM-CONTROL formulations. Prolonged IVM absorption
`half—life (p < 0.05) and delayed peak plasma concentration (p < 0.001) were obtained following
`the SC administration of the IVM-TEST compared to the IVM-CONTROL formulation. No differ-
`ences in total plasma availability were observed among treatments. However, the plasma residence
`time and elimination half-life of IVM were significantly longer after injection of the IVM-TEST
`formulation. lVM plasma concentrations were above 0.5 ng/ml for 20.6 (CONTROL) and 27.5 days
`(IVM—TEST SC), respectively (p < 0.05). The modified kinetic behaviour ofIVM obtained after the
`administration of the novel oil-based formulation examined in this trial, compared to the standard
`
`* Corresponding author. Fax: +54—2293—426667
`Ermaii address: clanussc@vct.uniccn.cdu.ar (C. Lanussc)
`
`()3()4—40l7/99/$ 7 see front matter @1999 Elsevier Science B.V. All rights reserved.
`PII: 80304-4017(99)00142-9
`
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`204
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`A, Lifsdn'tz et a], / Veterinary Parasitology 86 {1999) 2037215
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`
`preparation, may positively impact on its strategic use in cattle. ©l999 Elsevier Science B.V. All
`rights reserved.
`
`Keywords: Ivermectin; Oil-based formulation; Pharmacokinetics; Cattle
`
`1. Introduction
`
`The averrnectin family includes a series of natural and semisynthetic molecules, such as
`abarnectin, ivermectin (IVM), doramectin and eprinornectin, which share some structural
`and physicochernical properties. The excellent spectrum of activity of avermectins and
`milbemycins against several nematode and arthropod species resulted in the all-embracing
`name ‘endectocide’, with which they are now classified (McKellar and Benchaoui, 1996).
`They exhibit endectocide activity at extremely low dosage rates based on a common mode
`of action. IVM is commercially available as injectable and pour-0n formulations for use in
`cattle. IVM is highly effective against adults as well as developing and hypobiotic larvae of
`most gastrointestinal nematodes, ltmgworms (Egerton et al., 1981) and many arthropods in
`cattle (Campbell et al., 1983).
`The avermectins are closely related 16-membered macrocyclic lactones, with a disaccha-
`ride substituent at C13 (Fisher and Mrozik, 1989). IVM, a semisynthetic derivative of the
`avermectin family, contains a minimum of 80% 22723 dihydroaverrnectin Bla and a maxi-
`mum of 20% 22—23 dihy droaverrnectin Blb IVM is a large and highly lipophilic molecule
`that dissolves in most organic solvents; despite possessing two sugar rings and two hydroxyl
`groups, it is relatively insoluble in water (Jackson, 1989).
`The pharrnacokinetic behaviour of IVM has been studied in different species (Prichard et
`al., 1985; Fink and Porras, 1989; Bogan and McKellar, 1988; Alvinerie et al., 1993; Toutain
`et al., 1997). The pharmacokinetic behaviour of the drug differs according to the route of
`administration, formulation and animal species (Fink and Porras, 1989). The comparative
`plasma disposition kinetics of IVM, moxidectin and doramectin subcutaneously injected
`into cattle, have been characterized recently (Lanusse et al., 1997). The high lipophilicity
`of these molecules accounts for a wide tissue distribution and long residence in plasma,
`which was clearly reflected in the pharmacokinetic results obtained in those studies.
`The antiparasitic spectrum and efficacy pattern of the different endectocide molecules are
`similar; however, differences in physico-chemical properties among them may account for
`differences in formulation flexibility, kinetic behaviour, and in the potency and persistence
`of their antiparasitic activity. It has been demonstrated that plasma availability of IVM (Lo
`et a1, 1985) and doramectin (Wicks et al., 1993) in cattle is profoundly affected by the
`solvent vehicle in which the drug is formulated.
