1
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Sorret L, Tan WH, Voss S, Favrod P, Chalus P, Winzer M. Impact on Quality during In-Use Preparation of an Antibody Drug Conjugate with Eight Different Closed System Transfer Device Brands. AAPS J 2024; 26:61. [PMID: 38750400 DOI: 10.1208/s12248-024-00931-9] [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: 01/31/2024] [Accepted: 05/03/2024] [Indexed: 06/07/2024] Open
Abstract
The aim of this study was to investigate the in-use compatibility of eight commercially available closed system transfer device brands (CSTDs) with a formulated model antibody drug conjugate (ADC). Overall, in-use simulated dosing preparation applying the CSTD systems investigated raised concerns for several product quality attributes. The incompatibilities observed were mainly associated with increased visible and subvisible particles formation as well as significant changes in holdup volumes. Visible and subvisible particles contained heterogeneous mixtures of particle classes, with the majority of subvisible particles associated with silicone oil leaching from CSTD systems during simulated dose preparation upon contact with the ADC formulation. These observations demonstrate that CSTD use may adversely impact product quality and delivered dose which could potentially lead to safety and efficacy concerns during administration. Other product quality attributes measured including turbidity, color, ADC recovery, and purity by size exclusion HPLC, did not show relevant changes. It is therefore strongly recommended to test and screen the compatibility of CSTDs with the respective ADC, in a representative in-use simulated administration setting, during early CMC development, i.e., well before the start of clinical studies, to include information about compatibility and to ensure that the CSTD listed in the manuals of preparation for clinical handling has been thoroughly assessed before human use.
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Affiliation(s)
- Léa Sorret
- Lonza AG, Drug Product Services, Hochbergerstrasse 60G, 4057, Basel, Switzerland.
| | - Wei Han Tan
- Lonza AG, Drug Product Services, Hochbergerstrasse 60G, 4057, Basel, Switzerland
| | - Senta Voss
- Merck Healthcare KGaA, 64293, Darmstadt, Germany
| | - Patrick Favrod
- Lonza AG, Drug Product Services, Hochbergerstrasse 60G, 4057, Basel, Switzerland
| | - Pascal Chalus
- Lonza AG, Drug Product Services, Hochbergerstrasse 60G, 4057, Basel, Switzerland
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2
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Saggu M, Bou-Assaf GM, Bucher R, Budyak IL, Buecheler J, Cao S, Groenning M, Khan E, Kwok SC, Minocha S, Pisupati K, Radhakrishnan V, Videbæk N, Yang DT, Zhang B, Narhi LO. Evaluating Clinical Safety and Analytical Impact of Subvisible Silicone Oil Particles in Biopharmaceutical Products. J Pharm Sci 2024; 113:1401-1414. [PMID: 38220088 DOI: 10.1016/j.xphs.2024.01.002] [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: 09/25/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
Silicone oil is a commonly used lubricant in pre-filled syringes (PFSs) and can migrate over time into solution in the form of silicone oil particles (SiOPs). The presence of these SiOPs can result in elevated subvisible particle counts in PFS drug products compared to other drug presentations such as vials or cartridges. Their presence in products presents analytical challenges as they complicate quantitation and characterization of other types of subvisible particles in solution. Previous studies have suggested that they can potentially act as adjuvant resulting in potential safety risks for patients. In this paper we present several analytical case studies describing the impact of the presence of SiOPs in biotherapeutics on the analysis of the drug as well as clinical case studies examining the effect of SiOPs on patient safety. The analytical case studies demonstrate that orthogonal techniques, especially flow imaging, can help differentiate SiOPs from other types of particulate matter. The clinical case studies showed no difference in the observed patient safety profile across multiple drugs, patient populations, and routes of administration, indicating that the presence of SiOPs does not impact patient safety.
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Affiliation(s)
- Miguel Saggu
- Pharmaceutical Development, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA.
| | | | - Reinhard Bucher
- Product Development Safety, Clinical Safety, F. Hoffmann-La Roche, Basel, Switzerland
| | - Ivan L Budyak
- Biopharmaceutical Research and Development, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana 46285, USA
| | - Jakob Buecheler
- Technical Research and Development, Novartis Pharma AG, 4002 Basel, Switzerland
| | - Shawn Cao
- Process Development, Amgen Inc., 1 Amgen Center Drive, Thousand Oaks, CA 91320, USA
| | - Minna Groenning
- CMC Biophysical Analysis, Novo Nordisk A/S, Novo Nordisk Park, Måløv, Denmark
| | - Emon Khan
- Late Respiratory and Immunology, AstraZeneca, Academy House, Cambridge, UK
| | - Stanley C Kwok
- Dosage Form Design & Development, BioPharmaceuticals Development, AstraZeneca, One Medimmune Way, Gaithersburg, Maryland 20878, USA
| | - Shalini Minocha
- Injectable Drug Product Development, Alexion, AstraZeneca Rare Disease, 121 Seaport Blvd, Boston, Massachusetts, USA
| | - Karthik Pisupati
- Biopharmaceutical Research and Development, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana 46285, USA
| | - Vinay Radhakrishnan
- Injectable Drug Product Development, Alexion, AstraZeneca Rare Disease, 121 Seaport Blvd, Boston, Massachusetts, USA
| | - Nicoline Videbæk
- Clinical Immunogenicity Analysis, Novo Nordisk A/S, Novo Nordisk Park, Måløv, Denmark
| | - Dennis T Yang
- Biopharmaceutical Research and Development, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana 46285, USA
| | - Bin Zhang
- Injectable Drug Product Development, Alexion, AstraZeneca Rare Disease, 121 Seaport Blvd, Boston, Massachusetts, USA
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3
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Simatos D, Jacobs IE, Dobryden I, Nguyen M, Savva A, Venkateshvaran D, Nikolka M, Charmet J, Spalek LJ, Gicevičius M, Zhang Y, Schweicher G, Howe DJ, Ursel S, Armitage J, Dimov IB, Kraft U, Zhang W, Alsufyani M, McCulloch I, Owens RM, Claesson PM, Knowles TPJ, Sirringhaus H. Effects of Processing-Induced Contamination on Organic Electronic Devices. SMALL METHODS 2023; 7:e2300476. [PMID: 37661594 DOI: 10.1002/smtd.202300476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/28/2023] [Indexed: 09/05/2023]
Abstract
Organic semiconductors are a family of pi-conjugated compounds used in many applications, such as displays, bioelectronics, and thermoelectrics. However, their susceptibility to processing-induced contamination is not well understood. Here, it is shown that many organic electronic devices reported so far may have been unintentionally contaminated, thus affecting their performance, water uptake, and thin film properties. Nuclear magnetic resonance spectroscopy is used to detect and quantify contaminants originating from the glovebox atmosphere and common laboratory consumables used during device fabrication. Importantly, this in-depth understanding of the sources of contamination allows the establishment of clean fabrication protocols, and the fabrication of organic field effect transistors (OFETs) with improved performance and stability. This study highlights the role of unintentional contaminants in organic electronic devices, and demonstrates that certain stringent processing conditions need to be met to avoid scientific misinterpretation, ensure device reproducibility, and facilitate performance stability. The experimental procedures and conditions used herein are typical of those used by many groups in the field of solution-processed organic semiconductors. Therefore, the insights gained into the effects of contamination are likely to be broadly applicable to studies, not just of OFETs, but also of other devices based on these materials.
