[Vaccine cold chain interruption in a primary care center and economic evaluation]

Minimizing polyphenols and enzymes degradation using hydrogel packaging with combined evaporative and daytime radiative cooling functions during ambient transportation

Polyphenols and enzymes usually suffer from degradation during transportation due to the lack of a cold chain system in developing countries and regions. In this study, anthocyanin and trypsin were selected as examples of polyphenols and enzymes and investigated for minimizing their degradation during ambient transportation using hydrogel packaging with combined evaporative and daytime radiative cooling functions. A polyacrylamide/polyvinyl alcohol contained with nanoparticles (NPs@PAAm/PVA) hydrogel packaging was thus developed. The NPs@PAAm/PVA packaging exhibited desirable swelling behaviour, high solar reflectance, and strong atmospheric emissivity to synergistically achieve evaporative and daytime radiative cooling. The indoor experiments indicated that the vial with NPs@PAAm/PVA packaging realised sub-ambient temperatures under different working temperatures and humidities, and the field tests indicated that the vial with NPs@PAAm/PVA packaging could effectively preserve the anthocyanin and trypsin without degradation caused by strong sunlight and high temperature. Consequently, the NPs@PAAm/PVA packaging with evaporative and daytime radiative cooling effects has promising prospects for anthocyanin and trypsin transportation in an energy-saving and sustainable manner.

Validity of an instrument to evaluate the immunobiological cold chain

Objective: To develop and to test the validity of content and layout of a multidimensional tool to evaluate maintenance of the cold chain for immunobiological conservation.Method: A methodological study carried out in three steps: integrative review; development of theoretical and logical model for the development of the tool; implementation of the Delphi Technique to test the validity of content and layout. The Content Validity Index (CVI) and Content Validity Ratio (CVR) were calculated considering appropriate those values greater than or equal to 75% and 0.4, respectively.Results: The instrument consisted of 7 questions about structure and 20 about process, subdivided into three components: Transportation/Reception (n=3); Storage/Handling (n=13); Supervision/Permanent education (n=4). The CVI value was 87.4%, with values equal to 85.7% and 89% in the structure and process dimensions, respectively. The process components obtained CVI values equal to 88.9, 88.9 and 89.2%, respectively. The CVR was 0.8, with values equal to 0.7 and 0.8 in the structure and process dimensions. As for the layout validation, the questionnaire was considered intelligible.Conclusion: The study provides an instrument with validity of content and layout for health professionals in charge of the supervision of activities of immunobiological conservation, ensuring the maintenance of the immunogenic quality of the products offered to the population.

The Effect of Fluctuating Temperature on the Stability of Turoctocog Alfa for Hemophilia A

Background and objective

Factor VIII (FVIII) is indicated for the prevention or treatment of bleeding in patients with hemophilia A. FVIII product stability under high and fluctuating temperatures is important, particularly for patients who reside in, or travel to, regions with high ambient temperatures, as they may remove their product from the refrigerator and return it, unused, multiple times. We evaluated the effect of variable temperature storage conditions, including up to 40 °C, on the stability of the recombinant FVIII product, turoctocog alfa.

Methods

Turoctocog alfa dry powder stability was assessed when moved between storage conditions of 5 °C (ambient humidity) and 40 °C (75% relative humidity) multiple times over a 2-month period, followed by long-term storage at 40 °C for 3 months and 5 °C for 1 month. Three product strengths (250, 1500, and 3000 IU), including the lowest and highest doses, were evaluated. Stability assessments included potency, purity, oxidized forms, high molecular weight protein (HMWP), and water content.

Results

Overall, the three doses of turoctocog alfa tested remained stable under varying temperature conditions, without any potency or purity impairment, nor were any major increases in oxidized forms, HMWP, or water content observed. All results were within shelf-life specification limits.

Conclusion

The results demonstrated that turoctocog alfa can be subjected to variable storage conditions, including cycling between 5 °C and ≤ 40 °C, and subsequent storage for 3 months up to 40 °C, without loss of stability. This suggests that turoctocog alfa may offer greater product storage flexibility for patients in everyday practice, with a potential reduction in wastage.

Evaporative Cooling Hydrogel Packaging for Storing Biologics Outside of the Cold Chain

Stabilizing thermolabile pharmaceuticals outside of the cold chain has the potential to alleviate some of the logistical and monetary burden of providing health care access in the developing world. Evaporative cooling hydrogel packaging is designed to extend the storage stability of existing pharmaceutical products without the need for reformulation. Hydrogels with high water content and reversible hydrophilicity offer a promising platform for reducing storage temperatures without refrigeration. As a model, poly(N-isopropylacrylamide) is selected as a basis for creating a potentially low cost and easy-to-fabricate hydrogels.