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Determination of Rifapentine and 25-O-desacetyl Rifapentine from 100 µl human breastmilk by LC-MS/MS using protein precipitation and solid phase extraction

There is currently no information available on the transfer of the second-line anti-TB drug, rifapentine and its metabolite, into breastmilk. The subsequent implications to the breastfed infant, as well as consequences of long-term exposure to potentially sub-therapeutic drug levels with regards to...

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Main Author: Mkhize, Buyisile
Other Authors: Wiesner, Lubbe
Format: Thesis
Language:English
Published: Department of Medicine 2020
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access_status_str Open Access
author Mkhize, Buyisile
author2 Wiesner, Lubbe
author_browse Mkhize, Buyisile
Wiesner, Lubbe
author_facet Wiesner, Lubbe
Mkhize, Buyisile
author_sort Mkhize, Buyisile
collection Thesis
description There is currently no information available on the transfer of the second-line anti-TB drug, rifapentine and its metabolite, into breastmilk. The subsequent implications to the breastfed infant, as well as consequences of long-term exposure to potentially sub-therapeutic drug levels with regards to the development of drug resistant bacteria is therefore not known. A liquid chromatography method with detection by mass spectrometry (LC-MS/MS) is described for the quantification of rifapentine and its metabolite, 25-O-desacetyl rifapentine in human breastmilk, using rifampicin-d3 as an internal standard. An AB Sciex 4000 mass spectrometer at unit resolution in the multiple reaction monitoring (MRM) mode was used to monitor the transition of the protonated precursor ions m/z 877.5, m/z 835.4 and m/z 827.4 to the product ions m/z 151.1, m/z 453.2 and m/z 151.200 for rifapentine, 25-Odesacetyl rifapentine and rifampicin-d3, respectively. Ions were produced using Electro spray ionisation (ESI) in the positive ionisation mode. An Agilent Poroshell 120 EC-C18 (4.6 x 50 mm, 2.7 μm) column was used for chromatographic separation using an isocratic method of acetonitrile containing 0.1% formic acid and water containing 10% methanol and 0.1% formic acid (55:45, v/v), at a flow rate of 450 µl per minute. The retention times for rifapentine, 25- O-desacetyl rifapentine and rifampicin-d3 were ≈2.67, ≈1.88 and ≈1.96 minutes, respectively. The method was developed and validated according to FDA guidelines. The extraction method consisted of a combination of protein precipitation and C18 solid phase extraction. Rifapentine and 25-O-desacetyl rifapentine showed no significant carry over on the Agilent autosampler. The method was reproducible when analysed with human breastmilk from six different sources from Western Cape Maternity Breastmilk Bank. Rifapentine mean extraction yield was 84.2% (%CV = 1.7) and that of 25-O-desacetyl rifapentine was 71.1% (%CV = 10.8). Rifapentine had a mean process efficiency of 80.4% (%CV = 4.7) and that of 25-O-desacetyl rifapentine was 95.7% (%CV = 5.7). Intra- and inter day validations over 3 days were performed. The calibration curves fit a quadratic regression with 1/x weighting over a concentration range of 2 - 2000 ng/ml for both rifapentine and 25-Odesacetyl rifapentine based on the analyte/internal standard peak area ratios, the accuracy ranged from 92.9% to 105.5% for both rifapentine and 25-O-desacetyl rifapentine standards. The Quality Controls accuracy ranged from 97.4% to 106.0% for both rifapentine and 25-Odesacetyl rifapentine. Stock solutions were shown to be stable for 69 days at -80°C. v Rifapentine and 25-O-desacetyl rifapentine were stable in human breastmilk for up to 72 hours at approximately -80°C and -20°C, on benchtop for ≈4.5 hours on ice and after three freeze-thaw cycles. Rifapentine and 25-O-desacetyl rifapentine were shown to be stable on the autosampler over a period of approximately 48 hours after which the entire batch could be reinjected. Autosampler stability revealed a decrease in peak area ratios, indicating that a partial batch cannot be reinjected after 48 hours in case of instrument failure. This method will be utilized in the analysis of patient samples from a clinical study in South Africa in breastfeeding women with tuberculosis.