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Affiliation(s)
- Dimitrios Simatos
- Optoelectronics Group, Cavendish Laboratory, University of Cambridge, Cambridge, CB3 0HE, UK
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge, CB2 1EW, UK
| | - Ian E Jacobs
- Optoelectronics Group, Cavendish Laboratory, University of Cambridge, Cambridge, CB3 0HE, UK
| | - Illia Dobryden
- RISE Research Institutes of Sweden, Division of Bioeconomy and Health, Department of Material and Surface Design, RISE Research Institutes of Sweden, 11486, Stockholm, Sweden
| | - Małgorzata Nguyen
- Optoelectronics Group, Cavendish Laboratory, University of Cambridge, Cambridge, CB3 0HE, UK
| | - Achilleas Savva
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, CB3 OAS, UK
| | - Deepak Venkateshvaran
- Optoelectronics Group, Cavendish Laboratory, University of Cambridge, Cambridge, CB3 0HE, UK
| | - Mark Nikolka
- Optoelectronics Group, Cavendish Laboratory, University of Cambridge, Cambridge, CB3 0HE, UK
| | - Jérôme Charmet
- School of Engineering-HE-Arc Ingénierie, HES-SO University of Applied Sciences Western Switzerland, 2000, Neuchâtel, Switzerland
| | - Leszek J Spalek
- Optoelectronics Group, Cavendish Laboratory, University of Cambridge, Cambridge, CB3 0HE, UK
| | - Mindaugas Gicevičius
- Optoelectronics Group, Cavendish Laboratory, University of Cambridge, Cambridge, CB3 0HE, UK
| | - Youcheng Zhang
- Optoelectronics Group, Cavendish Laboratory, University of Cambridge, Cambridge, CB3 0HE, UK
| | - Guillaume Schweicher
- Laboratoire de Chimie des Polymères, Faculté des Sciences, Université Libre de Bruxelles (ULB), 1050, Bruxelles, Belgium
| | - Duncan J Howe
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge, CB2 1EW, UK
| | - Sarah Ursel
- Optoelectronics Group, Cavendish Laboratory, University of Cambridge, Cambridge, CB3 0HE, UK
| | - John Armitage
- Optoelectronics Group, Cavendish Laboratory, University of Cambridge, Cambridge, CB3 0HE, UK
| | - Ivan B Dimov
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, CB3 0FA, UK
| | - Ulrike Kraft
- Department of Molecular Electronics, Max Planck Institute for Polymer Research, 55128, Mainz, Germany
| | - Weimin Zhang
- Physical Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, 23955-6900, Saudi Arabia
| | - Maryam Alsufyani
- Department of Chemistry, University of Oxford, Oxford, OX1 3TA, UK
| | - Iain McCulloch
- Physical Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, 23955-6900, Saudi Arabia
- Department of Chemistry, University of Oxford, Oxford, OX1 3TA, UK
| | - Róisín M Owens
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, CB3 OAS, UK
| | - Per M Claesson
- KTH Royal Institute of Technology, School of Engineering Sciences in Chemistry, Biotechnology and Health, Department of Chemistry, Division of Surface and Corrosion Science, 10044, Stockholm, Sweden
| | - Tuomas P J Knowles
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge, CB2 1EW, UK
| | - Henning Sirringhaus
- Optoelectronics Group, Cavendish Laboratory, University of Cambridge, Cambridge, CB3 0HE, UK
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4
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Vitharana S, Stillahn JM, Katayama DS, Henry CS, Manning MC. Application of Formulation Principles to Stability Issues Encountered During Processing, Manufacturing, and Storage of Drug Substance and Drug Product Protein Therapeutics. J Pharm Sci 2023; 112:2724-2751. [PMID: 37572779 DOI: 10.1016/j.xphs.2023.08.003] [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: 10/14/2022] [Revised: 07/24/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023]
Abstract
The field of formulation and stabilization of protein therapeutics has become rather extensive. However, most of the focus has been on stabilization of the final drug product. Yet, proteins experience stress and degradation through the manufacturing process, starting with fermentaition. This review describes how formulation principles can be applied to stabilize biopharmaceutical proteins during bioprocessing and manufacturing, considering each unit operation involved in prepration of the drug substance. In addition, the impact of the container on stabilty is discussed as well.
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Affiliation(s)
| | - Joshua M Stillahn
- Legacy BioDesign LLC, Johnstown, CO 80534, USA; Department of Chemistry, Colorado State University, Fort Collins, CO 80523, USA
| | | | - Charles S Henry
- Department of Chemistry, Colorado State University, Fort Collins, CO 80523, USA
| | - Mark Cornell Manning
- Legacy BioDesign LLC, Johnstown, CO 80534, USA; Department of Chemistry, Colorado State University, Fort Collins, CO 80523, USA.