`Since the antiparasite activity of endectocide molecules depends on drug concentrations
`and time of parasite exposure to them, an evaluation of the comparative pharrnacokinetic
`profiles may help to estimate and optimize drug efficacy. Small dilferences in formulation
`can alter disposition kinetics, and may result in important changes in ecto—endoparasiticide
`activity in livestock. The goal of the study reported here was to evaluate the disposition
`kinetics and plasma availability of IVM following subcutaneous and intramuscular admin-
`istration as a novel oil-based formulation to cattle.
`
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`2. Materials and methods
`
`2. I . EXperimentaI design
`
`2.1.1. Animals
`
`The trial was conducted in 24 parasite-free Aberdeen Angus male calves, weighing
`240—280 kg. All the animals were purchased from the same cattle ranch (area of Tandil,
`Province of Buenos Aires, Argentina). The health of the animals was monitored prior to
`and throughout the experimental period. Animals were in optimal nutritional condition and
`grazing on a lucerne/red clover pasture during the entire experimental period. They had free
`access to water.
`
`2.1.2. Treatments
`
`Calves were randomly allocated into three groups of eight animals each. Treatments were
`given as follows:
`
`2.1.3. Group A
`Experimental animals were treated with an oil-based pharmaceutical preparation of iver-
`mectin (IVM-TEST formulation) (10 mg/ml) (Baymec Prolong®, Batch 005) provided by
`Bayer Argentina SA. The treatment was givenby subcutaneous (SC) injection in the shoul-
`der area at 200 pug/kg body weight. This formulation contains IVM formulated in an oily
`vehicle and was considered as the test product in the pharmacokinetic trial.
`
`2.1.4. Group B
`Exerirnental animals were treated with the IVM-TEST formulation (10 mg/ml) (Baymec
`Prolong ®, Batch 005) provided by Bayer Argentina S.A by intramuscuIar (1M) injection
`in the isquio-tibial region at 200 pug/kg body weight.
`
`2.1.5. Group C
`Eperimental animals were treated with a commercially available formulation of iver-
`mectin (lvomec®, MSD Agvet, NJ, Batch PR108) by subcutaneous injection in the shoul-
`der area at 200 pug/kg body weight. This non-aqueous preparation contains IVM (10 mg/ml)
`formulated in a propylene glycol/glycerol formal (60 : 40) vehicle and was considered as
`the reference formulation (IVM-CONTROL) in the trial.
`
`2.1.6. Sampling
`Blood samples were taken into heparinized vacutainer tubes prior to, and at, 0.5, 1, 2, 3,
`4, 5, 7, 9, ll, 15, 20, 25, 30 and 35 days post-treatment. Blood samples were centrifuged
`at 2000 x gfor 20 min and the recovered plasma was kept in labelled vials at —200C until
`analyzed within 2 to 3 weeks of collection.
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`22. Analytical procedures
`
`2. 2.1. Chemical eXtraction and derivatization
`
`The extraction of WWI from spiked and experimental plasma samples was carried out
`following adaptations ofthe technique describedby De Montigny et al. (1990) and Alvinerie
`et al. (1993); Alvinerie et al. (1995). Briefly, a 1-ml aliquot of plasma sample was combined
`with 100 ptl of internal standard (abamectin, 100 ng/ml) and then mixed with l-llll acetoni-
`trile. After mixing for 20 min, the solvent-sample mixture was centrifuged at 2000 >< gfor
`15 min. The supernatant was injected into a Supelclean LC13 cartridge (Supelco, Bellfonte,
`PA) previously conditioned with 2 ml methanol and 2 ml deionized water. The cartridge was
`flushed with 2 ml of water/methanol (3 : 1). The analytes were eluted with 1 ml of methanol
`and concentrated to dryness under a stream of nitrogen. The reconstitution was done using
`100 ptl of a solution of N—methylimidazole (Sigma, St. Louis, MO) in acetonitrile (1 : l).
