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Kassahun H, Van Schepdael A, Ketema G, Adams E. Development and validation of a simple and affordable LC-UV method for identification and assay of selected antimicrobial medicines. J Pharm Biomed Anal 2024; 244:116127. [PMID: 38554556 DOI: 10.1016/j.jpba.2024.116127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/14/2024] [Accepted: 03/25/2024] [Indexed: 04/01/2024]
Abstract
Antimicrobials, particularly antibiotics, are among the most common classes of drugs reported as substandard and falsified (SF) in developing countries. Therefore, it is important to develop simple and affordable analytical methods for the quality control of antimicrobial medicines. In this study, a liquid chromatographic method with ultraviolet detection (LC-UV) was developed and validated for the screening and quantification of 13 antimicrobial medicines and one beta-lactamase inhibitor in pharmaceutical formulations. LC separation was carried out on a Kinetex C18 column (150 mm × 4.6 mm, 2.6 µm) with gradient elution. The mobile phase consisted of mixtures of acetonitrile-water-10 mM phosphate buffer pH 3.5 at ratios of 3:92:5, v/v/v for mobile phase A and 50:45:5, v/v/v for mobile phase B with a flow rate of 0.5 mL/min. The screening method was intended for confirmation of the identity of the actives and validated for specificity and robustness, whereas the quantification method (using only a different detection wavelength) was further validated in terms of linearity, accuracy, sensitivity and precision (repeatability, intermediate precision). For all compounds, the method was found to be linear (r2 > 0.999), precise (%RSD < 1%), accurate (% recovery of 98-102%), sensitive, specific and robust. The developed LC method was successfully applied for the identification and assay of 12 antimicrobial samples from Ethiopia. Among the 12 samples analyzed, one (8.3%) product was confirmed to be falsified.
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Affiliation(s)
- Haile Kassahun
- KU Leuven, Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, Herestraat 49, O&N2, PB, 923, Leuven 3000, Belgium; Wollo University, College of Medicine and Health Sciences, Department of Pharmacy P.O. Box 1145, Dessie, , Ethiopia
| | - Ann Van Schepdael
- KU Leuven, Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, Herestraat 49, O&N2, PB, 923, Leuven 3000, Belgium
| | - Gebremariam Ketema
- Wollo University, College of Medicine and Health Sciences, Department of Pharmacy P.O. Box 1145, Dessie, , Ethiopia
| | - Erwin Adams
- KU Leuven, Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, Herestraat 49, O&N2, PB, 923, Leuven 3000, Belgium.
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2
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Vanhee C, Jacobs B, Kamugisha A, Canfyn M, Van Der Meersch H, Ceyssens B, Deconinck E, Van Hoorde K, Willocx M. Substandard and falsified ivermectin tablets obtained for self-medication during the COVID-19 pandemic as a source of potential harm. Drug Test Anal 2023. [PMID: 38043940 DOI: 10.1002/dta.3618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 12/05/2023]
Abstract
In 2019, a global viral pandemic, due to the SARS-CoV-2 virus, broke out. Soon after, the search for a vaccine and/or antiviral medicine began. One of the candidate antiviral medicines tested was ivermectin. Although several health authorities warned the public against the use of this medicine outside clinical trials, the drug was widely used at the end of 2020 and in 2021. Simultaneously, several reports started to emerge demonstrating serious adverse effects after self-medicating with ivermectin. It stands to reason that the self-administration of substandard or falsified (SF) medicines bearing harmful quality deficiencies have contributed to this phenomenon. In order to have a better view on the nature of these harmful quality deficiencies, SF ivermectin samples, intercepted in large quantities by the Belgian regulatory agencies during the period 2021-2022, were analyzed in our official medicines control laboratory. None of the samples (n = 19) were compliant to the quality criteria applicable to medicinal products. These SF products either suffered from a systematic underdosing of the active pharmaceutical ingredient or were severely contaminated with bacteria, two of which were contaminated with known pathogens that cause gastrointestinal illness upon oral intake. In addition to the direct risks of self-medicating with such a product, the improper usage and dosage of ivermectin medication might also facilitate ivermectin tolerance or resistance in parasites. This may have detrimental consequences on a global scale, certainly as the number of newly developed active pharmaceutical ingredients that can safely be used to combat parasites is rather scarce.
