Pharmacokinetic and pharmacodynamic evaluation of a single dose of new, first in world, high dose aqueous formulation versus conventional oil based preparation of cholecalciferol

Authors

  • Mohit Changani Medical Affairs, Cadila Pharmaceuticals Limited, Ahmedabad, Gujarat, India https://orcid.org/0000-0003-0536-0112
  • Ameet Soni Medical Affairs, Cadila Pharmaceuticals Limited, Ahmedabad, Gujarat, India
  • Arani Chatterjee CRO, Cadila Pharmaceuticals Limited, Dholka, Gujarat, India
  • Ashish Amarsheda CRO, Cadila Pharmaceuticals Limited, Dholka, Gujarat, India
  • Chandrakant Mavadhiya Bioanalytics, Cadila Pharmaceuticals Limited, Dholka, Gujarat, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20233025

Keywords:

Cholecalciferol, Aqueous formulation, VDD, PKs, PDs

Abstract

Background: Vitamin D deficiency (VDD) is a common condition in India with prevalence in general population varying from 50-94%. VDD has been associated with increased susceptibility to a wide range of viral infections including COVID-19. It is associated with worse outcomes and greater morbidity and mortality in medical as well as surgical ICUs. The objective of the study was to evaluate the pharmacokinetic (PK)/pharmacodynamic (PD) of aqueous cholecalciferol injection in comparison with conventional oil-based injection in VDD healthy adult subjects.

Methods: 24 eligible vitamin D deficient healthy adult males, fulfilling the inclusion/exclusion criteria, were enrolled in the study. Subjects received a single dose of either test (T) [Aqueous cholecalciferol injection 600K IU/2 mL] or reference (R) [Cholecalciferol 600K IU oil-based injection] intramuscularly. Various PK parameters (Cmax, AUC0-t, AUC0-∞ and Tmax) and PD parameters (concentration of cholecalciferol and 25(OH)D) were measured along with safety analysis.

Results: A significantly higher concentration of cholecalciferol and 25(OH)D were observed with test product compared to reference (p<0.01) from 1-hour post-administration till end of the study. A statistically significant difference between test and reference product was observed for the calculated Cmax and Tmax for cholecalciferol and 25(OH)D (p<0.0001). All 12 (100%) subject in test arm achieved the normal level of 25(OH)D by 72 hr post-administration as compared to none in reference arm (p=0.0017). There were no serious adverse events (SAEs) or deaths reported during the study.

Conclusions: This first in world, aqueous formulation of cholecalciferol injection was found to be superior in various PK/PD parameters as compared to conventional oil based injection, which resulted in rapid and sustained rise in serum 25(OH)D levels.

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References

Aparna P, Muthathal S, Nongkynrih B, Gupta SK. Vitamin D deficiency in India. J Family Med Prim Care. 2018;7(2):324-30.

Ritu G, Gupta A. Vitamin D deficiency in India: prevalence, causalities and interventions. Nutrients. 2014;6(2):729-75.

Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G. Vitamin D: Metabolism, Molecular Mechanism of Action, and Pleiotropic Effects. Physiol Rev. 2016;96(1):365-408.

Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol. 2009;19(2):73-8.

Bouillon R, Manousaki D, Rosen C, Trajanoska K, Rivadeneira F, Richards JB. The health effects of vitamin D supplementation: evidence from human studies. Nat Rev Endocrinol. 2022;18(2):96-110.

Padhi S, Suvankar S, Panda VK, Pati A, Panda AK. Lower levels of vitamin D are associated with SARS-CoV-2 infection and mortality in the Indian population: An observational study. Int Immunopharmacol. 2020;88:107001.

Ohaegbulam KC, Swalih M, Patel P, Smith MA, Perrin R. Vitamin D Supplementation in COVID-19 Patients: A Clinical Case Series. Am J Therapeutics. 2020:e485.

Wang R, DeGruttola V, Lei Q, Mayer KH, Redline S, Hazra A, Mora S, Willett WC, Ganmaa D, Manson JE. The vitamin D for COVID-19 (VIVID) trial: A pragmatic cluster randomized design. Contemporary Clin Trials. 2020;106176.

Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Tmava Berisha A, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr. 2020;74(11):1498-513.

Ohaegbulam KC, Swalih M, Patel P, Smith MA, Perrin R. Vitamin D Supplementation in COVID-19 Patients: A Clinical Case Series. Am J Therapeutics. 2020;e485.

Wang R, DeGruttola V, Lei Q, Mayer KH, Redline S, Hazra A, et al. The vitamin D for COVID-19 (VIVID) trial: A pragmatic cluster randomized design. Contemporary Clin Trials. 2020;106176.

Amrein K, Papinutti A, Mathew E, Vila G, Parekh D. Vitamin D and critical illness: what endocrinology can learn from intensive care and vice versa. Endocr Connect. 2018;7(12):R304-15.

Menger J, Lee ZY, Notz Q, Wallqvist J, Hasan MS, Elke G, et al. Administration of vitamin D and its metabolites in critically ill adult patients: an updated systematic review with meta-analysis of randomized controlled trials. Crit Care. 2022;26(1):268.

Alcala-Diaz JF, Limia-Perez L, Gomez-Huelgas R, Martin-Escalante MD, Cortes-Rodriguez B, Zambrana-Garcia JL, et al. Treatment and Hospital Mortality Due to COVID-19: A Cohort Study. Nutrients. 2021;13(6):1760.

Nogues X, Ovejero D, Pineda-Moncusí M, Bouillon R, Arenas D, Pascual J, et al. Calcifediol Treatment and COVID-19-Related Outcomes. J Clin Endocrinol Metab. 2021;106(10):e4017-27.

Mata-Granados JM, Vargas-Vasserot J, Ferreiro-Vera C, Luque de Castro MD, Pavón RG, Quesada Gómez JM. Evaluation of vitamin D endocrine system (VDES) status and response to treatment of patients in intensive care units (ICUs) using an on-line SPE-LC-MS/MS method. J Steroid Biochem Mol Biol. 2010;121(1-2):452-5.

Amrein K, Schnedl C, Holl A, Riedl R, Christopher KB, Pachler C, et al. Effect of high-dose vitamin D3 on hospital length of stay in critically ill patients with vitamin D deficiency: the VITdAL-ICU randomized clinical trial. JAMA. 2014;312(15):1520-30.

Murai IH, Fernandes AL, Sales LP, Pinto AJ, Goessler KF, Duran CSC, et al. Effect of a Single High Dose of Vitamin D3 on Hospital Length of Stay in Patients With Moderate to Severe COVID-19: A Randomized Clinical Trial. JAMA. 2021;325(11):1053-60.

Singh V, Misra AK, Singh M, Midha NK, Kumar B, Ambwani S, et al. An open-label, randomized, 10 weeks prospective study on the efficacy of vitamin D (daily low dose and weekly high dose) in vitamin D deficient patients. J Family Med Prim Care. 2019;8:1958-63.

Gupta N, Farooqui KJ, Batra CM, Marwaha RK, Mithal A. Effect of oral versus intramuscular Vitamin D replacement in apparently healthy adults with Vitamin D deficiency. Indian J Endocr Metab. 2017;21:131-6.

Chhabra S, Sharma A, Gupta SP, Bilandi A, Meena M, Mathur AK. Comparing the Effectiveness of Oral versus Intramuscular Vitamin D Supplementation in Adults with Fracture around Hip and Vitamin D Deficiency. J Clin Diagnostic Res. 2022;16(6):RC01-4.

Purohit V. Effect of single injection of vitamin d (cholecalciferol, 6 lac iu) in adults: does body mass index determine dosage frequency and rise in serum 25(oh)d3 level? Asian J Pharm Clin Res. 2015;8(4):192-4.

Whyte MP, Haddad JG Jr, Walters DD, Stamp TC. Vitamin D bioavailability: serum 25-hydroxyvitamin D levels in man after oral, subcutaneous, intramuscular, and intravenous vitamin D administration. J Clin Endocrinol Metab. 1979;48(6):906-11.

Claassen V. Intramuscular Drug Administration. Techniques in the Behavioral and Neural Sciences, Elsevier. 1994;12:23-34.

Kaur P, Mishra SK, Mithal A. Vitamin D toxicity resulting from overzealous correction of vitamin D deficiency. Clin Endocrinol (Oxf). 2015;83(3):327-31.

Taylor PN, Davies JS. A review of the growing risk of vitamin D toxicity from inappropriate practice. Br J Clin Pharmacol. 2018;84(6):1121-7.

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Published

2023-09-29

How to Cite

Changani, M., Soni, A., Chatterjee, A., Amarsheda, A., & Mavadhiya, C. (2023). Pharmacokinetic and pharmacodynamic evaluation of a single dose of new, first in world, high dose aqueous formulation versus conventional oil based preparation of cholecalciferol. International Journal of Research in Medical Sciences, 11(10), 3714–3721. https://doi.org/10.18203/2320-6012.ijrms20233025

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Original Research Articles