Enoxaparin is a widely used low-molecular-weight heparin (LMWH) obtained by alkaline β-eliminative cleavage of heparin benzyl ester derived from the porcine intestinal mucosa. Currently, several biosimilars/generics of LMWHs with differing potencies are being developed and marketed in various parts of the world. They differ in their PK and PD properties, which could be possibly due to the depolymerization processes or the manufacturing methods that result in its structural variability. Therefore, it is important that the potency of each biosimilar LMWH be compared with its innovator's molecule.~The PK properties and bioavailability of LMWHs are routinely determined by pharmacodynamic (PD) surrogates such as Anti-Xa activity, Anti-IIa activity, tissue factor pathway inhibitor (TFPI) and activated partial thromboplastin time (aPTT).~This study was designed as a double-blind, randomized, two-period, two-treatment, two-sequence, crossover, balanced, single-dose pharmacodynamic study in healthy, adult, human subjects under fasting conditions to compare and evaluate the pharmacodynamic profile of test product [Enoxaparin Sodium prefilled syringe BP; 40 mg/0.4 mL (Venus Remedies Limited, India)] with that of reference product ['Clexane®' Enoxaparin Sodium prefilled syringe; 40 mg/0.4 mL (Sanofi, Germany)]. The study was conducted with 24 subjects in accordance with protocol.~After overnight fasting of at least 08 hours, a single dose of either test product or reference product was administered to the subjects slowly by subcutaneous route (shaved abdominal wall) alternated in both period between left or right anterolaterally in a supine posture under the supervision of trained study personnel.~The subjects received the test product (A) and reference product (B) in the study as per the randomization schedule. Participants were randomly selected for one of the two sequences: either AB or BA. The washout period between administration of study drugs in each period was 7 days. Blood samples to assess PD parameters were collected in both study periods at the following time points: pre-dose (0.0 hour) and at 0.5, 1.0, 1.5, 2.0, 2.333, 2.667, 3.0, 3.333, 3.667, 4.0, 4.5, 5.0, 6.0, 8.0, 10.0, 12.0, 16.0, and 24.0 hours after dosing.~The Anti-Xa and Anti-IIa activity was measured by the chromogenic method using commercial reagent kits - STA®-liquid Anti-Xa, Diagnostica Stago and Actichrome® Heparin (Anti-IIa) kit, Biomedica Diagnostics, respectively. TFPI was assessed using Enzyme-Linked Immunosorbent Assay (ELISA) kit (Quantikine® Human TFPI ELISA kit) and aPTT was determined using clotting assay reagent kit - STA-C.K. Prest® 5-Diagnostica Stago.~Statistical analysis was performed on the pharmacodynamic data to assess bioequivalence between the test product to the reference product. The average bioequivalence of the products was concluded if two-sided 90% CI for the test to the reference ratio of the population means was within 80% and 125% interval for each of the Ln-transformed data, Amax and AUECt for Anti-Xa and Anti-IIa (primary objective).
This is a single-dose, randomized, double-blind, two-period, two-treatment, two-sequence, crossover, balanced, pharmacodynamic (PD) study with 7 days wash-out period. The objective of this study is to assess the bioequivalence between the Enoxaparin (Venus Remedies Limited, India) and its innovator product (Clexane®, Sanofi, Germany).