SlideShare una empresa de Scribd logo
1 de 17
BIOEQUVALENCE
AND
BIOAVAILBILITY
Manoj Kumar Pandey
Definition Of Bioavailability (BA)
FDA Official statement (1997)
The rate and extent to which the active ingredient
of therapeutic moiety is absorbed from a drug
product and becomes available at the site of
action .
 The

extent of bioavailability: AUC , Cmax
 Rate of availability: Rate of availability: C Cmax
max, , T Tmax
Definition Of Bioequivalence (BE)
FDA Official statement (1997)
Two formulations are said to be bioequivalent if
″The rate and extent of absorption of the test drug do
not show a significant difference from the rate and
extent of absorption of the reference drug, when
administered at the same molar dose of the
therapeutic ingredient under similar experimental
conditions in either single dose or multiple doses ″
WHEN BA/BE STAUDIES DO


Clinical Service Form to Final Market Form



Change of formulations (capsules to tablet)



Generic Formulations



Change of Process or manufacturing site (some times)
BA/BE PARAMETERS
Following s are the BA/BE parameters

Cmax-This is the maximum drug concentration achieved in
systemic circulation following drug administration .



AUC0-t- Area under the plasma concentration – time curve
from 0 h to last sampling time.



AUC0-inf - Area under the plasma concentration – time curve
from 0 h to infinity time .
Contd..
 Tmax-

It is the time required to achieve maximum drug
concentration in systemic circulation .
 Kel
 Thalf-

It is the time necessary to reduce the drug
concentration in blood ,plasma or serum to one-half after
equilibrium is reached .
Different
Need for Conducting BA/BE Studies
BA
 To evaluate the absolute systemic availability To active drug
substance from a dosage form
 To

 To

estimate the inter and intra subject variability
study the effect of food on bioavailability
Need for Conducting BA/BE Studies
BE
 When significant changes are made in the manufacture of
the marketed
 When a new generic formulation is tested against the
innovator ’s marketed product
Analysis of Data for Bioequivalence
Determination


Calculation of the natural log of the AUC and Cmax data The
FDA advocates logarithmically transforming AUC and Cmax
data prior to analysis.



Calculation of the difference between the transformed data for
each metric for each subject



The transformed value of the reference AUC is subtracted
from the transformed value of the test AUC for each patient.
This procedure is repeated for the transformed Cmax values.



Calculation of the mean difference between the trans-formed
data.
Contd..


Calculation of the standard deviation of the difference
between the transformed data.



Calculation of the P value of Difference



Calculation of the high and low bounds of confidence intervals
about the mean difference of the transformed data.



Calculation of the intra subject and inter subject variability.



Power calculation .
Decision rule


Bioequivalence is concluded if the confidence intervals about
the ratio of AUC and Cmax both fall within the range of 0.81.25. That is the lower bounds of the confidence intervals must
be greater than or equal to 0.8 and the upper bounds of the
confidence intervals must be less than or equal to 1.25. In the
present example, bioequivalence is not concluded as the lower
bound of each confidence interval is less than 0.8.
Snap Shot of BA/BE With 2x2
Cross Over Design
Two way crossover design
Two way crossover design
 The

BA/BE studies mostly conducted with standard two way
crossover design for regulatory submission
stats
Least Square Mean (LSM)
Test - T
Reference - R
Geometric LSM*
Test - T
Reference - R
LSM Difference (T - R)
SE Difference
p-value (Difference)
Geometric LSM Ratio (%)
Test - T / Reference - R (%)
90% Confidence Interval (%)
Test - T vs. Reference - R
Lower Confidence Limit
Upper Confidence Limit
Intra-Subject Variability (CV %)
Inter-Subject Variability (CV %)
Power (%)

AUCT

AUCI

CMAX

2.9521
2.8817

3.0065
2.9486

0.547
0.5266

19.15
17.84
0.0705
0.081
0.3901

20.22
19.08
0.058
0.0778
0.4615

1.73
1.69
0.0204
0.0833
0.808

107.3

105.97

102.06

93.57
123.04
35.33
23.21
76.3

92.9
120.87
33.88
20.38
79.53

88.66
117.49
36.4
19.92
73.93
ANOVA Table
source
df
ss
ms
fvalue probf
Sequence
1 0.301686 0.301686
2.57 0.1185
Subject(Sequence)
34 7.567339 0.222569
1.89 0.0336
Period
1 0.013442 0.013442
0.11 0.7374
Treatment
1 0.089132 0.089132
0.76 0.3901
Residual
34 3.998678 0.117608 --------Sequence*
1 0.301686 0.301686
1.36 0.2524
Intra-Subject Variability (CV %) =
35.33
Inter-Subject Variability (CV %) =
23.21