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5
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Wong B, Zhao X, Su Y, Ouyang H, Rhodes T, Xu W, Xi H, Fu D. Characterizing Silicone Oil-Induced Protein Aggregation with Stimulated Raman Scattering Imaging. Mol Pharm 2023; 20:4268-4276. [PMID: 37382286 DOI: 10.1021/acs.molpharmaceut.3c00391] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Particles in biopharmaceutical products present high risks due to their detrimental impacts on product quality and safety. Identification and quantification of particles in drug products are important to understand particle formation mechanisms, which can help develop control strategies for particle formation during the formulation development and manufacturing process. However, existing analytical techniques such as microflow imaging and light obscuration measurement lack the sensitivity and resolution to detect particles with sizes smaller than 2 μm. More importantly, these techniques are not able to provide chemical information to determine particle composition. In this work, we overcome these challenges by applying the stimulated Raman scattering (SRS) microscopy technique to monitor the C-H Raman stretching modes of the proteinaceous particles and silicone oil droplets formed in the prefilled syringe barrel. By comparing the relative signal intensity and spectral features of each component, most particles can be classified as protein-silicone oil aggregates. We further show that morphological features are poor indicators of particle composition. Our method has the capability to quantify aggregation in protein therapeutics with chemical and spatial information in a label-free manner, potentially allowing high throughput screening or investigation of aggregation mechanisms.
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Affiliation(s)
- Brian Wong
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Xi Zhao
- Analytical Enabling Capabilities, Analytical Research and Development, Merck & Co., Inc., Rahway, New Jersey 07065, United States
- Sterile and Specialty Products, Pharmaceutical Sciences & Clinical Supply, Merck & Co., Inc., Rahway, New Jersey 07065, United States
| | - Yongchao Su
- Analytical Enabling Capabilities, Analytical Research and Development, Merck & Co., Inc., Rahway, New Jersey 07065, United States
| | - Hanlin Ouyang
- Analytical Enabling Capabilities, Analytical Research and Development, Merck & Co., Inc., Rahway, New Jersey 07065, United States
| | - Timothy Rhodes
- Analytical Enabling Capabilities, Analytical Research and Development, Merck & Co., Inc., Rahway, New Jersey 07065, United States
| | - Wei Xu
- Analytical Enabling Capabilities, Analytical Research and Development, Merck & Co., Inc., Rahway, New Jersey 07065, United States
| | - Hanmi Xi
- Analytical Enabling Capabilities, Analytical Research and Development, Merck & Co., Inc., Rahway, New Jersey 07065, United States
| | - Dan Fu
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
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6
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Hada S, Na KJ, Jeong J, Choi DH, Kim NA, Jeong SH. Evaluation of subvisible particles in human immunoglobulin and lipid nanoparticles repackaged from a multi-dose vial using plastic syringes. Int J Biol Macromol 2023; 232:123439. [PMID: 36716845 DOI: 10.1016/j.ijbiomac.2023.123439] [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: 09/05/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 01/28/2023]
Abstract
The multi-dose vial (MDV) is widely used for most biopharmaceuticals that are repackaged in plastic syringes before use. However, subvisible particle formation with the use of plastic syringes containing silicone oil (SO syringes) for handling therapeutic proteins can be problematic. This study aimed to evaluate the extent of and trends in microparticle (>1 μm) formation and accumulation in repackaged syringes from MDVs containing human immunoglobulin (IgG) and lipid nanoparticles (LNPs). Light obscuration (LO) and flow imaging (FI) were used to analyze the microparticles. The number of microparticles observed with the use SO syringes was greater than that with SO-free syringes, and the number of microparticles continuously increased as did the number of times of repackaging in syringes for both drugs. However, a large variation was observed across different brands of SO syringes. In contrast, using a different technique of drug withdrawal from the vial significantly reduced the number of microparticles. Furthermore, the use of filter-integrated needles or the inclusion of stabilizers such as acetyl-arginine and Tween 20 into the formulation also helped reduce particle formation.
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Affiliation(s)
- Shavron Hada
- BK21 FOUR Team and Integrated Research Institute for Drug Development, College of Pharmacy, Dongguk University, Gyeonggi 10326, Republic of Korea.
| | - Kyung Jun Na
- BK21 FOUR Team and Integrated Research Institute for Drug Development, College of Pharmacy, Dongguk University, Gyeonggi 10326, Republic of Korea.
| | - Junoh Jeong
- BK21 FOUR Team and Integrated Research Institute for Drug Development, College of Pharmacy, Dongguk University, Gyeonggi 10326, Republic of Korea.
| | - Du Hyung Choi
- Department of Pharmaceutical Engineering, Inje University, Gyeongnam 621-749, Republic of Korea; College of Pharmacy, Daegu Catholic University, Gyeongsan, Gyeongbuk 38430, Republic of Korea.
| | - Nam Ah Kim
- BK21 FOUR Team and Integrated Research Institute for Drug Development, College of Pharmacy, Dongguk University, Gyeonggi 10326, Republic of Korea; College of Pharmacy, Mokpo National University, Jeonnam 58554, Republic of Korea.
| | - Seong Hoon Jeong
- BK21 FOUR Team and Integrated Research Institute for Drug Development, College of Pharmacy, Dongguk University, Gyeonggi 10326, Republic of Korea.
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7
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Kim NA, Noh GY, Hada S, Na KJ, Yoon HJ, Park KW, Park YM, Jeong SH. Enhanced protein aggregation suppressor activity of N-acetyl-l-arginine for agitation-induced aggregation with silicone oil and its impact on innate immune responses. Int J Biol Macromol 2022; 216:42-51. [PMID: 35779650 DOI: 10.1016/j.ijbiomac.2022.06.176] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/07/2022] [Accepted: 06/26/2022] [Indexed: 11/26/2022]
Abstract
Previously, N-acetyl-l-arginine (NALA) suppressed the aggregation of intravenous immunoglobulins (IVIG) more effectively and with a minimum decrease in transition temperature (Tm) than arginine monohydrochloride. In this study, we performed a comparative study with etanercept (commercial product: Enbrel®), where 25 mM arginine monohydrochloride (arginine) was added to the prefilled syringe. The biophysical properties were investigated using differential scanning calorimetry (DSC), dynamic light scattering (DLS), size-exclusion chromatography (SEC), and flow-imaging microscopy (FI). NALA retained the transition temperature of etanercept better than arginine, where arginine significantly reduced the Tm by increasing its concentration. End-over-end rotation was applied to each formulation for 5 days to accelerate protein aggregation and subvisible particle formation. Higher monomeric content was retained with NALA with a decrease in particle level. Higher aggregation onset temperature (Tagg) was detected for etanercept with NALA than arginine. The results of this comparative study were consistent with previous study, suggesting that NALA could be a better excipient for liquid protein formulations. Agitated IVIG and etanercept were injected into C57BL/6 J female mice to observe immunogenic response after 24 h. In the presence of silicone oil, NALA dramatically reduced IL-1 expression, implying that decreased aggregation was related to reduced immunogenicity of both etanercept and IVIG.