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Affiliation(s)
- Celine Vanhee
- Service Medicines and Health Products, Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
| | - Bram Jacobs
- Service of Foodborne Pathogen, Scientific Direction of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Angélique Kamugisha
- Service Medicines and Health Products, Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
| | - Michael Canfyn
- Service Medicines and Health Products, Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
| | | | - Bart Ceyssens
- Federal Agency for Medicine and Health Care Products, Brussels, Belgium
| | - Eric Deconinck
- Service Medicines and Health Products, Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
| | - Koenraad Van Hoorde
- Service of Foodborne Pathogen, Scientific Direction of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Marie Willocx
- Service Medicines and Health Products, Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
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3
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Van Schepdael A. Capillary electrophoresis as a simple and low-cost analytical tool for use in money-constrained situations. Trends Analyt Chem 2023. [DOI: 10.1016/j.trac.2023.116992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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4
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Zabala GA, Bellingham K, Vidhamaly V, Boupha P, Boutsamay K, Newton PN, Caillet C. Substandard and falsified antibiotics: neglected drivers of antimicrobial resistance? BMJ Glob Health 2022; 7:e008587. [PMID: 35981806 PMCID: PMC9394205 DOI: 10.1136/bmjgh-2022-008587] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/10/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Antimicrobial resistance (AMR) is a significant global health threat with substandard and falsified (SF) antibiotics being neglected contributing factors. With their relationships poorly understood, more research is needed in order to determine how interventions to reduce SF antibiotics should be ranked as priorities in national AMR action plans. We assessed the evidence available on the global prevalence of SF antibiotics, examined the quality of the evidence and discussed public health impact. MATERIALS/METHODS We searched PubMed, Embase, Google and Google Scholar for publications on antibiotic quality up to 31 December 2020. Publications reporting on the prevalence of SF antibiotics were evaluated for quantitative analysis and assessed using the Medicines Quality Assessment Reporting Guidelines. RESULTS Of the 10 137 screened publications, 648 were relevant to antibiotic quality. One hundred and six (16.4%) surveys, published between 1992 and 2020 and conducted mainly in low-income and middle-income countries (LMICs) (89.9% (480/534) of the data points), qualified for quantitative analysis. The total number of samples tested for quality in prevalence surveys was 13 555, with a median (Q1-Q3) number of samples per survey of 47 (21-135). Of the 13 555 samples, 2357 (17.4%) failed at least one quality test and the median failure frequency (FF) per survey was 19.6% (7.6%-35.0%). Amoxicillin, sulfamethoxazole-trimethoprim and ciprofloxacin were the most surveyed antibiotics, with FF of 16.1% (355/2208), 26.2% (329/1255) and 10.4% (366/3511), respectively. We identified no SF survey data for antibiotics in the WHO 'Reserve' group. The mean Medicine Quality Assessment Reporting Guidelines score was 11 (95% CI 10.1 to 12.2) out of 26. CONCLUSIONS SF antibiotics are widely spread with higher prevalence in LMICs. The quality of the evidence is poor, and these data are not generalisable that 17.4% of global antibiotic supply is SF. However, the evidence we have suggests that interventions to enhance regulatory, purchasing and financial mechanisms to improve the global antibiotic supply are needed. PROSPERO REGISTRATION NUMBER CRD42019124988.
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Affiliation(s)
- Guillermo A Zabala
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Medicine Quality Research Group, Laboratory of Microbiology, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Nuffield Department of Medicine, Medicine Quality Research Group, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, UK
- Clinical Infection Unit, Saint George's University Hospital NHS Foundation Trust, London, UK
- Nuffield Department of Medicine, Infectious Diseases Data Observatory (IDDO)/WorldWide Antimalarial Resistance Network (WWARN), Medicine Quality Research Group, University of Oxford, Oxford, UK
| | - Khonsavath Bellingham
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Medicine Quality Research Group, Laboratory of Microbiology, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Nuffield Department of Medicine, Medicine Quality Research Group, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, UK
