An innovative ethosuximide granule formulation designed for pediatric use: Comparative pharmacokinetics, safety, tolerability, and palatability profile versus reference syrup.

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Ressource 1Download: Article_Leonore Diezi_An innovative ethosuximide granule formulation designed for pediatric use_Pharmacol Res Perspec_2022.pdf (1240.82 [Ko])
State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_8A3E445B0338
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
An innovative ethosuximide granule formulation designed for pediatric use: Comparative pharmacokinetics, safety, tolerability, and palatability profile versus reference syrup.
Journal
Pharmacology research & perspectives
Author(s)
Diezi L., Dao K., Jullien V., Roussel-Maupetit C., Burton I., André P., Bardinet C., Rothuizen L.E., Chtioui H., Manso-Silvan M.A., Guittet C., Brunner-Ferber F., Vandenhende F., Chiron C., Granier L.A., Buclin T.
ISSN
2052-1707 (Electronic)
ISSN-L
2052-1707
Publication state
Published
Issued date
02/2023
Peer-reviewed
Oui
Volume
11
Number
1
Pages
e01032
Language
english
Notes
Publication types: Randomized Controlled Trial ; Clinical Trial, Phase I ; Journal Article
Publication Status: ppublish
Abstract
Ethosuximide, the first-line therapy for childhood absence epilepsy, is currently formulated as a syrup (Zarontin®, Pfizer) with a bitter taste and high sugar content, poorly adapted to children, and a ketogenic diet. The collaborative European FP7 project KIEKIDS aimed at developing an innovative sugar-free, tasteless formulation convenient for pediatric use. This dual Phase-I study evaluated two granule formulations based on lipid multiparticulate (LMP) technology. Two panels of 6 healthy adult volunteers underwent a randomized, placebo-controlled, partly blinded, 3-way cross-over trial, comparing ethosuximide granules A or B with placebo granules and syrup at single 10 mg/kg doses. Corresponding plasma pharmacokinetic profiles of ethosuximide were compared, along with palatability, safety, and tolerability. The LMP granule A proved suboptimal due to bitterness and adherence to beaker walls, while the optimized granule B revealed excellent palatability, similar to placebo granules, and low adherence to glass. The relative bioavailability of granules A versus syrup, based on dose-normalized C <sub>max</sub> and AUC <sub>0-∞</sub> was 93.7% [90% CI: 76.3-115.1] and 96.1% [91.0-101.5], respectively. For granules B it was 87.6% [81.6-94.0] and 92.5% [88.5-96.6], respectively, with slightly delayed t <sub>max</sub> of 0.75 h [0.5-4.05] compared to syrup 0.5 h [0.3-0.8]. Tolerability visual analog scales revealed a trend for statistically non-significant improvement versus syrup at peak (30 min) for transient dizziness (both granules), fatigue (granules A), and anxiety (granules B). The innovative ethosuximide granule formulation B achieves a suitable profile for pediatric use, being sugar-free, tasteless, bioequivalent, and well-tolerated while enabling precise adjustment to body weight.
Keywords
Adult, Humans, Child, Ethosuximide, Biological Availability, Therapeutic Equivalency, Area Under Curve, bioequivalence, epilepsy, paediatrics, pharmacokinetics, phase I
Pubmed
Web of science
Open Access
Yes
Create date
27/12/2022 10:53
Last modification date
07/02/2023 7:56
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