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Affiliation(s)
- Nam Ah Kim
- BK21 FOUR Team and Integrated Research Institute for Drug Development, College of Pharmacy, Dongguk University, Gyeonggi 10326, Republic of Korea; College of Pharmacy, Mokpo National University, Jeonnam 58554, Republic of Korea.
| | - Ga Yeon Noh
- BK21 FOUR Team and Integrated Research Institute for Drug Development, College of Pharmacy, Dongguk University, Gyeonggi 10326, Republic of Korea
| | - Shavron Hada
- BK21 FOUR Team and Integrated Research Institute for Drug Development, College of Pharmacy, Dongguk University, Gyeonggi 10326, Republic of Korea
| | - Kyung Jun Na
- BK21 FOUR Team and Integrated Research Institute for Drug Development, College of Pharmacy, Dongguk University, Gyeonggi 10326, Republic of Korea
| | - Hee-Jung Yoon
- Division of Health and Kinesiology, Incheon National University, Incheon 22012, Republic of Korea
| | - Ki-Woong Park
- Division of Health and Kinesiology, Incheon National University, Incheon 22012, Republic of Korea.
| | - Young-Min Park
- Division of Health and Kinesiology, Incheon National University, Incheon 22012, Republic of Korea.
| | - Seong Hoon Jeong
- BK21 FOUR Team and Integrated Research Institute for Drug Development, College of Pharmacy, Dongguk University, Gyeonggi 10326, Republic of Korea.
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8
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Kim M, Kim JT. Differences in the incidence of aflibercept-related sterile endophthalmitis according to types of disposable syringes used. Graefes Arch Clin Exp Ophthalmol 2022; 260:1139-1145. [PMID: 34977967 DOI: 10.1007/s00417-021-05454-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/15/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To evaluate the difference between the incidences of sterile endophthalmitis after administration of intravitreal aflibercept injection using two different types of syringes. METHODS We administered a total of 498 intravitreal aflibercept injections between September 2017 and August 2021. The disposable syringe used was changed from a 1-mL disposable syringe (Profi syringe, Shinchang Medical., Ltd. Korea) to a 1-mL Becton Dickenson Luer-Lok syringe (BD, Franklin, NJ, USA) in September 2019. Thus, the patients who received injections before and after September 1, 2019, were classified into group 1 and group 2, respectively. The incidence of aflibercept-related sterile endophthalmitis between the two groups was compared. RESULTS In group 1, six (2.791%) out of 215 cases were diagnosed with sterile endophthalmitis and prescribed topical or oral steroids. In group 2, one (0.353%) out of 283 cases was diagnosed with sterile endophthalmitis and prescribed a steroid eye drop. The incidence of sterile endophthalmitis was significantly different between the two groups (P = 0.046). CONCLUSION The BD Luer-Lok syringe is associated with a lower incidence of aflibercept-related sterile endophthalmitis than the conventional polypropylene syringe. Differences in immunogenicity associated with silicone oil lubricants within the syringes might be one of the potential reasons behind the difference in the incidence of the sterile endophthalmitis.
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Affiliation(s)
- Minjeong Kim
- Department of Ophthalmology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea, #06974
| | - Jee Taek Kim
- Department of Ophthalmology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea, #06974.
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9
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Patke S, Gaillat EN, Calero-Rubio C, Gooding T, Audat H, Leman M, Filipe V, Saluja A. A Systematic Approach to Evaluating Closed System Drug-Transfer Devices during Drug Product Development. J Pharm Sci 2021; 111:1325-1334. [PMID: 34958824 DOI: 10.1016/j.xphs.2021.12.020] [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: 11/01/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 10/19/2022]
Abstract
The use of Closed System Drug-Transfer Devices (CSTDs) has increased significantly in recent years due to NIOSH and USP recommendations to use them during preparation of hazardous drugs. Mechanistic and material differences between CSTDs and traditional in-use components warrant an assessment of their impact on product quality and dosing accuracy. Using a combination of prevalent CSTDs with biologic molecules, we performed an extensive assessment of the effect of using CSTDs for dose preparation and observed no negative impact on product quality attributes. Additionally, we found that the CSTD hold-up volume is 2 to 4-fold higher than conventional in-use components and exhibited a strong dependence on the CSTD brand used. We also found that the CSTD brand and dosing volume have a major influence on dosing accuracy with suboptimal protein recovery at very low dosing volumes. We identified entrapment of product in the CSTD spike as the root cause for this sub-optimal recovery and found that flushing the CSTD spike with a brand-new syringe and not the dosing syringe aided in complete protein recovery. Taken together we present a systematic approach to evaluate the risks and impact of CSTD to drug product quality, dose preparation, and dosing accuracy.
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Affiliation(s)
- Sanket Patke
- Biologics Drug Product Development, Sanofi, Framingham, United States.
| | | | | | - Tamera Gooding
- Biologics Drug Product Development, Sanofi, Framingham, United States
| | - Heloise Audat
- Biologics Drug Product Development, Sanofi, Vitry, France
| | - Marie Leman
- Biologics Drug Product Development, Sanofi, Vitry, France
| | - Vasco Filipe
- Biologics Drug Product Development, Sanofi, Vitry, France
| | - Atul Saluja
- Biologics Drug Product Development, Sanofi, Framingham, United States
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10
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Particles in Biopharmaceutical Formulations, Part 2: An Update on Analytical Techniques and Applications for Therapeutic Proteins, Viruses, Vaccines and Cells. J Pharm Sci 2021; 111:933-950. [PMID: 34919969 DOI: 10.1016/j.xphs.2021.12.011] [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: 12/07/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 11/21/2022]
Abstract
Particles in biopharmaceutical formulations remain a hot topic in drug product development. With new product classes emerging it is crucial to discriminate particulate active pharmaceutical ingredients from particulate impurities. Technical improvements, new analytical developments and emerging tools (e.g., machine learning tools) increase the amount of information generated for particles. For a proper interpretation and judgment of the generated data a thorough understanding of the measurement principle, suitable application fields and potential limitations and pitfalls is required. Our review provides a comprehensive overview of novel particle analysis techniques emerging in the last decade for particulate impurities in therapeutic protein formulations (protein-related, excipient-related and primary packaging material-related), as well as particulate biopharmaceutical formulations (virus particles, virus-like particles, lipid nanoparticles and cell-based medicinal products). In addition, we review the literature on applications, describe specific analytical approaches and illustrate advantages and drawbacks of currently available techniques for particulate biopharmaceutical formulations.