`Derivatization was initiated by adding 150 ptl trifluoroacetic anhydride (Sigma, St. Louis,
`MO) solution in acetonitrile (1 :2). After completion of the reaction (<30 s), an aliquot
`(100 pl) of this solution was injected directly into the chromatograph.
`
`2.2.2. Drug analysis
`IVM plasma concentrations were determined by high performance liquid chromatogra-
`phy (HPLC) using a Shimadzu 10 A HPLC system (Shimadzu, Kyoto, Japan). HPLC anal-
`ysis was undertaken using a reverse phase C18 column (Phenomenex, 5 ptm, 4.6 x 250 mm)
`kept in a column oven at 3 00 C (Shimadzu, Kyoto, Japan) and an acetonitrile/methanol/water
`(55/40/5) mobile phase at a flow rate of 1.5 ml/min. IVM was detected with a fluorescence
`detector (Spectrofluorometric detector RF-l 0, Shimadzu, Kyoto, Japan), reading at an ex-
`citation wavelength of 365 nm and an emission wavelength of 475 nm. IVM concentrations
`were determined by the internal standard method using the Class LC 10 Software version 1.2
`(Shimadzu, Kyoto, Japan) on an IBM compatible AT 486 computer. The IVM/abamectin
`peak area ratio was used to estimate the IVM concentration in spiked (validation of the
`analytical method) and experimental samples. There was no interference of endogenous
`compounds in the chromatographic determinations. The solvents (Baker, Phillipsburg, NJ)
`used during the extraction and drug analysis were HPLC grade.
`
`2.2.3. Validation procedures
`A complete validation of the analytical procedures for extraction and quantification of
`IVM was performed before starting the analysis of experimental samples from the phar-
`macokinetic trial. IVM (Batch # 95051 2BER01, purity 97.5%) and abamectin (Batch
`# 9505 25BER01, purity 97.4%) reference standards provided by Bayer Argentina S.A.,
`were used to prepare calibration curves in a range between 0.25—10ng/ml and 10—100
`ng/ml, respectively. The analytical method was validated according to the following
`criteria:
`
`(a) Linearity. IVM and the internal standard were identified by comparison with the re-
`tention times of pure reference standards. Linearity was established to determine the
`concentration-detector response relationship, as determined by injection of spiked IVM
`standards in plasma at different concentrations (triplicate determinations). Calibration
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`207
`
`curves were established using least-squares linear regression analysis and correlation
`coefficients (r) and coefficient of variation (CV) calculated.
`(b) Recovery. Drug recovery was estimated from calibration lines prepared with different
`IVM-fortified plasma samples using abamectin as internal standard. Percentages of IVM
`recovery from plasma samples were obtained in the range between 0.5 and 50 ng/ml. The
`mean percentage of recovery and the coefficient of variation (CV) were calculated. The
`CV was obtained as the ratio between the standard deviations and the mean recovery
`values of at least three determinations.
`
`(0) Precision: Inter-assay precision of the extraction and chromatography procedures was
`evaluated by processing replicate aliquots of pooled cattle plasma samples containing
`known amounts of NM (2 and 20 ng/ml) on different days.
`((1) Detection and quantification limits: The limit of drug detection was established With
`injection and HPLC analysis of plasma blanks fortified with the internal standard, mea-
`suring the baseline noise at the time of retention of the IVM peak. The mean baseline
`noise at the IVM retentiontime plus three standard deviations was defined as the detection
`limit. The meanbaseline noise plus six standard deviations was defined as the theoretical
`quantification limit.