Más contenido relacionado

Destacado

英語での効果的な研究プレゼンのコツと技法ワークショップ
英語での効果的な研究プレゼンのコツと技法ワークショップ英語での効果的な研究プレゼンのコツと技法ワークショップ
英語での効果的な研究プレゼンのコツと技法ワークショップ
英文校正エディテージ
 
Homework1 presentation
Homework1 presentationHomework1 presentation
Homework1 presentation
James Donnelly
 
[Editage Seminar] Common language mistakes made by Japanese authors and essen...
[Editage Seminar] Common language mistakes made by Japanese authors and essen...[Editage Seminar] Common language mistakes made by Japanese authors and essen...
[Editage Seminar] Common language mistakes made by Japanese authors and essen...
英文校正エディテージ
 
Report text elephant vina 9c 32
Report text elephant vina 9c 32Report text elephant vina 9c 32
Report text elephant vina 9c 32
Vina Herlinasari
 

Destacado (13)

уцмр
уцмруцмр
уцмр
 
英語での効果的な研究プレゼンのコツと技法ワークショップ
英語での効果的な研究プレゼンのコツと技法ワークショップ英語での効果的な研究プレゼンのコツと技法ワークショップ
英語での効果的な研究プレゼンのコツと技法ワークショップ
 
研究成果の発表に効果的な図表の使い方
研究成果の発表に効果的な図表の使い方研究成果の発表に効果的な図表の使い方
研究成果の発表に効果的な図表の使い方
 
Homework1 presentation
Homework1 presentationHomework1 presentation
Homework1 presentation
 
Cep 812
Cep 812Cep 812
Cep 812
 
How to personally brand yourself - The Marketing Muse 360
How to personally brand yourself   - The Marketing Muse 360 How to personally brand yourself   - The Marketing Muse 360
How to personally brand yourself - The Marketing Muse 360
 
уцмр
уцмруцмр
уцмр
 
インパクトファクターとジャーナルの名声を評価するその他の指標
インパクトファクターとジャーナルの名声を評価するその他の指標インパクトファクターとジャーナルの名声を評価するその他の指標
インパクトファクターとジャーナルの名声を評価するその他の指標
 
優れたタイトルとアブストラクト、適切なキーワード選び
優れたタイトルとアブストラクト、適切なキーワード選び優れたタイトルとアブストラクト、適切なキーワード選び
優れたタイトルとアブストラクト、適切なキーワード選び
 
[Editage Seminar] Common language mistakes made by Japanese authors and essen...
[Editage Seminar] Common language mistakes made by Japanese authors and essen...[Editage Seminar] Common language mistakes made by Japanese authors and essen...
[Editage Seminar] Common language mistakes made by Japanese authors and essen...
 
Report text elephant vina 9c 32
Report text elephant vina 9c 32Report text elephant vina 9c 32
Report text elephant vina 9c 32
 
Introduction to the LLVM Compiler System
Introduction to the LLVM  Compiler SystemIntroduction to the LLVM  Compiler System
Introduction to the LLVM Compiler System
 
ジャーナルが論文をリジェクトする最も一般的な理由
ジャーナルが論文をリジェクトする最も一般的な理由ジャーナルが論文をリジェクトする最も一般的な理由
ジャーナルが論文をリジェクトする最も一般的な理由
 

Similar a Bioequvalence and bioavailbility by Manoj Pandey

Jignesh patel,ivivc
Jignesh patel,ivivcJignesh patel,ivivc
Jignesh patel,ivivc
jigs2163
 
Bioavailability studies lecture7
Bioavailability studies lecture7Bioavailability studies lecture7
Bioavailability studies lecture7
homebwoi
 
Bioavailability and bioequivalence of Drug Productppt2.pptx
Bioavailability and bioequivalence of Drug Productppt2.pptxBioavailability and bioequivalence of Drug Productppt2.pptx
Bioavailability and bioequivalence of Drug Productppt2.pptx
abhisheksinghcompute
 