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11
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Melo GB, Cruz NFS, Monte Agra LL, Emerson GG, Lima LH, Linkuviene V, Maia M, Farah ME, Carpenter JF, Rodrigues EB, Probst C. Silicone oil-free syringes, siliconized syringes and needles: quantitative assessment of silicone oil release with drugs used for intravitreal injection. Acta Ophthalmol 2021; 99:e1366-e1374. [PMID: 33890418 DOI: 10.1111/aos.14838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/17/2021] [Accepted: 02/23/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE This study aimed to quantify the amount of silicone oil (SO) released across a variety of syringe and needle models routinely used for intravitreal injection. METHODS The release of SO was assessed in eight models of syringes, two of which were reported to be 'SO-free', and eleven models of needles with unknown SO content. To evaluate SO release within the context of anti-VEGF therapeutics, syringes were evaluated using aflibercept, bevacizumab, buffer, ziv-aflibercept and formulation buffer. All syringe tests were performed with or without agitation by flicking for syringes. Needles were evaluated without agitation only. Samples were fluorescently labelled to identify SO, and triplicate measurements were collected using imaging flow cytometry. RESULTS Seven out of 8 syringe models showed a statistically significant increase in the SO particle count after agitation. The two SO-free syringe models (HSW Norm-Ject, Daikyo Crystal Zenith) released the least SO particles, with or without agitation, whereas the BD Ultra-Fine and Saldanha-Rodrigues syringes released the most. More SO was released when the syringes were prefilled with formulation buffer than with ziv-aflibercept. Syringes filled with aflibercept and bevacizumab had intermediate levels. Agitation increased the release of SO into each of the drug solutions. Silicone oil (SO) was detected in all needles. CONCLUSIONS Agitation of the syringe by flicking leads to a substantial increase in the number of SO particles. Silicone oil (SO)-free syringes had the best performance, but physicians must also be aware that needles are siliconized and also contribute to the injection of SO into the vitreous.
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Affiliation(s)
- Gustavo Barreto Melo
- Department of Ophthalmology Federal University of São Paulo São Paulo Brazil
- Hospital de Olhos de Sergipe Aracaju Brazil
| | | | - Lydianne Lumack Monte Agra
- Department of Ophthalmology Federal University of São Paulo São Paulo Brazil
- Hospital de Olhos de Sergipe Aracaju Brazil
| | | | - Luiz H. Lima
- Department of Ophthalmology Federal University of São Paulo São Paulo Brazil
| | - Vaida Linkuviene
- Department of Pharmaceutical Sciences University of Colorado Denver CO USA
| | - Maurício Maia
- Department of Ophthalmology Federal University of São Paulo São Paulo Brazil
| | - Michel Eid Farah
- Department of Ophthalmology Federal University of São Paulo São Paulo Brazil
| | - John F. Carpenter
- Department of Pharmaceutical Sciences University of Colorado Denver CO USA
| | - Eduardo Büchele Rodrigues
- Department of Ophthalmology Federal University of São Paulo São Paulo Brazil
- Department of Ophthalmology Saint Louis University School of Medicine Saint Louis MO USA
| | - Christine Probst
- Department of Research and Development Sciences Luminex Corporation Seattle WA USA
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12
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Silicone oil droplets in the vitreous after intravitreal injections: review of literature with clinical examples. OPHTHALMOLOGY JOURNAL 2021. [DOI: 10.17816/ov59959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Currently, intravitreal injections are firmly in the lead as a drug delivery method for treatment of a wide range of eye diseases. With the accumulation of clinical material, knowledge about the complications and side effects of this technique is expanding. One of the undesirable phenomena that has been actively studied recently is the ingress of silicone oil droplets from single-use syringes and needles used to perform the procedure into the vitreous cavity of patients eyes. The analysis of the results of original studies on this issue is carried out, and the currently available practical recommendations aimed at reducing the risk of this complication are presented. The article is illustrated with original clinical examples. It can be concluded that the penetration of silicone oil into the eye cavity during intravitreal injections is an urgent problem of modern ophthalmology that requires further investigation and solution.
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13
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Influence of Protein Adsorption on Aggregation in Prefilled Syringes. J Pharm Sci 2021; 110:3568-3579. [PMID: 34310973 DOI: 10.1016/j.xphs.2021.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 11/23/2022]
Abstract
Protein aggregate formation in prefilled syringes (PFSs) can be influenced by protein adsorption and desorption at the solid-liquid interface. Although inhibition of protein adsorption on the PFS surface can lead to a decrease in the amount of aggregation, the mechanism underlying protein adsorption-mediated aggregation in PFSs is unclear. This study investigated protein aggregation caused by protein adsorption on silicone oil-free PFS surfaces [borosilicate glass (GLS) and cycloolefin polymer (COP)] and the factors affecting the protein adsorption on the PFS surfaces. The adsorbed proteins formed multilayered structures that consisted of two distinct types of layers: proteins adsorbed on the surface of the material and proteins adsorbed on top of the proteins on the surface. A pH-dependent electrostatic interaction was the dominant force for protein adsorption on the GLS surface, while hydrophobic effects were dominant for protein adsorption on the COP surface. When the repulsion force between proteins was weak, protein adsorption on the adsorbed protein layer was increased for both materials and as a result, protein aggregation increased. Therefore, a formulation with high colloidal stability can minimize protein adsorption on the COP surface, leading to reduced protein aggregation.