`
`2.3. Pharmacokinetic and statistical analyses oftlre data
`
`The plasma concentrations vs. time curves obtained after each treatment in each indi-
`vidual animal were fitted with PK Solutions 2.0 (Ashland, OH) computer software. Phar-
`macokinetic parameters were determined using a model-independent method. The peak
`concentration (Cmax) and time to peak concentration (Tmax) were read from the plotted
`concentration—time curve for each individual animal. The terminal (elimination) half-life
`(Tr/2a) and absorption half-life (T1 /Zab) were calculated as In 2/l3 and In 2/lrab, respectively,
`where l} is the terminal slope (h‘l) and 1% the rapid slope obtained by feathering which rep-
`resents the first-orderabsorptionrate constant (h‘ 1). The areas underthe concentration—time
`curves (AUC) were calculated by the trapezoidal rule (Gibaldi and Perrier, 1982) and further
`extrapolated to infinity by dividing the last experimental concentration by the terminal slope
`(IS). Statistical moment theory was applied to calculate the mean residence time (MRT) for
`IVM as follows
`
`
`T _ AUMC
`_ AUC
`
`where AUC is as defined previously and AUMC the area under the curve of the product of
`time and drug concentration vs. time from zero to infinity (Gibaldi and Perrier, 1982).
`
`lVM plasma concentrations are presented as mean :: SD. The phamracokinetic parame-
`
`ters are reported as mean :: SD. Mean pharrnacokinetic parameters for IVM obtained after
`the administration of the different formulations were statistically compared by ANOVA.
`Where F values were significantly different, the Tukey—Kramer multiple comparisons test
`was applied to indicate order of significance. A value ofp < 0.05 was considered significant.
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`
`ll- IVM-TEST SC
`m IVM-TEST 1M
`:u IVM—CONTROL
`
`
`
`V
`
`
`
`AUC 0-Tmax
`(ng.d/ml)
`
`T 1/2 ab
`(daYS)
`
`Fig. 1. Comparative partial area under the ivermectin(1VM) concentration vs. time curves obtained between treat-
`ment and the time ofthe peak plasma concentration (partial AUCO, Tm2X ), and absorption half-lives ( T1/2ab) obtained
`after the administration ofthe IVM-TEST (subcutaneous and intramuscular) and IVM-CONTROL (subcutaneous)
`fomiulations to cattle (200 ug/kg). Values are significantly different from those obtained for the IVM-CONTROL
`formulation at (*) p < 0.05.
`
`3. Results
`
`The analytical procedures, including chemical extraction, derivatization and HPLC anal-
`ysis of IVM were validated. The linear regression lines for IVM in the range between
`0.25—lOng/ml and 10—100 ng/ml showed correlation coefficients of 0.999 and 0.992, re-
`spectively. The mean recovery of IVM from plasma was 89.5%. The detection limit of the
`analytical technique was 0.03 ng/ml;the theoretical quantification limit was 0.05 ng/ml. The
`inter-assay precision of the analytical procedure obtained after HPLC analysis of spiked
`standards of IVM (2 and 10 ng/ml) on different days showed a CV of 1.84%.
`IVM was detected in plasma between 12 h and 35 days post-administration of the IVM-
`TEST (SC and IM injections) and WWI-CONTROL formulations. The partial AUC val-
`ues measured between treatment and the time of the peak concentration (AUCOJHW) and
`the absorption half-lives obtained for the three treatments are shown in Fig. l. The mean
`plasma concentrations of IVM obtained after the SC administration of the IVM-TEST and
`IVM-CONTROL formulations are shown in Fig. 2. IVM concentration profiles, obtained af-
`ter the 1M administration of the lVM-TEST fonnulation are compared with those obtained
`after the SC administration of the control formulation in Fig. 3. Mean IVM plasma con-
`centrations obtained at 20, 25, 30 and 35 days post-administration of the three treatments
`are shown in Fig. 4. The mean parameters that summarize the overall kinetic behaviour
`of the drug following the three treatments are compared in Table 1. The number of days
`
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`
`209
`
`
`
`_\
`
`(ng/ml) 0.1
`IVMconcentration
`
`
`
`
`
`0
`
`5
`
`1 0
`
`20
`1 5
`Days post-treatment
`
`25
`
`30
`
`35
`
`
`Fig. 2. Mean (::SD) plasma concentrations of iveimectin (IVM) obtained after the subcutaneous administration
`of the IVM-TEST and IVM-CONTROL formulations to cattle (200 [Jog/kg).