Similar a Bioequvalence and bioavailbility by Manoj Pandey (20)

BaBE-Bioavailability and Bioequivalance
BaBE-Bioavailability and BioequivalanceBaBE-Bioavailability and Bioequivalance
BaBE-Bioavailability and Bioequivalance
 
Bioequivalence studies : A statistical approach through "R"
Bioequivalence  studies : A statistical approach through "R"Bioequivalence  studies : A statistical approach through "R"
Bioequivalence studies : A statistical approach through "R"
 
BA-BE Bio-availability and Bio-equivalency
BA-BE Bio-availability and Bio-equivalencyBA-BE Bio-availability and Bio-equivalency
BA-BE Bio-availability and Bio-equivalency
 
In-Vitro-In Vivo (IVIVC).pdf
In-Vitro-In Vivo (IVIVC).pdfIn-Vitro-In Vivo (IVIVC).pdf
In-Vitro-In Vivo (IVIVC).pdf
 
IN-VITRO-IN VIVO CORRELATION (IVIVC).pptx
IN-VITRO-IN VIVO CORRELATION (IVIVC).pptxIN-VITRO-IN VIVO CORRELATION (IVIVC).pptx
IN-VITRO-IN VIVO CORRELATION (IVIVC).pptx
 
Bioavailability and bioequivalence
Bioavailability and bioequivalenceBioavailability and bioequivalence
Bioavailability and bioequivalence
 
Bioavailability and Bioequivalence Studies
Bioavailability and Bioequivalence StudiesBioavailability and Bioequivalence Studies
Bioavailability and Bioequivalence Studies
 
Bioequivalence studies ( Evaluation and Study design)
Bioequivalence studies ( Evaluation and Study design)Bioequivalence studies ( Evaluation and Study design)
Bioequivalence studies ( Evaluation and Study design)
 
Bioavailability & Bioequivalence.ppt
Bioavailability & Bioequivalence.pptBioavailability & Bioequivalence.ppt
Bioavailability & Bioequivalence.ppt
 
Bioequivalence of Highly Variable Drug Products
Bioequivalence of Highly Variable Drug ProductsBioequivalence of Highly Variable Drug Products
Bioequivalence of Highly Variable Drug Products
 
Bioequivalence of Highly Variable Drug Products
Bioequivalence of Highly Variable Drug ProductsBioequivalence of Highly Variable Drug Products
Bioequivalence of Highly Variable Drug Products
 
Jignesh patel,ivivc
Jignesh patel,ivivcJignesh patel,ivivc
Jignesh patel,ivivc
 
bioequivalence
bioequivalencebioequivalence
bioequivalence
 
Babe bppk
Babe bppkBabe bppk
Babe bppk
 
Dissolution profile comparisons
Dissolution profile comparisonsDissolution profile comparisons
Dissolution profile comparisons
 
Bioavailability studies lecture7
Bioavailability studies lecture7Bioavailability studies lecture7
Bioavailability studies lecture7
 
10th VOF - 11.2 Bioequivalence..pptx
10th VOF - 11.2 Bioequivalence..pptx10th VOF - 11.2 Bioequivalence..pptx
10th VOF - 11.2 Bioequivalence..pptx
 
Biopharmaceutics Applications in drug studies
Biopharmaceutics Applications in drug studiesBiopharmaceutics Applications in drug studies
Biopharmaceutics Applications in drug studies
 
10th VOF - 11.2 Bioequivalence..pptx
10th VOF - 11.2 Bioequivalence..pptx10th VOF - 11.2 Bioequivalence..pptx
10th VOF - 11.2 Bioequivalence..pptx
 
Bioavailability and bioequivalence of Drug Productppt2.pptx
Bioavailability and bioequivalence of Drug Productppt2.pptxBioavailability and bioequivalence of Drug Productppt2.pptx
Bioavailability and bioequivalence of Drug Productppt2.pptx
 

Último

Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
9953056974 Low Rate Call Girls In Saket, Delhi NCR
 

Último (20)

Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
 
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
 
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
 

Bioequvalence and bioavailbility by Manoj Pandey

  • 2. Definition Of Bioavailability (BA) FDA Official statement (1997) The rate and extent to which the active ingredient of therapeutic moiety is absorbed from a drug product and becomes available at the site of action .  The extent of bioavailability: AUC , Cmax  Rate of availability: Rate of availability: C Cmax max, , T Tmax
  • 3. Definition Of Bioequivalence (BE) FDA Official statement (1997) Two formulations are said to be bioequivalent if ″The rate and extent of absorption of the test drug do not show a significant difference from the rate and extent of absorption of the reference drug, when administered at the same molar dose of the therapeutic ingredient under similar experimental conditions in either single dose or multiple doses ″
  • 4. WHEN BA/BE STAUDIES DO  Clinical Service Form to Final Market Form  Change of formulations (capsules to tablet)  Generic Formulations  Change of Process or manufacturing site (some times)
  • 5. BA/BE PARAMETERS Following s are the BA/BE parameters Cmax-This is the maximum drug concentration achieved in systemic circulation following drug administration .  AUC0-t- Area under the plasma concentration – time curve from 0 h to last sampling time.  AUC0-inf - Area under the plasma concentration – time curve from 0 h to infinity time .
  • 6. Contd..  Tmax- It is the time required to achieve maximum drug concentration in systemic circulation .  Kel  Thalf- It is the time necessary to reduce the drug concentration in blood ,plasma or serum to one-half after equilibrium is reached .
  • 8. Need for Conducting BA/BE Studies BA  To evaluate the absolute systemic availability To active drug substance from a dosage form  To  To estimate the inter and intra subject variability study the effect of food on bioavailability
  • 9. Need for Conducting BA/BE Studies BE  When significant changes are made in the manufacture of the marketed  When a new generic formulation is tested against the innovator ’s marketed product
  • 10. Analysis of Data for Bioequivalence Determination  Calculation of the natural log of the AUC and Cmax data The FDA advocates logarithmically transforming AUC and Cmax data prior to analysis.  Calculation of the difference between the transformed data for each metric for each subject  The transformed value of the reference AUC is subtracted from the transformed value of the test AUC for each patient. This procedure is repeated for the transformed Cmax values.  Calculation of the mean difference between the trans-formed data.
  • 11. Contd..  Calculation of the standard deviation of the difference between the transformed data.  Calculation of the P value of Difference  Calculation of the high and low bounds of confidence intervals about the mean difference of the transformed data.  Calculation of the intra subject and inter subject variability.  Power calculation .
  • 12. Decision rule  Bioequivalence is concluded if the confidence intervals about the ratio of AUC and Cmax both fall within the range of 0.81.25. That is the lower bounds of the confidence intervals must be greater than or equal to 0.8 and the upper bounds of the confidence intervals must be less than or equal to 1.25. In the present example, bioequivalence is not concluded as the lower bound of each confidence interval is less than 0.8.
  • 13. Snap Shot of BA/BE With 2x2 Cross Over Design
  • 15. Two way crossover design  The BA/BE studies mostly conducted with standard two way crossover design for regulatory submission
  • 16. stats Least Square Mean (LSM) Test - T Reference - R Geometric LSM* Test - T Reference - R LSM Difference (T - R) SE Difference p-value (Difference) Geometric LSM Ratio (%) Test - T / Reference - R (%) 90% Confidence Interval (%) Test - T vs. Reference - R Lower Confidence Limit Upper Confidence Limit Intra-Subject Variability (CV %) Inter-Subject Variability (CV %) Power (%) AUCT AUCI CMAX 2.9521 2.8817 3.0065 2.9486 0.547 0.5266 19.15 17.84 0.0705 0.081 0.3901 20.22 19.08 0.058 0.0778 0.4615 1.73 1.69 0.0204 0.0833 0.808 107.3 105.97 102.06 93.57 123.04 35.33 23.21 76.3 92.9 120.87 33.88 20.38 79.53 88.66 117.49 36.4 19.92 73.93
  • 17. ANOVA Table source df ss ms fvalue probf Sequence 1 0.301686 0.301686 2.57 0.1185 Subject(Sequence) 34 7.567339 0.222569 1.89 0.0336 Period 1 0.013442 0.013442 0.11 0.7374 Treatment 1 0.089132 0.089132 0.76 0.3901 Residual 34 3.998678 0.117608 --------Sequence* 1 0.301686 0.301686 1.36 0.2524 Intra-Subject Variability (CV %) = 35.33 Inter-Subject Variability (CV %) = 23.21