Development and validation of a UHPLC-MS/MS method for quantification of the prodrug remdesivir and its metabolite GS-441524: a tool for clinical pharmacokinetics of SARS-CoV-2/COVID-19 and Ebola virus disease

J Antimicrob Chemother. 2020 Jul 1;75(7):1772-1777. doi: 10.1093/jac/dkaa152.

Abstract

Background: Remdesivir has received significant attention for its potential application in the treatment of COVID-19, caused by SARS-CoV-2. Remdesivir has already been tested for Ebola virus disease treatment and found to have activity against SARS and MERS coronaviruses. The remdesivir core contains GS-441524, which interferes with RNA-dependent RNA polymerases alone. In non-human primates, following IV administration, remdesivir is rapidly distributed into PBMCs and converted within 2 h to the active nucleoside triphosphate form, while GS-441524 is detectable in plasma for up to 24 h. Nevertheless, remdesivir pharmacokinetics and pharmacodynamics in humans are still unexplored, highlighting the need for a precise analytical method for remdesivir and GS-441524 quantification.

Objectives: The validation of a reliable UHPLC-MS/MS method for remdesivir and GS-441524 quantification in human plasma.

Methods: Remdesivir and GS-441524 standards and quality controls were prepared in plasma from healthy donors. Sample preparation consisted of protein precipitation, followed by dilution and injection into the QSight 220 UHPLC-MS/MS system. Chromatographic separation was obtained through an Acquity HSS T3 1.8 μm, 2.1 × 50 mm column, with a gradient of water and acetonitrile with 0.05% formic acid. The method was validated using EMA and FDA guidelines.

Results: Analyte stability has been evaluated and described in detail. The method successfully fulfilled the validation process and it was demonstrated that, when possible, sample thermal inactivation could be a good choice in order to improve biosafety.

Conclusions: This method represents a useful tool for studying remdesivir and GS-441524 clinical pharmacokinetics, particularly during the current COVID-19 outbreak.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives*
  • Adenosine Monophosphate / analysis
  • Adenosine Monophosphate / blood
  • Adenosine Monophosphate / pharmacokinetics
  • Adenosine Triphosphate / analogs & derivatives*
  • Adenosine Triphosphate / analysis
  • Adenosine Triphosphate / blood
  • Adenosine Triphosphate / pharmacokinetics
  • Alanine / analogs & derivatives*
  • Alanine / analysis
  • Alanine / blood
  • Alanine / pharmacokinetics
  • Betacoronavirus
  • COVID-19
  • COVID-19 Drug Treatment
  • Chromatography, High Pressure Liquid / methods*
  • Coronavirus Infections / drug therapy
  • Hemorrhagic Fever, Ebola / drug therapy*
  • Humans
  • Pandemics
  • Pneumonia, Viral / drug therapy
  • SARS-CoV-2
  • Sensitivity and Specificity
  • Tandem Mass Spectrometry / methods*

Substances

  • remdesivir
  • Adenosine Monophosphate
  • Adenosine Triphosphate
  • GS-441524 triphosphate
  • Alanine