`
`
`
`IVMconcentration(ng/ml)
`
`10
`
`'
`
`-—.— IVM-TEST IM
`
`—V— IVM-CONTROL
`
`\R‘K 0.1
`
`H
`
`W—
`
`0
`
`5
`
`10
`
`20
`15
`Days post-treatment
`
`25
`
`30
`
`35
`
`
`Fig. 3. Mean (:: SD) plasma concentrations ofivermectin (IVM) obtained after the administration ofthe IVM-TEST
`(intramuscular) and IVM-CONTROL (subcutaneous) formulations to cattle (200 ug/kg).
`
`post-treatment in which plasma concentrations of IVM were greater than 0.5 and lng/ml
`after the administration of the IVM-TEST (SC and 1M treatments) and IVM-CONTROL
`(SC) formulations are shown in Table 2.
`
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`
`
`
`IVMconcentration(ng/ml)
`
`
`
`- IVM-TEST SC
`IVM-TEST 1M
`
`[3 IVM-CONTROL
`
`D—fi
`
`Days post-treatment
`
`Fig. 4. Comparative mean plasma concentrations of ivermectin (IVM) obtained between 20 and 35 days after
`the administration of the IVM-TEST (subcutaneous and intramuscular) and IVM-CONTROL (subcutaneous)
`fonnulations to cattle (200 ug/kg). Values are significantly different from those obtained for the IVM-CONTROL
`formulation at (*) p< 0.05 and (**) p< 0.01.
`
`Table 1
`Mean pharmacokinetic parameters for ivermectin (IVM) obtained after administration of the IVM-TEST (subcu-
`taneous and intramuscular) and IVM-CONTROL (subcutaneous) formulations to cattle at 200 ug/kg
`
`
`Kinetic parametersa
`IVM-TEST scf
`IVM-TEST 1Mf
`IVM-Controlf
`
`0.50 :: 0.17
`0.69 :: 0.30
`1.48 :: 0.92he
`T1 flab (days)
`g
`35.4 :: 9.67
`22.6 :: 4. 56'3
`19.9 :: 8. 840
`Cmax 11
`/1nl
`1.63 :: 0.51
`2.25 :: 0.88
`4.00 :: 1.41CLe
`Tmax (days)
`206 :: 35.8
`188 :: 23.9
`203 :: 43.9
`AUC (0735days)(11g day/ml)
`
`
`
`207 :: 35.7
`189 :: 24.0
`206 :: 41.3
`AUCtotal (11g day/ml)
`5.86 :: 2.26
`7.24 :: 2.66
`9.49 :: 3.89b
`MRT (days)
`3.99 :: 0.76
`5.20 :: 1.11b
`5.90 :: 3.36b
`Tum (days)
`a T1 /2ab: absorption half -life; Cum: peak )lasma concentration; Tum, time to peak plasma concentration;
`AUC(0735day), area under the concentration vs. time curve between drug administration and 35 day post-treatment;
`AUCLUM, area under the concentration vs. time curve extrapolated to infinity; MRT; mean residence time; T1 /261
`elimination half—life.
`
`
`
`
`
`
`
`bMean kinetic parameters are significantly different from those obtained for the IVM—CONTROL formulation at
`p < 0.05.
`0Mean kinetic parameters are significantly different from those obtained for the IVM—CONTROL formulation at
`p < 0.0 l .
`d Mean kinetic parameters are significantly different from those obtained for the IVM—CONTROL formulation at
`p < 0.00 1.
`8Mean kinetic parameters are significantly different from those obtained for IVM—TEST IM at p < 0.05.
`
`fData values are expressed as mean :: SD (n: 8).