- Nuffield Department of Medicine, Infectious Diseases Data Observatory (IDDO)/WorldWide Antimalarial Resistance Network (WWARN), Medicine Quality Research Group, University of Oxford, Oxford, UK
| | - Vayouly Vidhamaly
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Medicine Quality Research Group, Laboratory of Microbiology, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Nuffield Department of Medicine, Medicine Quality Research Group, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, UK
- Nuffield Department of Medicine, Infectious Diseases Data Observatory (IDDO)/WorldWide Antimalarial Resistance Network (WWARN), Medicine Quality Research Group, University of Oxford, Oxford, UK
| | - Phonepasith Boupha
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Medicine Quality Research Group, Laboratory of Microbiology, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Nuffield Department of Medicine, Medicine Quality Research Group, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, UK
- Nuffield Department of Medicine, Infectious Diseases Data Observatory (IDDO)/WorldWide Antimalarial Resistance Network (WWARN), Medicine Quality Research Group, University of Oxford, Oxford, UK
| | - Kem Boutsamay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Medicine Quality Research Group, Laboratory of Microbiology, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Nuffield Department of Medicine, Medicine Quality Research Group, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, UK
- Nuffield Department of Medicine, Infectious Diseases Data Observatory (IDDO)/WorldWide Antimalarial Resistance Network (WWARN), Medicine Quality Research Group, University of Oxford, Oxford, UK
| | - Paul N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Medicine Quality Research Group, Laboratory of Microbiology, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Nuffield Department of Medicine, Medicine Quality Research Group, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, UK
- Nuffield Department of Medicine, Infectious Diseases Data Observatory (IDDO)/WorldWide Antimalarial Resistance Network (WWARN), Medicine Quality Research Group, University of Oxford, Oxford, UK
| | - Céline Caillet
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Medicine Quality Research Group, Laboratory of Microbiology, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Nuffield Department of Medicine, Medicine Quality Research Group, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, UK
- Nuffield Department of Medicine, Infectious Diseases Data Observatory (IDDO)/WorldWide Antimalarial Resistance Network (WWARN), Medicine Quality Research Group, University of Oxford, Oxford, UK
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5
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Yabré M, Sakira AK, Bandé M, Goumbri BWF, Ouattara SM, Fofana S, Somé TI. Detection of Falsified Antimalarial Sulfadoxine-Pyrimethamine and Dihydroartemisinin-Piperaquine Drugs Using a Low-Cost Handheld Near-Infrared Spectrometer. JOURNAL OF ANALYTICAL METHODS IN CHEMISTRY 2022; 2022:5335936. [PMID: 35558651 PMCID: PMC9090531 DOI: 10.1155/2022/5335936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/20/2022] [Indexed: 06/15/2023]
Abstract
Falsified drugs are of serious concern to public health worldwide, particularly for developing countries where quality control of drugs is inefficient. In law enforcement against such fake medicines, there is a need to develop reliable, fast, and inexpensive screening methods. In this work, the ability of an innovative low-cost handheld near-infrared spectrometer to identify falsifications among two antimalarial fixed dose combination tablets, dihydroartemisinin/piperaquine and sulfadoxine/pyrimethamine, has been investigated. Analyzed samples were collected in Burkina Faso mainly in rural transborder areas that could be infiltrated by illicit drugs. A principal component analysis was applied on the acquired near-infrared spectra to identify trends, similarities, and differences between collected samples. This allowed to detect some samples of dihydroartemisinin/piperaquine and sulfadoxine/pyrimethamine which seemed to be falsified. These suspicious samples were semiquantitatively analyzed by thin-layer chromatography using Minalab® kits. Obtained results allowed to confirm the falsifications since the suspected samples did not contain any of the expected active pharmaceutical ingredients. The capacity of the low-cost near-infrared device to identify specifically a brand name of dihydroartemisinin/piperaquine or sulfadoxine/pyrimethamine has been also studied using soft independent modelling of class analogy (SIMCA) in the classical and data driven versions. The built models allowed a clear brand identification with 100% of both sensitivity and specificity in the studied cases. All these results demonstrate the potential of these low-cost near-infrared spectrometers to be used as first line screening tools, particularly in resource limited laboratories, for the detection of falsified antimalarial drugs.