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14
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Khaira M, Guy AL. Closed-system transfer device use with oncology biologics: A survey of Canadian healthcare practitioners. J Oncol Pharm Pract 2021; 28:805-815. [PMID: 34000919 PMCID: PMC9047104 DOI: 10.1177/10781552211010928] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Closed-system transfer devices (CSTDs) were introduced into clinical practice to protect healthcare practitioners (HCPs) from exposure to hazardous drugs. However, ambiguous guidelines have led to confusion as to when CSTD use is required, as institutes are instructed to maintain their own hazardous drug lists and determine the appropriate level of personal protective equipment for their staff. This study seeks to understand the current use of CSTDs by Canadian oncology HCPs, the influence of various stakeholders on their use and the challenges faced by HCPs surrounding the use of these medical devices. Methods The researchers compiled a set of questions to inform on the current use of CSTDs in clinical practice and administered an online survey to oncology HCPs across Canada. Results The results indicate that though CSTD use is common in Canadian oncology practice settings, there is variation in the extent of the use of these devices across provinces and with which products these devices are used. The survey results also show that the top challenges with the use of CSTDs include cost, lack of information on the compatibility of a CSTD with a drug product, and CSTD impact on drug quality. Many respondents are aligned that regulatory bodies are more likely to influence the use of CSTDs with specific drug products than drug manufacturers. Conclusion Guidelines for the application of CSTDs in clinical practice vary and are often ambiguous. Regulatory bodies are uniquely positioned to provide healthcare institutions with more clarity on when CSTD use is appropriate.
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Affiliation(s)
- Manmeet Khaira
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.,Product Development Regulatory, Hoffmann-La Roche Ltd, Mississauga, ON, Canada
| | - Allison L Guy
- Product Development Regulatory, Hoffmann-La Roche Ltd, Mississauga, ON, Canada
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15
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Anderson WJ, da Cruz NFS, Lima LH, Emerson GG, Rodrigues EB, Melo GB. Mechanisms of sterile inflammation after intravitreal injection of antiangiogenic drugs: a narrative review. Int J Retina Vitreous 2021; 7:37. [PMID: 33962696 PMCID: PMC8103589 DOI: 10.1186/s40942-021-00307-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/28/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Intraocular inflammation is an uncommon but potentially vision-threatening adverse event related to anti-VEGF therapy. This is of increasing importance given both the volume of injections performed, as well as the increased prevalence of inflammation seen with newer anti-VEGF agents. Brolucizumab, the newest anti-VEGF agent, has been associated with an inflammatory retinal vasculitis and the underlying mechanism is unclear. Reviewing potential mechanisms and clinical differences of intraocular inflammation may assist clinicians and scientists in reducing the risk of these events in the future. OBSERVATIONS Two types of inflammation are seen with intravitreal injections, acute onset sterile inflammation and delayed onset inflammatory vasculitis. Acute onset inflammation can be subcategorized into subclinical anterior chamber inflammation and sterile uveitis/endophthalmitis. Subclinical anterior chamber inflammation can occur at rates as high as 19% after intravitreal anti-VEGF injection. Rates of sterile uveitis/endophthalmitis range from 0.05% to 4.4% depending on the anti-VEGF agent. Inflammatory vasculitis is only associated with brolucizumab and occurred in 3.3% of injections according to the post hoc review of the HAWK/HARRIER data. In addition, silicone oil from syringes can induce immunogenic protein aggregates. Agitation of the syringe, freeze thawing, shipping and improper storage prior to injection may increase the amount of silicone oil released from the syringe. CONCLUSION The main factors which play a role in intraocular inflammation after anti-VEGF injection can be divided into three causes: patient-specific, medication-specific and delivery-specific. The majority of clinically significant inflammation seen after intravitreal injection is an acute onset inflammatory response with most patients recovering baseline VA in 3-5 weeks. The presence of pain, hypopyon, severe anterior chamber reaction, hyperemia and significant vision loss may help distinguish infectious from non-infectious etiologies of post injection inflammation. Avoiding temperature fluctuation, mechanical shock, agitation during transport and handling of syringes/drugs, and the use of SO-free syringes may help minimize intraocular inflammation. While a definitive mechanism has not yet been established, current knowledge of the clinical presentation and vitreous histopathology of brolucizumab-retinal vasculitis favors an auto-immune type IV hypersensitivity reaction.
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Affiliation(s)
- William J Anderson
- Department of Ophthalmology, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | | | - Luiz Henrique Lima
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | | | - Eduardo Büchele Rodrigues
- Department of Ophthalmology, Saint Louis University School of Medicine, Saint Louis, MO, USA.,Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Gustavo Barreto Melo
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. .,Hospital de Olhos de Sergipe, Rua Campo Do Brito, 995, Aracaju, SE, 49020-380, Brazil.
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16
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The Impact of Product and Process Related Critical Quality Attributes on Immunogenicity and Adverse Immunological Effects of Biotherapeutics. J Pharm Sci 2020; 110:1025-1041. [PMID: 33316242 DOI: 10.1016/j.xphs.2020.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 02/07/2023]
Abstract
The pharmaceutical industry has experienced great successes with protein therapeutics in the last two decades and with novel modalities, including cell therapies and gene therapies, more recently. Biotherapeutics are complex in structure and present challenges for discovery, development, regulatory, and life cycle management. Biotherapeutics can interact with the immune system that may lead to undesired immunological responses, including immunogenicity, hypersensitivity reactions (HSR), injection site reactions (ISR), and others. Many product and process related critical quality attributes (CQAs) have the potential to trigger or augment such immunological responses to the product. Tremendous efforts, both clinically and preclinically, have been invested to understand the impact of product and process related CQAs on adverse immunological effects. The information and knowledge are critical for the implementation of Quality by Design (QbD), which requires risk assessment and establishment of specifications and control strategies for CQAs. A quality target product profile (QTPP) that identifies the key CQAs through process development can help assign severity scores based on safety, immunogenicity, pharmacokinetics (PK) and pharmacodynamics (PD) of the molecule. Gaps and future directions related to biotherapeutics and emerging novel modalities are presented.