`
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`
`21 1
`
`Table 2
`Comparison of the number of days post-treatment during which IVM plasma concentrations were greater than
`0.5 or 1 ng’ml, after the administration ofthe lVM-TEST (subcutaneous and intramuscular) and IVM-CONTROL
`formulations to cattle
`
` Days >05 ng/ml Days >1 ng/ml
`
`IVM—TEST SC
`27.5 :: 5.97a
`22.5 :: 5.34a
`IVM—TEST IM
`23.8 :: 3.53
`20.0 :: 2.67
`IVM—CONTROL
`20.6 :: 3.20
`16.3 :: 2.32
`
`
`
`
`
`aValues are significantly different from those obtained for the IVM-CONTROL formulation at p < 0.05.
`
`4. Discussion
`
`Pharmaceutical technology has been applied to develop different drug fonnulations and
`delivery systems to optimize the pharmacological potency of IVM and other endectocide
`molecules currently available. Alternative IVM formulations for use in several different
`species have been introduced to the market or are under development since the expiration
`ofthe original patent for the first approved IVM formulation (Ivomec®, MSD AgVet.). The
`persistence of the broad-spectrum antiparasitic activity of endectocide compounds relies on
`their disposition kinetics and pattem of plasma/tissues exchange in the host (Lanusse et al.,
`1997). Even slight modifications to their plasma/tissue exchange pattern and/or disposition
`kinetics may result in substantial changes in their concentration and residence time at the
`site of parasite location which, in turn, would alter the potency and persistence of their
`antiparasitic activity. The influence of drug formulation and route of administration on the
`disposition and plasma bioavailability of IVM in cattle has been confirmed in the trial
`reported here.
`The aqueous solubility of an active ingredient and the features of its pharmacotechnical
`preparation may influence the systemic availability (bioavailability), which depends on
`the rate and extent of absorption of a drug from the site of injection to the bloodstream
`(Baggot and McKellar, 1994). The vehicle in which endectocides are fonnulated may play
`a role in their absorption kinetics and resultant plasma availability (Lo et al., 1985; Lanusse
`ct al., 1997). As demonstrated by Lo ct a1. (1985), the absorption of IVM is markedly
`influenced by its pharmaceutical preparation. Following parenteral administration, the low
`solubility ofIVM inwater and its deposition in subcutaneous tissue favour a slow absorption
`from the injection site and provide prolonged duration in the bloodstream (Lanusse et al.,
`1997)
`The determination of the incremental AUC (partial AUCs) has been proposed as an ade-
`quate way to estimate the comparative rates of absorption of different dnig formulations in
`bioequivalence trials (Chen, 1992). A significantly higher partial AUC0_Trmx was obtained
`following the SC administration of the IVM-TEST compared to the IVM-CONTROL for-
`mulation (Fig. 1). In fact, a delayed absorption of IVM from the site of SC injection was
`observed following the administration of the 1VM-TEST formulation. This slower absorp-
`tion process correlated with a peak plasma concentration attained at a delayed Tmax (4
`days), compared to those obtained after either the 1M administration of the same fonnu-
`lation (2.25 days) or the SC treatment with the IVM-CONTROL (1.63 days) formulation.
`Consistently, the absorption half-life of IVM given subcutaneously as an oil-based fonnu-
`
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`
`lation was significantly longer (1.48 days) than that obtained for the control formulation
`(0.50 days).
`IVM is absorbed relatively slowly from the site of injection, at rates which largely de-
`pend on the composition of the formulation vehicle. It has been previously shown that an
`inj ectable aqueous solution of IVM allows faster absorption and higher peak plasma concen-
`tration of the drug than administration of the drug in a non-aqueous vehicle (Lo et al., 1985).