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Affiliation(s)
- Moussa Yabré
- Higher Institute of Health Sciences (INSSA), Nazi BONI University, Bobo-Dioulasso, 01 P.O. Box 1091, Burkina Faso
- Laboratoire de Toxicologie Environnement et Santé (LATES), Joseph KI-ZERBO University, Ouagadougou, 03 P.O. Box 7021, Burkina Faso
| | - Abdoul Karim Sakira
- Laboratoire de Toxicologie Environnement et Santé (LATES), Joseph KI-ZERBO University, Ouagadougou, 03 P.O. Box 7021, Burkina Faso
| | - Moumouni Bandé
- Laboratoire de Toxicologie Environnement et Santé (LATES), Joseph KI-ZERBO University, Ouagadougou, 03 P.O. Box 7021, Burkina Faso
| | - Bertrand W. F. Goumbri
- Laboratoire de Toxicologie Environnement et Santé (LATES), Joseph KI-ZERBO University, Ouagadougou, 03 P.O. Box 7021, Burkina Faso
| | - Sandrine M. Ouattara
- Laboratoire de Toxicologie Environnement et Santé (LATES), Joseph KI-ZERBO University, Ouagadougou, 03 P.O. Box 7021, Burkina Faso
| | - Souleymane Fofana
- Higher Institute of Health Sciences (INSSA), Nazi BONI University, Bobo-Dioulasso, 01 P.O. Box 1091, Burkina Faso
| | - Touridomon Issa Somé
- Laboratoire de Toxicologie Environnement et Santé (LATES), Joseph KI-ZERBO University, Ouagadougou, 03 P.O. Box 7021, Burkina Faso
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6
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Duchateau C, Canfyn M, Desmedt B, Kauffmann JM, Stévigny C, De Braekeleer K, Deconinck E. CBD oils on the Belgian market: A validated MRM GC-MS/MS method for routine quality control using QuEChERS sample clean up. J Pharm Biomed Anal 2021; 205:114344. [PMID: 34492452 DOI: 10.1016/j.jpba.2021.114344] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022]
Abstract
Quality control of CBD oils on the Belgium market showed that the CBD content not always corresponds to the label claim. There is a pressing need to develop new analytical methods specifically developed to the assay of such oily samples. Analytical issues are, however, encountered for routine analyses due to the matrix complexity, high cost of cannabinoid standards and low Δ9-THC concentrations. An oily matrix could cause technical damages to analytical instruments and reduce the lifetime of the chromatographic columns. This paper proposes a procedure combining a sample cleanup by QuEChERS, removing the oily matrix, followed by a validated MRM GC-MS/MS method for the routine analysis of CBD oil samples. Eighteen CBD samples were selected on the Belgium market for analysis. This method allows the quantification of CBD, the legality check for the Δ9-THC content by a CBN standard and the screening of seven other cannabinoids namely CBN, CBDV, CBT, CBC, Δ8-THC, THCV and CBG. The method was validated at three concentration levels (0.5-1-2% (w/v)) for CBD and (0.05-0.1-0.2% (w/v)) for CBN. The detection limits for CBT, CBD, CBC, Δ8-THC, CBN and for the other cannabinoids of interest, were 10 and 14 ng/mL respectively. The accuracy profile values for CBD and CBN showed that the β-expectation tolerance intervals did not exceed the acceptance limits of ± 20%, meaning that 90% of future measurements will be included within this error range.
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Affiliation(s)
- Céline Duchateau
- Université Libre de Bruxelles (ULB) - Faculty of Pharmacy, RD3, Pharmacognosy, Bioanalysis and Drug Discovery Unit, Boulevard du Triomphe, Campus Plaine, CP 205/6, B-1050 Brussels, Belgium; Sciensano, Scientific Direction Physical and Chemical Health Risks, Medicines and Health Products, Rue Juliette Wytsmanstraat, 14, 1050 Brussels, Belgium
| | - Michaël Canfyn
- Sciensano, Scientific Direction Physical and Chemical Health Risks, Medicines and Health Products, Rue Juliette Wytsmanstraat, 14, 1050 Brussels, Belgium
| | - Bart Desmedt
- Sciensano, Scientific Direction Physical and Chemical Health Risks, Medicines and Health Products, Rue Juliette Wytsmanstraat, 14, 1050 Brussels, Belgium
| | - Jean-Michel Kauffmann
- Université Libre de Bruxelles (ULB) - Faculty of Pharmacy, RD3, Pharmacognosy, Bioanalysis and Drug Discovery Unit, Boulevard du Triomphe, Campus Plaine, CP 205/6, B-1050 Brussels, Belgium
| | - Caroline Stévigny
- Université Libre de Bruxelles (ULB) - Faculty of Pharmacy, RD3, Pharmacognosy, Bioanalysis and Drug Discovery Unit, Boulevard du Triomphe, Campus Plaine, CP 205/6, B-1050 Brussels, Belgium
| | - Kris De Braekeleer
- Université Libre de Bruxelles (ULB) - Faculty of Pharmacy, RD3, Pharmacognosy, Bioanalysis and Drug Discovery Unit, Boulevard du Triomphe, Campus Plaine, CP 205/6, B-1050 Brussels, Belgium
| | - Eric Deconinck
- Université Libre de Bruxelles (ULB) - Faculty of Pharmacy, RD3, Pharmacognosy, Bioanalysis and Drug Discovery Unit, Boulevard du Triomphe, Campus Plaine, CP 205/6, B-1050 Brussels, Belgium; Sciensano, Scientific Direction Physical and Chemical Health Risks, Medicines and Health Products, Rue Juliette Wytsmanstraat, 14, 1050 Brussels, Belgium.