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17
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Deiringer N, Haase C, Wieland K, Zahler S, Haisch C, Friess W. Finding the Needle in the Haystack: High-Resolution Techniques for Characterization of Mixed Protein Particles Containing Shed Silicone Rubber Particles Generated During Pumping. J Pharm Sci 2020; 110:2093-2104. [PMID: 33307040 DOI: 10.1016/j.xphs.2020.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/19/2020] [Accepted: 12/02/2020] [Indexed: 12/29/2022]
Abstract
During the manufacturing process of biopharmaceuticals, peristaltic pumps are employed at different stages for transferring and dosing of the final product. Commonly used silicone tubings are known for particle shedding from the inner tubing surface due to friction in the pump head. These nanometer sized silicone rubber particles could interfere with proteins. Until now, only mixed protein particles containing micrometer-sized contaminations such as silicone oil have been characterized, detected, and quantified. To overcome the detection limits in particle sizes of contaminants, this study aimed for the definite identification of protein particles containing nanometer sized silicone particles in qualitative and quantitative manner. The mixed particles consisted of silicone rubber particles either coated with a protein monolayer or embedded into protein aggregates. Confocal Raman microscopy allows label free chemical identification of components and 3D particle imaging. Labeling the tubing enables high-resolution imaging via confocal laser scanning microscopy and counting of mixed particles via Imaging Flow Cytometry. Overall, these methods allow the detection and identification of particles of unknown origin and composition and could be a forensic tool for solving problems with contaminations during processing of biopharmaceuticals.
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Affiliation(s)
- Natalie Deiringer
- Department of Pharmacy, Pharmaceutical Technology and Biopharmaceutics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christian Haase
- Department of Pharmacy, Pharmaceutical Technology and Biopharmaceutics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Karin Wieland
- Chair for Analytical Chemistry, Technische Universität München, Munich, Germany
| | - Stefan Zahler
- Department of Pharmacy, Pharmaceutical Biology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christoph Haisch
- Chair for Analytical Chemistry, Technische Universität München, Munich, Germany
| | - Wolfgang Friess
- Department of Pharmacy, Pharmaceutical Technology and Biopharmaceutics, Ludwig-Maximilians-Universität München, Munich, Germany.
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18
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Kagdi R, Le K, Doucet D, Ludlow J, Rinella JV. Determination of Holdup Volume and Transient Contact Compatibility of Closed System Transfer Devices for a Reconstituted Lyophilized Drug Product. J Pharm Sci 2020; 109:3504-3511. [DOI: 10.1016/j.xphs.2020.07.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/21/2020] [Accepted: 07/28/2020] [Indexed: 11/25/2022]
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19
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Kim NA, Kim DJ, Jeong SH. Do not flick or drop off-label use plastic syringes in handling therapeutic proteins before administration. Int J Pharm 2020; 587:119704. [DOI: 10.1016/j.ijpharm.2020.119704] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/08/2020] [Accepted: 07/25/2020] [Indexed: 12/28/2022]
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20
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Wang T, Richard CA, Dong X, Shi GH. Impact of Surfactants on the Functionality of Prefilled Syringes. J Pharm Sci 2020; 109:3413-3422. [PMID: 32771345 DOI: 10.1016/j.xphs.2020.07.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/24/2022]
Abstract
Previous studies revealed the impact of formulation factors (excipients and pH) on the functionality of prefilled syringes. Surfactant, a critical formulation component for therapeutic proteins and antibodies, aids in minimizing protein adsorption onto interfaces and reduces protein aggregation or particulate formation. This study evaluated the impact of different surfactants and protein concentration on the functionality of prefilled syringes. Syringes filled with solution formulations with different surfactants were stored at various temperatures and evaluated at selected time points. Upon thermal stress, polysorbate 80 and dodecyl-β-d-maltoside containing formulations showed significantly greater increase in glide force when compared with poloxamer 407 containing formulations. In contrast, syringes filled with poloxamer 188 containing formulations did not show any increase in glide force under the same conditions. Based on the results from this study, the increase in syringe glide force was inversely correlated with hydrophobic-lipophilic balance values and surface tension of different surfactants. The mechanism of increase in glide force was primarily the change of silicone oil coverage and lubricity in the barrel of syringes.
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Affiliation(s)
- Tingting Wang
- Bioproduct Research and Development, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA.
| | - Coralie A Richard
- Delivery Device and Connected Solutions, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - Xia Dong
- Biotechnology Research (Bio TDR), Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - Galen Huaiqiu Shi
- Delivery Device and Connected Solutions, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
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21
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Richard CA, Wang T, Clark SL. Using First Principles to Link Silicone Oil/Formulation Interfacial Tension With Syringe Functionality in Pre-Filled Syringes Systems. J Pharm Sci 2020; 109:3006-3012. [PMID: 32565353 DOI: 10.1016/j.xphs.2020.06.014] [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: 03/19/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 01/08/2023]
Abstract
Numerous interactions can arise at the interface between the glass barrel/silicone oil coating/aqueous formulation in pre-filled syringes that can affect the functionality of the medical device. In this study, the Young-Dupré equation was applied at these interfaces to correlate the interfacial tension between the silicone oil coating and aqueous formulation to the functionality of the syringe. It was shown that lower silicone oil/drug product formulation interfacial tension led to an increase in the glide force of the syringe. The relationship between glide force profiles and silicone oil thickness after injection was also investigated and the data revealed that the silicone oil was removed at the end of the syringe barrel when the formulation contains polysorbate 80.
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Affiliation(s)
- Coralie A Richard
- Delivery Device and Connected Solutions, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA.
| | - Tingting Wang
- Bioproduct Pharma Design, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - Sarah L Clark
- Delivery Device and Connected Solutions, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
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22
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Melo GB, Cruz NFSD, Emerson GG, Rezende FA, Meyer CH, Uchiyama S, Carpenter J, Shiroma HF, Farah ME, Maia M, Rodrigues EB. Critical analysis of techniques and materials used in devices, syringes, and needles used for intravitreal injections. Prog Retin Eye Res 2020; 80:100862. [PMID: 32311476 DOI: 10.1016/j.preteyeres.2020.100862] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/23/2020] [Accepted: 04/02/2020] [Indexed: 12/26/2022]
Abstract
Intravitreal injections have become the most commonly performed intraocular treatments worldwide. Because intravitreal injections may induce severe adverse events, such as infectious and noninfectious endophthalmitis, cataract, ocular hypertension, vitreous hemorrhage, or retinal detachment, appropriate awareness of the materials and techniques used are essential to reduce these sight-threatening complications. This review provides insights into the needles, syringes, silicone oil coating, sterilization methods, devices to assist intravitreal injections, scleral piercing techniques using needles, syringe handling, anesthesia, and safety issues related to materials and techniques. It is paramount that physicians be aware of every step involved in intravitreal injections and consider the roles and implications of all materials and techniques used. The ability to understand the theoretical and practical circumstances may definitely lead to state-of-the-art treatments delivered to patients. The most important practical recommendations are: choosing syringes with as little silicone oil as possible, or, preferably, none; avoiding agitation of syringes; awareness that most biologics (e.g., antiangiogenic proteins) are susceptible to changes in molecular properties under some conditions, such as agitation and temperature variation; understanding that improper materials and techniques may lead to complications after intravitreal injections, e.g., inflammation; and recognizing that some devices may contribute to an enhanced, safer, and faster intravitreal injection technique.