`The commercially used vehicle contains propylene glycol/glycerol formal (60 :40) and is
`the formulation used as control preparation in the current trial, whereas the IVM-TEST
`formulation is prepared in an oil-based vehicle. The release of the drug from the subcu-
`taneous depot of the oily vehicle after SC administration of the IVM-TEST formulation
`delays the absorption process, resulting in a delayed peak concentration (delayed 711m) and
`prolonged absorption half-life. Thus, the rate of absorption from the subcutaneous space
`appears to be the rate limiting step in the disposition of IVM after SC administration of the
`TEST formulation. This interpretation of the data is compatible with the lower peak plasma
`concentration (Cmax) obtained after SC administration of IVM in the oil-based vehicle com-
`pared with the IVM-CONTROL formulation. Field utility of long-acting formulations for
`endectocides may be more favoured by a delayed elimination with higher concentration
`profiles between 20 and 35 days post-treatment, instead of a high peak concentration; it
`is also likely that this consideration may be different for the control of different types of
`internal/extemal parasites,
`The comparative analysis of the absorption phase suggests that the absorption process
`of the oil-based preparation may be faster from the site of 1M injection compared to SC
`injection. This faster absorption was reflected in an earlier 711m and shorter Tl /Zab obtained
`after IM treatment compared to SC administration of the same TEST formulation (Table 1).
`Greater blood flow in muscle tissue, compared to the subcutaneous space, may favour faster
`absorption after IM treatment. However, a subcutaneously injected drug solution tends to
`take the shape of the space into which it is administered, resulting in an increased absorption
`surface compared to IM administration; this extended area of contact between the drug and
`blood vessels may compensate for the reduced blood flow in SC tissue (Nowakowski et
`al., 1995). The absorption of IVM injected as a non-oily preparation (IVM-CONTROL)
`from the SC tissue was consistently faster than that observed following the SC and IM
`administration of the TEST preparation. Both, the delayed absorption given by the oily
`vehicle and the increased absorption surface at the SC site of injection may account for the
`‘flip-flop’ phenomenon, in which the disposition of the drug from the body is controlled by
`the absorption process (Lanusse et al., 1997). In fact, the disposition of IVM given SC and
`IM as the TEST formulation was delayed compared to that obtained for the CONTROL
`preparation; both, the mean residence time (MRT) and T1/2e1 of the drug were prolonged
`after treatments with the oil-based formulation. A delayed elimination controlled by the
`rate of release of the drug from the depot at the site of injection, contributes to the greater
`persistence of IVM given as the TEST preparation. The influence of the absorption kinetics
`on the disposition of parenterally administered IVM has been demonstrated in this trial; an
`absorption rate-limited elimination of IVM may account for the long residence of high drug
`concentrations in the bloodstream following injection of the oil-based formulation to cattle.
`IVM is a highly lipophilic molecule that is extensively distributed into tissues (Bogan
`and McKellar, 1988; Chiu et al., 1990). The distribution into adipose tissue is particularly
`
`AstraZeneca Exhibit 2120 p. 10
`
`

`

`A. Lifsdu'tz et a]. / Veterinary Parasitology 86 {I 999) 2037215
`
`213
`
`relevant, since it may act as a drug reservoir that contributes to the long residence of the
`drug in the bloodstream. Higher IVM plasma concentrations were obtained between 7 and
`35 days after the SC administration of the IVM-TEST compared with the IVM-CONTROL
`formulation (Fig. 2). The plasma profiles of IVM after its 1M administration were higher
`than the CONTROL from Day 11 to Day 35 post-treatment (Fig. 3). IVM concentration
`profiles in plasma reflect those achieved in different tissues, including those in which tar-
`get parasites are located (Lanusse and Prichard, 1993). A high correlation between drug
`concentrations in plasma and those achieved in different target tissues has been obtained
`after the SC administration of WWI, moxidectin and doramectin in cattle (Lifschitz et al.,
`1998). Therefore, the enhanced IVM plasma profiles obtained between 20 and 35 days
`after administration of the IVM-TEST formulation may result in an increased availability
`of the active drug in the tissues where target parasites are located, which may account for
`the prolonged anthelmintic persistence of the drug given to cattle in the TEST formulation.