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7
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Application of NIR handheld transmission spectroscopy and chemometrics to assess the quality of locally produced antimalarial medicines in the Democratic Republic of Congo. TALANTA OPEN 2021. [DOI: 10.1016/j.talo.2020.100025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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8
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Bakker-'t Hart IME, Ohana D, Venhuis BJ. Current challenges in the detection and analysis of falsified medicines. J Pharm Biomed Anal 2021; 197:113948. [PMID: 33582458 DOI: 10.1016/j.jpba.2021.113948] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/28/2021] [Accepted: 01/31/2021] [Indexed: 10/22/2022]
Abstract
Falsified medicines affect public health all around the globe. Complex distribution routes, illegal online webshops and reuse of packaging materials make them hard to detect. In order to tackle this problem, detection methods for the recognition of suspicious medicines and subsequent confirmation of falsification by analytical techniques is required. In this review, we focus on the developments and challenges that existed in the last five years (2015-2020) in the detection and analysis of falsified medicines. These challenges might have not been solved yet or arisen with new types of falsifications, new analytical techniques or detection strategies. Detection of suspicious medicines starts with visual inspection of packaging materials. However, re-use of packaging materials and high-quality imitations complicate visual inspection. Recent developments in the analysis of packaging by microscopic and spectroscopic techniques such as optical microscopy, X-ray fluorescence, infrared spectroscopy and Raman spectroscopy or microscopy, in combination with multivariate analysis show promising results in the detection of falsified medicines. An ongoing big challenge in the analysis of falsified medicines is the affordability of analytical devices. Yet, recent reports showed that lower cost devices, such as Counterfeit Drug Indicator or Counterfeit Detection device version 3 show promising use in the detection of falsified medicines. Furthermore, combining the outcomes of different low-cost analytical techniques, such as Minilab, colorimetry and Counterfeit Drug Indicator significantly increased selectivity and sensitivity in the detection of falsified medicines. Also, recent developments make it possible to link a low-cost technique, such as TLC, to mobile phones. Proper training of personnel has shown room for improvement and remains a challenge, even for relatively simple techniques. With an increased use of analytical fingerprints, an upcoming challenge is the accessibility of the growing pool of data. There is also the need of validated reference libraries on both national and international levels. Developments of the last few years bring us a step closer in the fight against falsified medicines, however challenges remain in the worldwide accessibility of affordable, easily operable and sensitive techniques.
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Affiliation(s)
- Ingrid M E Bakker-'t Hart
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Antonie Van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, the Netherlands
| | - Dana Ohana
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Antonie Van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, the Netherlands
| | - Bastiaan J Venhuis
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Antonie Van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, the Netherlands.
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9
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Deconinck E, Vanhee C, Keizers P, Guinot P, Mihailova A, Syversen PV, Li-Ship G, Young S, Blazewicz A, Poplawska M, Al-Sayed JL, Stengelshøj Olsen L, El-Atma O, Leist R, Jönsson KH, Afxentiou M, Barrios MM, Diaz ID, Zemser M, Kozokin A, Hackl A, Portela MJ, Beerbaum N, Bertrand M. The occurrence of non-anatomical therapeutic chemical-international nonproprietary name molecules in suspected illegal or illegally traded health products in Europe: A retrospective and prospective study. Drug Test Anal 2021; 13:833-840. [PMID: 33453144 DOI: 10.1002/dta.3001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/23/2020] [Accepted: 01/12/2021] [Indexed: 11/11/2022]
Abstract
The General European Official Medicines Control Laboratory (OMCL) Network (GEON), co-ordinated by the European Directorate for the Quality of Medicines & HealthCare (EDQM), regularly organises market surveillance studies on specific categories of suspected illegal or illegally traded products. These studies are generally based on a combination of retrospective and prospective data collection over a defined period of time. This paper reports the results of the most recent study in this context with the focus on health products containing non-Anatomical Therapeutic Chemical-International Nonproprietary Name (ATC-INN) molecules. In total 1104 cases were reported by 16 countries for the period between January 2017 and the end of September 2019. The vast majority of these samples (83%) were collected from the illegal market, while only 3% originated from a legal source. For the rest of the samples, categorisation was not possible. Moreover, 69% of all the reported samples were presented as medicines, including sexual performance enhancers, sports performance enhancers, physical performance enhancers and cognitive enhancers or nootropic molecules that act on the central nervous system (CNS). Although the popularity of anabolics, PDE-5 inhibitors and CNS drugs in illegal products has already been reported, the study showed some new trends and challenges. Indeed, 11% of the samples contained molecules of biological origin, that is, research peptides, representing the second most reported category in this study. Furthermore, the study also clearly shows the increasing popularity of Selective Androgen Receptor Modulators and nootropics, two categories that need attention and should be further monitored.
