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Pharmacokinetics of Taurolidine following Repeated Intravenous Infusions Measured by HPLC-ESI-MS/MS of the Derivatives Taurultame and Taurinamide in Glioblastoma Patients

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Abstract

Background and objective

Taurolidine is known to have antimicrobial activity. Furthermore, at lower concentrations, it has been found to exert a selective antineoplastic effect in vitro and in vivo. The aim of this study was to investigate the pharmacokinetics of taurolidine in vivo following repeated intravenous infusion in a schedule used for the treatment of glioblastoma. As a prerequisite, the pharmacokinetics of taurolidine in human blood plasma and whole blood in vitro was investigated.

Patients and methods

The pharmacokinetics of taurolidine and its derivatives taurultame and taurinamide were investigated in human blood plasma and in whole blood in vitro using blood from a healthy male volunteer. During repeated intravenous infusion therapy with taurolidine, plasma samples were taken every hour for a period of 13 hours per day in seven patients (three male, four female; mean age 48.4 ± 12.8 years, range 27–66 years) with a glioblastoma. Following dansyl derivatisation, the concentrations of taurultame and taurinamide were determined using a new method based on high-performance liquid chromatography (HPLC) online coupled to electrospray ionisation tandem mass spectrometry (ESI-MS/MS) in the multiple reaction monitoring mode. Under the experimental conditions used, taurolidine could not be determined directly and was back-calculated from the taurultame and taurinamide values.

Results

The new HPLC-ESI-MS/MS method demonstrated high accuracy and reproducibility. In vitro plasma concentrations of taurultame and taurinamide remained constant over the incubation period. In whole blood in vitro, a time-dependent formation of taurinamide was observed. At the start of the incubation, the taurultame-taurinamide ratio (TTR) was 0.95 at an initial taurolidine concentration of 50 μg/mL, and 1.69 at 100 μg/mL. The concentration of taurultame decreased at the same rate as the taurinamide concentration increased, showing logarithmic kinetics. The calculated taurolidine concentration remained largely constant over the 6-hour incubation period. During repeated infusions in patients, calculated plasma concentrations of taurolidine showed a strong increase after the start of each infusion and continued to increase until the end of infusion, followed by a rapid decline. The TTR was found to fluctuate between 0.1 and 0.3, depending on the relation to the previous or next infusion period. The volume of distribution was markedly higher for taurolidine, taurultame and taurinamide than the plasma volume.

Conclusions

Taurolidine displayed a stable pattern of derivatives in plasma in vitro, whereas in whole blood, a time- and concentration-dependent conversion was apparent. In patients, the calculated average taurolidine plasma concentration, achieved with the repeated infusion regimen, was in the antineoplastic-effective concentration range. The tissue concentrations of taurolidine and taurultame are expected to be higher than the plasma concentrations, taking into account the calculated volumes of distribution. Repeated infusion of taurolidine is the thera-peutically adequate mode of administration for the indication of glioblastoma.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgements

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Department of Neurosurgery, Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Ruediger Stendel & Ingo Fiss

  2. Institute of Pharmacology, University of Zurich, Switzerland

    Louis Scheurer & Hanns M. öhler

  3. Department of Chemistry and Applied Biosciences, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland

    Louis Scheurer & Hanns M. öhler

  4. Institute for Clinical Chemistry and Laboratory Medicine, University Hospital, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany

    Kathrin Schlatterer

  5. Institute of Organic Chemistry, University of Zurich, Zurich, Switzerland

    Urs Stalder & Laurent Bigler

  6. Weggis-Lucerne, Switzerland

    Rolf W. Pfirrmann

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  1. Ruediger Stendel
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Correspondence to Ruediger Stendel.

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Stendel, R., Scheurer, L., Schlatterer, K. et al. Pharmacokinetics of Taurolidine following Repeated Intravenous Infusions Measured by HPLC-ESI-MS/MS of the Derivatives Taurultame and Taurinamide in Glioblastoma Patients. Clin Pharmacokinet 46, 513–524 (2007). https://doi.org/10.2165/00003088-200746060-00005

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