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Use of single and multiple-dose studies is required to establish the bioequivalence between two extended-release oral dosage forms under the current European Guidelines. However, FDA is less strict in this regard and only requires a single-dose study. The objective of this work is to use a computer simulation in order to test the two approaches. Three pharmacokinetic models, representing different release mechanisms, were considered, and Monte Carlo simulations with intra- and inter-individual variabilities were performed. Five different bioequivalence protocols were used and a new pharmacokinetic metric -C(τ), the concentration at the end of the intended dosing interval obtained in the single-dose study - is proposed in order to avoid the need for steady-state studies while keeping the ability to detect differences between formulations. Results have shown that the European requirements are more capable to discriminate between two potentially different formulations but at the cost of the multiple-dose study and with an increased number of subjects when compared to the FDA requirements. However, the use of C(max) and AUC(0-)(t) obtained on a single-dose study with the added C(τ) metric equals the discriminatory ability of the current EMA requirements, without the need of a multiple-dose study. This proposed approach results in the reduction in the number of studies and volunteers enrolled in clinical bioequivalence trials, without compromising the quality assurance of a new extended-release oral formulation., (Copyright © 2011 Elsevier B.V. All rights reserved.)

In this MiniReview, the main modifications made during the revision of the current Note for Guidance on the Investigation of Bioavailability and Bioequivalence are reviewed and justified. Several new features have been added to this guideline, as well as changes aimed at improving the clarity of the guidance provided. The first issue to be addressed was to limit the scope of the guideline to bioequivalence studies for immediate release dosage forms with systemic action. Therefore, the guideline refers to bioequivalence alone. Moreover, the new definition of Generic Medicinal Product has been incorporated. Clearer guidance covering more specific cases is now given on sections such as: fed/fasting conditions, use of metabolite data, enantiomers and strength to be used in the bioequivalence study. Steady-state design is now restricted and other designs, such as parallel group design, replicate design and two-stage design, are now incorporated in a more explicit form. New practical guidance on Highly Variable Drug Products and Narrow Therapeutic Index Drugs has been incorporated. The possibility for a biowaiver based on the Biopharmaceutics Classification System is now more explicit for Class I drugs and can be extended to Class III drugs under restricted conditions. We are aware that the initial goal of providing a very specific and clear guidance on these issues has not been entirely achieved, mainly because it is almost impossible to cover all individual cases and predict every possible situation that may arise. Demonstration of bioequivalence will still require in many instances a case by case approach.