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Affiliation(s)
- Eric Deconinck
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, Sciensano, Brussels, Belgium
| | - Celine Vanhee
- Scientific Direction Chemical and Physical Health Risks, Service of Medicines and Health Products, Sciensano, Brussels, Belgium
| | - Peter Keizers
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Department of Product Composition, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Pauline Guinot
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Laboratory Controls Division, French National Agency for Medicines and Health Products Safety, Vendargues, France
| | - Albena Mihailova
- Laboratory, Division Reliable Supply, Norwegian Medicines Agency, Oslo, Norway
| | - Per Vidar Syversen
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Laboratory, Division Reliable Supply, Norwegian Medicines Agency, Oslo, Norway
| | - Graziella Li-Ship
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Inspections, Enforcement and Standards Division, Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Steven Young
- Inspections, Enforcement and Standards Division, Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Agata Blazewicz
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Falsified Medicines and medical Devices Department, National Medicines Institute, Warsaw, Poland
| | - Magdalena Poplawska
- Falsified Medicines and medical Devices Department, National Medicines Institute, Warsaw, Poland
| | | | - Lone Stengelshøj Olsen
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Medicines Control and Inspection Division, Danish Medicines Agency, Copenhagen, Denmark
| | - Oliver El-Atma
- Medicinal Products, Chemical and Veterinary Investigation Office, Karlsruhe, Germany
| | - Roman Leist
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,OMCL, Swissmedic, Swiss Agency for Therapeutic Products, Bern, Switzerland
| | - Karl-Henrik Jönsson
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Laboratory Department, Swedish Medical Products Agency, Uppsala, Sweden
| | - Maria Afxentiou
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Forensic Chemistry and Toxicology Laboratory, State General Laboratory, Nicosia, Cyprus
| | - M Mendoza Barrios
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Chemical and Pharmaceutical Division, Medicines for Human Use Department, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, Spain
| | - I Dorronsoro Diaz
- Chemical and Pharmaceutical Division, Medicines for Human Use Department, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, Spain
| | - Marina Zemser
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Institute of Standardization and Control of Pharmaceuticals, Ministry of Health Israel, Jerusalem, Israel
| | - Alla Kozokin
- Institute of Standardization and Control of Pharmaceuticals, Ministry of Health Israel, Jerusalem, Israel
| | - Andreas Hackl
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Institute Assessment & Analytics, Analytics of chemical-pharmaceutical Medicinal Products, AGES-Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH, Wien, Austria
| | - Maria-Jao Portela
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France.,Direção de Comprovação da Qualidade, INFARMED-Autoridade Nacional do Medicamento e Produtos de Saúde, I.P., Lisbon, Portugal
| | - Nico Beerbaum
- Institut für Lebensmittel, Arzneimittel, Tierseuchen und Umwelt, Landeslabor Berlin-Brandenburg, Berlin, Germany
| | - Marie Bertrand
- OMCL Falsified Medicines Working Group, GEON Network, EDQM-Council of Europe, Strasbourg, France
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10
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Tie Y, Duchateau C, Van de Steene S, Mees C, De Braekeleer K, De Beer T, Adams E, Deconinck E. Spectroscopic techniques combined with chemometrics for fast on-site characterization of suspected illegal antimicrobials. Talanta 2020; 217:121026. [PMID: 32498874 DOI: 10.1016/j.talanta.2020.121026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
Abstract
The threats of substandard and falsified (SF) antimicrobials, posed to public health, include serious adverse drug effects, treatment failures and even development of antimicrobial resistance. Next to these issues, it has no doubt that efficient methods for on-site screening are required to avoid that SF antimicrobials reach the patient or even infiltrate the legal supply chain. This study aims to develop a fast on-site screening method for SF antimicrobials using spectroscopic techniques (mid infrared, benchtop near infrared, portable near infrared and Raman spectroscopy) combined with chemometrics. 