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institution University of Cape Town (South Africa)
language eng
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2020
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/32087 Determination of Rifapentine and 25-O-desacetyl Rifapentine from 100 µl human breastmilk by LC-MS/MS using protein precipitation and solid phase extraction Mkhize, Buyisile Wiesner, Lubbe Kellermann, Tracy Norman, Jennifer Clinical Pharmacology There is currently no information available on the transfer of the second-line anti-TB drug, rifapentine and its metabolite, into breastmilk. The subsequent implications to the breastfed infant, as well as consequences of long-term exposure to potentially sub-therapeutic drug levels with regards to the development of drug resistant bacteria is therefore not known. A liquid chromatography method with detection by mass spectrometry (LC-MS/MS) is described for the quantification of rifapentine and its metabolite, 25-O-desacetyl rifapentine in human breastmilk, using rifampicin-d3 as an internal standard. An AB Sciex 4000 mass spectrometer at unit resolution in the multiple reaction monitoring (MRM) mode was used to monitor the transition of the protonated precursor ions m/z 877.5, m/z 835.4 and m/z 827.4 to the product ions m/z 151.1, m/z 453.2 and m/z 151.200 for rifapentine, 25-Odesacetyl rifapentine and rifampicin-d3, respectively. Ions were produced using Electro spray ionisation (ESI) in the positive ionisation mode. An Agilent Poroshell 120 EC-C18 (4.6 x 50 mm, 2.7 μm) column was used for chromatographic separation using an isocratic method of acetonitrile containing 0.1% formic acid and water containing 10% methanol and 0.1% formic acid (55:45, v/v), at a flow rate of 450 µl per minute. The retention times for rifapentine, 25- O-desacetyl rifapentine and rifampicin-d3 were ≈2.67, ≈1.88 and ≈1.96 minutes, respectively. The method was developed and validated according to FDA guidelines. The extraction method consisted of a combination of protein precipitation and C18 solid phase extraction. Rifapentine and 25-O-desacetyl rifapentine showed no significant carry over on the Agilent autosampler. The method was reproducible when analysed with human breastmilk from six different sources from Western Cape Maternity Breastmilk Bank. Rifapentine mean extraction yield was 84.2% (%CV = 1.7) and that of 25-O-desacetyl rifapentine was 71.1% (%CV = 10.8). Rifapentine had a mean process efficiency of 80.4% (%CV = 4.7) and that of 25-O-desacetyl rifapentine was 95.7% (%CV = 5.7). Intra- and inter day validations over 3 days were performed. The calibration curves fit a quadratic regression with 1/x weighting over a concentration range of 2 - 2000 ng/ml for both rifapentine and 25-Odesacetyl rifapentine based on the analyte/internal standard peak area ratios, the accuracy ranged from 92.9% to 105.5% for both rifapentine and 25-O-desacetyl rifapentine standards. The Quality Controls accuracy ranged from 97.4% to 106.0% for both rifapentine and 25-Odesacetyl rifapentine. Stock solutions were shown to be stable for 69 days at -80°C. v Rifapentine and 25-O-desacetyl rifapentine were stable in human breastmilk for up to 72 hours at approximately -80°C and -20°C, on benchtop for ≈4.5 hours on ice and after three freeze-thaw cycles. Rifapentine and 25-O-desacetyl rifapentine were shown to be stable on the autosampler over a period of approximately 48 hours after which the entire batch could be reinjected. Autosampler stability revealed a decrease in peak area ratios, indicating that a partial batch cannot be reinjected after 48 hours in case of instrument failure. This method will be utilized in the analysis of patient samples from a clinical study in South Africa in breastfeeding women with tuberculosis. 2020-06-29T09:34:22Z 2020-06-29T09:34:22Z 2019 2020-06-29T09:34:00Z Master Thesis Masters MPhil https://hdl.handle.net/11427/32087 eng application/pdf Department of Medicine Faculty of Health Sciences
spellingShingle Clinical Pharmacology
Mkhize, Buyisile
Determination of Rifapentine and 25-O-desacetyl Rifapentine from 100 µl human breastmilk by LC-MS/MS using protein precipitation and solid phase extraction
thesis_degree_str Master's
title Determination of Rifapentine and 25-O-desacetyl Rifapentine from 100 µl human breastmilk by LC-MS/MS using protein precipitation and solid phase extraction
title_full Determination of Rifapentine and 25-O-desacetyl Rifapentine from 100 µl human breastmilk by LC-MS/MS using protein precipitation and solid phase extraction
title_fullStr Determination of Rifapentine and 25-O-desacetyl Rifapentine from 100 µl human breastmilk by LC-MS/MS using protein precipitation and solid phase extraction
title_full_unstemmed Determination of Rifapentine and 25-O-desacetyl Rifapentine from 100 µl human breastmilk by LC-MS/MS using protein precipitation and solid phase extraction
title_short Determination of Rifapentine and 25-O-desacetyl Rifapentine from 100 µl human breastmilk by LC-MS/MS using protein precipitation and solid phase extraction
title_sort determination of rifapentine and 25 o desacetyl rifapentine from 100 µl human breastmilk by lc ms ms using protein precipitation and solid phase extraction
topic Clinical Pharmacology
url https://hdl.handle.net/11427/32087
work_keys_str_mv AT mkhizebuyisile determinationofrifapentineand25odesacetylrifapentinefrom100μlhumanbreastmilkbylcmsmsusingproteinprecipitationandsolidphaseextraction