`This may be relevant to control arrested larvae of developmental stages of gastrointestinal
`nematodes. Additionally, the duration of effective IVM plasma concentrations may be par-
`ticularly important in the treatment of tick infestations, since these organisms may feed on
`blood over several days.
`The drug concentration of an endectocide molecule required at the target tissues to inhibit
`either the development of larval stages or the establishment of difierent internal and external
`parasites has not been determined. While IVM plasma concentrations as low as 0.48 ng/ml
`have been shown to control Hypoderma flies (Alvinerie et al., 1994), it is not clear what
`drug concentration is necessary to inhibit the development of incoming L30f gastrointestinal
`nematodes. However, the correlation between the available data on the persistence of the
`anthehnintic activity of IVM and the concentration profiles determined in different pharma-
`cokinetic trials may provide useful information to estimate the minimal drug concentration
`above which larval development does not occur. It seems likely that IVM plasma concen-
`trations between 0.5 and lng/ml would be indicative of the minimal drug level required
`for optimal anthelmintic activity for most gastrointestinal/lung nematodes. This theoretical
`as smnption may assist in the indirect estimate of the impact of modified IVM formulations,
`such as the TEST preparation under study in the current trial, on the persistence of an-
`thelmintic activity. A comparative estimation of the period of time post-treatment in which
`IVM plasma concentrations were greater than either 0.5 or 1 ng/ml after administration
`of the different treatments is shown in Table 2. Consistent with the longer residence time
`of IVM administered subcutaneously as an oil-based formulation, there were significantly
`longer time periods during which IVM concentrations were >05 (27.5 days) and >1 ng/ml
`(22.5 days) after SC administration of the IVM-TEST formulation, compared with those
`obtained for the standard IVM-CONTROL formulation (20,6 and 16.3 days, respectively).
`Although IM administration of the TEST formulation resulted in apparently greater ‘protec-
`tionperiods’ than the SC treatment with the IVM-CONTROL formulation, these differences
`did not reach statistical significance.
`Pharmaceutical preparations can be designed to modify systemic phannacokinetie pro-
`files through manipulation of the rate of absorption from the SC space (Wicks et al., 1993).
`Since the discovery and development of new molecules are long and expensive processes,
`the improvement of pharmaceutical preparations and delivery systems for existing dnrgs
`has been proposed as a reasonable alternative for the future of parasite control in livestock
`
`AstraZeneca Exhibit 2120 p. 11
`
`

`

`214
`
`A, Lifschr'rz et a], / Veterinary Parasitology 86 {1999) 2037215
`
`(McKellar, 1994; Hennessy, 1997). The modified pharrnacokinetic pattern obtained for IVM
`after the administration of the novel oil-based formulation examined in this trial, compared
`to the standard preparation, may positively impact on the strategic use of the drug in parasite
`control.
`
`Acknowledgements
`
`Adrian Lifschitz is a recipient of a fellowship from the Consejo Nacional de Investiga-
`ciones Cientificas y Tenicas (CONICET), Argentina. The technical advice of Dr. Michel
`Alvinerie (INRA, Toulouse, France) in the development of the analytical techniques is ac-
`knowledged. The authors gratefully acknowledge the cattle facilities provided by Dr. Mario
`Nardello. Research at the Laboratorio de Farmacologia, Departamento de Fisiopatologia,
`Facultad de Ciencias Veterinarias, Universidad Nacional del Centro (Tandil, Argentina)
`is partially supported by the Consejo Nacional de Investigaciones Cientificas y Ténicas
`(CONICET), Argentina, Comision de Investigaciones Cientificas de la Provincia de Buenos
`Aires (CICPBA) and Fundacién Antorchas (Argentina).
`
`References
`
`Alvinen'e, M., Sutra, J.F., Galtier, P., 1993. lvermectin in g

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