58 real-life illegal antimicrobials (claiming 18 different antimicrobials and one beta-lactamase inhibitor) confiscated by the Belgian Federal Agency for Medicines and Health Products (FAMHP) and 14 genuine antimicrobials were analyzed and used to build and validate models. Two types of models were developed and validated using supervised chemometric tools. One was used for the identification of the active pharmaceutical ingredients (APIs) by applying partial least squares-discriminant analysis (PLS-DA) and another one was used for the detection of non-compliant (overdosed or underdosed) samples by applying PLS-DA, k-nearest neighbors (k-NN) and soft independent modelling by class analogy (SIMCA). The best model capable of identifying amoxicillin and clavulanic acid (co-amoxiclav), azithromycin, co-trimoxazole and amoxicillin was based on the mid-infrared spectra with a correct classification rate (ccr) of 100%. The optimal model capable of detecting non-compliant samples within the combined group of amoxicillin and co-amoxiclav via SIMCA showed a ccr for the test set of 88% (7/8) using mid infrared or benchtop near infrared spectroscopy. The best model for detecting non-compliant samples within the group of amoxicillin via SIMCA was obtained using mid-infrared or Raman spectra, resulting in a ccr of 80% for the test set (4/5) and a ccr for calibration of 100%. For the group of co-amoxiclav, the optimal models showed a ccr of 100% for the detection of non-compliant samples by applying mid-infrared, benchtop near infrared or portable near infrared spectroscopy. Taken together, the obtained models, hyphenating spectroscopic techniques and chemometrics, enable to easily identify suspected SF antimicrobials and to differentiate non-compliant samples from compliant ones.
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Affiliation(s)
- Yaxin Tie
- Scientific Direction Chemical and Physical Health Risks, Section Medicines and Health Products, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium; KU Leuven, University of Leuven, Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, Herestraat 49, O&N2, PB 923, B-3000, Leuven, Belgium
| | - Céline Duchateau
- Scientific Direction Chemical and Physical Health Risks, Section Medicines and Health Products, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium; Université Libre de Bruxelles, Faculty of Pharmacy, RD3 - Pharmacognosy, Bioanalysis and Drug Research Unit, Boulevard du Triomphe, Campus Plaine, CP 205/06, 1050, Brussels, Belgium
| | - Shana Van de Steene
- Ghent University, Department of Pharmaceutical analysis, Laboratory of Pharmaceutical Process Analytical Technology, Ottergemsesteenweg 460, 9000, Ghent, Belgium
| | - Corenthin Mees
- Université Libre de Bruxelles, Faculty of Pharmacy, RD3 - Pharmacognosy, Bioanalysis and Drug Research Unit, Boulevard du Triomphe, Campus Plaine, CP 205/06, 1050, Brussels, Belgium
| | - Kris De Braekeleer
- Université Libre de Bruxelles, Faculty of Pharmacy, RD3 - Pharmacognosy, Bioanalysis and Drug Research Unit, Boulevard du Triomphe, Campus Plaine, CP 205/06, 1050, Brussels, Belgium
| | - Thomas De Beer
- Ghent University, Department of Pharmaceutical analysis, Laboratory of Pharmaceutical Process Analytical Technology, Ottergemsesteenweg 460, 9000, Ghent, Belgium
| | - Erwin Adams
- KU Leuven, University of Leuven, Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, Herestraat 49, O&N2, PB 923, B-3000, Leuven, Belgium
| | - Eric Deconinck
- Scientific Direction Chemical and Physical Health Risks, Section Medicines and Health Products, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium.
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11
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Li L, Zhu Y, Zhang F, Li H, Iqbal J, Wu T, Du Y. Rapid detection of sulfamethoxazole in plasma and food samples with in-syringe membrane SPE coupled with solid-phase fluorescence spectrometry. Food Chem 2020; 320:126612. [PMID: 32197124 DOI: 10.1016/j.foodchem.2020.126612] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 02/20/2020] [Accepted: 03/13/2020] [Indexed: 01/10/2023]
Abstract
In this work, in-syringe membrane solid-phase extraction (MSPE) device was fabricated for the on-site sampling of sulfamethoxazole (SMX) in food samples followed by solid-phase fluorescence spectra analysis. The samples and fluorescamine (FA) were added to a syringe for derivation. Then, the derivative of SMX was extracted by a membrane in the syringe SPE device. Subsequently, the derivative on the membrane was measured immediately without additional elution procedure. The method was successfully applied in plasma, milk, and egg samples for the trace SMX detection, with the recovery of 98%-102%, RSDs from 1% to 6%. Compared with liquid chromatography, direct detection of the concentrated analyte significantly improved the sensitivity. Moreover, fluorescamine made it unnecessary to separate SMX from the interference. Consequently, it was a time-saving, low-cost, and easy-operation method, which demonstrated the potential of in-syringe SPE as a promising candidate for on-site analysis.
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Affiliation(s)
- Long Li
- Shanghai Key Laboratory of Functional Materials Chemistry, School of Chemistry and Molecular Engineering, East China University of Science and Technology, 130 Meilong Road, Shanghai 200237, China
| | - Ying Zhu
- Shanghai Key Laboratory of Functional Materials Chemistry, School of Chemistry and Molecular Engineering, East China University of Science and Technology, 130 Meilong Road, Shanghai 200237, China
| | - Feiyu Zhang
- Shanghai Key Laboratory of Functional Materials Chemistry, School of Chemistry and Molecular Engineering, East China University of Science and Technology, 130 Meilong Road, Shanghai 200237, China
| | - Hui Li
- Department of Science and Engineering, Dehong Teachers'College, Xianchi Road 14, Mangshi 678400, China
| | - Jibran Iqbal
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Ting Wu
- Shanghai Key Laboratory of Functional Materials Chemistry, School of Chemistry and Molecular Engineering, East China University of Science and Technology, 130 Meilong Road, Shanghai 200237, China
| | - Yiping Du
- Shanghai Key Laboratory of Functional Materials Chemistry, School of Chemistry and Molecular Engineering, East China University of Science and Technology, 130 Meilong Road, Shanghai 200237, China.
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12
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Tie Y, Adams E, Deconinck E, Vanhee C. Substandard and falsified antimicrobials: A potential biohazard in disguise? Drug Test Anal 2019; 12:285-291. [PMID: 31758727 DOI: 10.1002/dta.2740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/04/2019] [Accepted: 11/04/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Yaxin Tie
- Scientific Direction Chemical and Physical Health Risks, Section Medicines and Health Products, Sciensano, Brussels, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, KU Leuven, University of Leuven, Leuven, Belgium
| | - Erwin Adams
- Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, KU Leuven, University of Leuven, Leuven, Belgium
| | - Eric Deconinck
- Scientific Direction Chemical and Physical Health Risks, Section Medicines and Health Products, Sciensano, Brussels, Belgium
| | - Celine Vanhee
- Scientific Direction Chemical and Physical Health Risks, Section Medicines and Health Products, Sciensano, Brussels, Belgium
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13
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Tie Y, van Loock K, Deconinck E, Adams E. Evaluation of impurities and dissolution profiles of illegal antimicrobial drugs encountered in Belgium. Drug Test Anal 2019; 12:53-66. [PMID: 31454468 DOI: 10.1002/dta.2690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 11/07/2022]
Abstract
Substandard and falsified (SF) antimicrobials are gaining popularity in both developing and developed countries, posing a growing threat to public health. In general, the evaluation of SF antimicrobial drugs mainly focuses on the identification and quantification of the pharmaceutical active ingredients, ignoring other parameters of drug quality control. This study performed an in-depth characterization and hazard identification of suspected SF antimicrobial medicinal products encountered in Belgium. In this comprehensive evaluation, impurity tests and dissolution studies were carried out. The dissolution profiles of illegal SF antimicrobials were mathematically compared to their genuine counterparts using the f1 and f2 -factor. The results indicated that 17 out of 57 illegal samples contained higher than permitted amounts of impurities and clearly demonstrated low equivalences of dissolution profiles between SF antimicrobials and genuine products. The variations between tablets at the different time points of the dissolution curves were also higher for the SF medicines. Moreover, 11 out of 19 illegal samples failed to meet the dissolution criteria prescribed by the United States Pharmacopeia. As impurities may induce adverse reactions and improper dissolution patterns may be the cause of insufficient drug efficacy, aggravation of illness and even promotion of antimicrobial resistance can be expected.
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Affiliation(s)
- Yaxin Tie
- Scientific Direction Chemical and Physical Health Risks, Section Medicines and Health Products, Sciensano, Brussels, Belgium.,Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, KU Leuven, University of Leuven, Leuven, Belgium
| | - Kevin van Loock
- Scientific Direction Chemical and Physical Health Risks, Section Medicines and Health Products, Sciensano, Brussels, Belgium
| | - Eric Deconinck
- Scientific Direction Chemical and Physical Health Risks, Section Medicines and Health Products, Sciensano, Brussels, Belgium
| | - Erwin Adams
- Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, KU Leuven, University of Leuven, Leuven, Belgium
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