Bioequivalence studies of tibolone in premenopausal women and effects on expression of the tibolone-metabolizing enzyme AKR1C (aldo-keto reductase) family caused by estradiol

• Published in: Journal of clinical pharmacology Vol. 48; no. 12; p. 1430
• Main Authors: Kang, Keon W, Kim, Yoon G
• Format: Journal Article
• Language: English
• Published: England 01.12.2008
• Subjects: 20-Hydroxysteroid Dehydrogenases - genetics; 20-Hydroxysteroid Dehydrogenases - metabolism; 3-Hydroxysteroid Dehydrogenases - genetics; 3-Hydroxysteroid Dehydrogenases - metabolism; Adult; Alcohol Oxidoreductases - genetics; Alcohol Oxidoreductases - metabolism; Aldehyde Reductase; Aldo-Keto Reductase Family 1 Member C3; Aldo-Keto Reductases; Area Under Curve; Cell Line, Tumor; Cross-Over Studies; Enzyme Activation - drug effects; Estradiol - pharmacology; Estrogen Receptor Modulators - metabolism; Estrogen Receptor Modulators - pharmacokinetics; Estrogen Receptor Modulators - pharmacology; Female; Gene Expression Regulation, Enzymologic - drug effects; Gene Expression Regulation, Enzymologic - genetics; Glucose Transporter Type 1 - genetics; Glucose Transporter Type 1 - metabolism; Half-Life; Humans; Hydroxyprostaglandin Dehydrogenases - genetics; Hydroxyprostaglandin Dehydrogenases - metabolism; Hydroxysteroid Dehydrogenases - genetics; Hydroxysteroid Dehydrogenases - metabolism; Immunoblotting; Norpregnenes - blood; Norpregnenes - metabolism; Norpregnenes - pharmacokinetics; Norpregnenes - pharmacology; Premenopause - metabolism; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger - genetics; RNA, Messenger - metabolism; Therapeutic Equivalency; Young Adult
• ISSN: 0091-2700
• DOI: 10.1177/0091270008323262

This study aimed to investigate the bioequivalence of a test formulation of tibolone with the marketed reference formulation in 24 young healthy female volunteers. Tibolone is a synthetic steroid hormone for menopausal women. Volunteers were treated with the 2 formulations of tibolone (total dose of active ingredient 2.5 mg) according to a 2 x 2 crossover design with a 1-week washout period. Plasma concentrations of 3alpha- and 3beta-hydroxytibolone, which are major metabolites of tibolone, were assayed in timed samples over a 24-hour period with a validated gas chromatography/mass spectrometry (GC/MS) method that had a lower limit of quantification of 0.5 ng/mL. The reference and test formulations gave a mean 3alpha-hydroxytibolone C(max) of 5.0 and 5.2 ng/mL, respectively, and a mean 3beta-hydroxytibolone C(max) of 16.4 and 16.5 ng/mL, respectively. The mean AUC(t) of 3alpha-hydroxytibolone was 24.7 and 24.3 ng h/mL, whereas the mean AUC(t) of 3beta-hydroxytibolone was 57.6 and 54.8 ng h/mL for the test and reference formulations, respectively. The authors did not find significant differences in pharmacokinetic parameters between the 2 formulations, but metabolite formation was different from reports in postmenopausal women. The authors therefore measured the effects of estradiol on the expression of the tibolone-metabolizing enzymes, from the aldo-keto reductase (AKR1C) family, using HepG2 cell (human hepatoma cells) and MCF-7 cell (human breast cancer cells). Estradiol increased mRNA levels of AKR1C1, AKR1C2, and AKR1C3 and protein levels of total AKR1C in HepG2 cells. Estradiol selectively enhanced levels of AKR1C2 mRNA in MCF-7 cells. Thus, changes in the major metabolites of tibolone might result from changes in AKR1C family expression by patient estrogen status.