Gastrointestinal pH and Transit Time Profiling in Healthy Volunteers Using the IntelliCap System Confirms Ileo-Colonic Release of ColoPulse Tablets

INTRODUCTION: ColoPulse tablets are an innovative development in the field of oral dosage forms characterized by a distal ileum and colon-specific release. Previous studies in humans showed release in the ileo-colonic region, but the relationship between gastrointestinal pH and release was not experimentally proven in vivo. This information will complete the in vivo release-profile of ColoPulse tablets. MATERIALS AND METHODS: Release from ColoPulse tablets was studied in 16 healthy volunteers using the dual label isotope strategy. To determine gastrointestinal pH profiles and transit times the IntelliCap system was used. A ColoPulse tablet containing (13)C-urea and an uncoated, immediate release tablet containing (15)N(2)-urea were taken simultaneously followed by a standardized breakfast after three hours. Five minutes after intake of the tablets the IntelliCap capsule was swallowed and pH was measured until excretion in the feces. Breath and urine samples were collected for isotope analysis. RESULTS: Full analysis could be performed in 12 subjects. Median bioavailability of (13)C -urea was 82% (95% CI 74–94%, range 61–114%). The median lag time (5% release of (13)C) was 5:42 h (95% CI 5:18–6:18 h, range 2:36–6:36 h,) There was no statistically significant difference between lag time based on isotope signal and colon arrival time (CAT) based on pH (median 5:42 vs 5:31 h p = 0.903). In all subjects an intestinal pH value of 7.0 was reached before release of (13)C from the ColoPulse tablet occurred. DISCUSSION AND CONCLUSIONS: From the combined data from the IntelliCap system and the (13)C -isotope signal it can be concluded that release from a ColoPulse tablet in vivo is not related to transit times but occurs in the ileo-colonic region after pH 7.0 is reached. This supports our earlier findings and confirms that the ColoPulse system is a promising delivery system for targeting the distal ileum and colon. TRIAL REGISTRATION: ISRCTN Registry 18301880