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Affiliation(s)
- Gustavo Barreto Melo
- Hospital de Olhos de Sergipe, Rua Campo do Brito, 995, Aracaju, SE, Brazil; Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil.
| | | | | | | | - Carsten H Meyer
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil; Department of Ophthalmology, Philipps University of Marburg, Robert-Koch-Strasse 4, Marburg, Germany
| | - Susumu Uchiyama
- Department of Biotechnology, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Osaka, Japan
| | - John Carpenter
- Department of Pharmaceutical Sciences, University of Colorado, Denver/Aurora, CO, USA
| | - Hélio Francisco Shiroma
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil
| | - Michel Eid Farah
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil
| | - Maurício Maia
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil
| | - Eduardo Büchele Rodrigues
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil; Department of Ophthalmology, SSM Health Saint Louis University Hospital, Saint Louis University, 1755, S. Grand Boulevard, Saint Louis, MO, USA
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23
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Jiao N, Barnett GV, Christian TR, Narhi LO, Joh NH, Joubert MK, Cao S. Characterization of Subvisible Particles in Biotherapeutic Prefilled Syringes: The Role of Polysorbate and Protein on the Formation of Silicone Oil and Protein Subvisible Particles After Drop Shock. J Pharm Sci 2020; 109:640-645. [DOI: 10.1016/j.xphs.2019.10.066] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/09/2019] [Accepted: 10/29/2019] [Indexed: 11/29/2022]
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24
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Petoskey F, Kwok SC, Jackson W, Jiang S. Overcoming Challenges of Implementing Closed System Transfer Device Clinical In-Use Compatibility Testing for Drug Development of Antibody Drug Conjugates. J Pharm Sci 2020; 109:761-768. [DOI: 10.1016/j.xphs.2019.07.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/12/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
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25
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Joh NH, Thomas L, Christian TR, Verlinsky A, Jiao N, Allotta N, Jawa V, Cao S, Narhi LO, Joubert MK. Silicone Oil Particles in Prefilled Syringes With Human Monoclonal Antibody, Representative of Real-World Drug Products, Did Not Increase Immunogenicity in In Vivo and In Vitro Model Systems. J Pharm Sci 2019; 109:845-853. [PMID: 31628922 DOI: 10.1016/j.xphs.2019.09.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 12/13/2022]
Abstract
Silicone oil is a lubricant for prefilled syringes (PFS), a common primary container for biotherapeutics. Silicone oil particles (SiOP) shed from PFS are a concern for patients due to their potential for increased immunogenicity and therefore also of regulatory concern. To address the safety concern in a context of manufacturing and distribution of drug product (DP), SiOP was increased (up to ∼25,000 particles/mL) in PFS filled with mAb1, a fully human antibody drug, by simulated handling of DP mimicked by drop shock. These samples are characterized in a companion report (Jiao N et al. J Pharm Sci. 2020). The risk of immunogenicity was then assessed using in vitro and in vivo immune model systems. The impact of a common DP excipient, polysorbate 80, on both the formation and biological consequences of SiOP was also tested. SiOP was found associated with (1) minimal cytokine secretion from human peripheral blood mononuclear cells, (2) no response in cell lines that report NF-κB/AP-1 signaling, and (3) no antidrug antibodies or significant cytokine production in transgenic Xeno-het mice, whether or not mAb1 or polysorbate 80 was present. These results suggest that SiOP in mAb1, representative of real-world DP in PFS, poses no increased risk of immunogenicity.
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Affiliation(s)
| | | | | | | | - Nancy Jiao
- Amgen Inc., Thousand Oaks, California 91320
| | | | - Vibha Jawa
- Amgen Inc., Thousand Oaks, California 91320
| | - Shawn Cao
- Amgen Inc., Thousand Oaks, California 91320
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Expanding Bedside Filtration-A Powerful Tool to Protect Patients From Protein Aggregates. J Pharm Sci 2018; 107:2775-2788. [PMID: 30059660 DOI: 10.1016/j.xphs.2018.07.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 12/29/2022]
Abstract
Protein immunogenicity is intensively researched by academics, biopharmaceutical companies, and authorities as it can compromise the safety and efficacy of a biopharmaceutical drug. So far, the exact protein aggregate properties inducing immune responses are not known. Possible protein-related factors could be size, chemical modifications, or higher order structures. It is impossible to achieve an absolute absence of protein aggregates even for very stable formulations. The application of "bedside filtration," meaning filtration during the preparation or administration of the drug product immediately before injection, has the potential to increase the safety of every drug container and could prevent the undesired injection of particulate matter into the patient. In this study, the high efficiency of filtration for reducing the amount of protein particles was demonstrated with more than 19 stressed and nonstressed biopharmaceutical products which covered a broad concentration and molecular weight range. Furthermore, critical aspects regarding the usage of filters such as particle shedding from filters, protein loss as a result of protein adsorption, or the hold-up volume of the filters were assessed. Although differences between the filters were observed, no negative impact by the investigated filters could be found. A broader application of bedside filtration is therefore proposed.
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27
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Deep Convolutional Neural Network Analysis of Flow Imaging Microscopy Data to Classify Subvisible Particles in Protein Formulations. J Pharm Sci 2018; 107:999-1008. [DOI: 10.1016/j.xphs.2017.12.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/27/2017] [Accepted: 12/07/2017] [Indexed: 11/19/2022]
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28
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Daniels AL, Randolph TW. