Applying metabolomics to detect growth hormone administration in athletes: Proof of concept.

Growth hormone (GH), an endogenous peptide regulating anabolism and lipolysis in humans, is known to be abused by athletes to improve their performance. Despite the development of two distinct screening methods, few positive cases have been reported by the antidoping authorities, probably due to the quick turnover of GH and the masking effects of age, ethnicity, and sex. Apart from growth regulation, GH is known to affect several metabolic pathways in humans including ketosis, amino-acid uptake, and protein breakdown. It is reasonable to imagine observing its markers of effects through the leading tool on metabolism study, metabolomics. In this proof-of-concept study, a cohort of well-trained volunteers was split in two equal groups and administered with micro-doses of EPO or EPO + GH every second day for 2 weeks. Urine and plasma samples were collected before, during, and after treatment and analyzed using metabolomics and lipidomics approaches. The results show that, by applying a direct discriminant analysis on the treated groups, it is possible to distinguish the treatments, and to use this difference to classify them correctly. High intragroup variability is observed, due to the subject-specific effect of the hormones. Through time 0 centering the data, a longitudinally tracking of the group was performed and a higher difference was observed between the groups, including a perfect classification of the samples before and after the treatments.

Pharmacodynamic and Pharmacokinetic Equivalences of Epoetin Hospira and Epogen(®) After Multiple Subcutaneous Doses to Healthy Male Subjects.

PURPOSE: The purpose of this study was to evaluate the pharmacodynamic (PD) and pharmacokinetic (PK) equivalences of multiple doses of the proposed biosimilar Epoetin Hospira to the reference product Epogen(⁎), when each is administered three times per week over 28 days to healthy male subjects METHODS: This single center, open-label, randomized, parallel group study was conducted in 129 healthy male subjects. Subjects were randomized to receive 100 U/kg Epoetin Hospira or 100 U/kg Epogen, each administered subcutaneously 3 times per week over 28 days. Blood was collected for determination of hemoglobin (Hb) concentrations for PD properties and for determination of epoetin concentrations for PK properties. The primary PD end point was the geometric mean ratio (GMR) of the 2 treatments for area under the effect curve for Hb from day 1 through 48 hours after the final dose of study drug administration on day 26, and the primary PK end point was the GMR of the 2 treatments for AUC0-48 and Cmax for epoetin after the final dose of study drug on day 26. FINDINGS: The GMR (Epoetin Hospira/Epogen) for the area under the effect curve for Hb from day 1 through 48 hours after the final dose of study drug administration on day 26 was 1.006 with a 95% CI of 0.996 to 1.016, which was contained within the prespecified equivalence margin of 0.965 to 1.035. The GMRs (Epoetin Hospira/Epogen) for the epoetin-derived PK parameters were 0.974 for AUC0-48 with a 90% CI of 0.896 to 1.059, and 0.938 for Cmax with a 90% CI of 0.839 to 1.049, with both 90% CIs contained within the prespecified equivalence margin of 0.80 to 1.25. The incidence (21.2% and 23.8% for Epoetin Hospira and Epogen, respectively) and severity of adverse events were similar between the 2 groups. One subject in each treatment group had a positive recombinant human erythropoietin antibody result by radioimmunoprecipitation assay before dosing and throughout study conduct with negative immunoglobulin M and neutralizing antibodies and with no evidence of clinical deterioration or of impact on PD, PK, or safety profile. IMPLICATIONS: The results of this study established PD and PK equivalences of multiple subcutaneous doses of the proposed biosimilar Epoetin Hospira to the reference product Epogen in healthy male subjects, and supported the overall demonstration of biosimilarity of Epoetin Hospira and Epogen.

Quality and Batch-to-Batch Consistency of Original and Biosimilar Epoetin Products.

Comprehensive physicochemical characterization and biological assays are essential parts in assessing quality attributes of biologicals. Here, we compared the quality of different marketed recombinant human erythropoietin (epoetin) products: originators, Eprex and NeoRecormon as well as 2 biosimilars, Retacrit and Binocrit. In addition, assessment of batch-to-batch variability was included by collecting 2 or more batches of each product. Common assays which included sodium dodecyl sulfate-polyacrylamide gel electrophoresis, high-performance size-exclusion chromatography, asymmetrical flow field-flow fractionation, capillary zone electrophoresis, and potency testing were used. Of the tested products and among batches of single products, variations in epoetin content, isoform profiles, and potency were found. Ultimately, this study demonstrated the high quality of epoetin products with some degree of variation among products and batches, confirming the "similar but not identical" paradigm of biologicals.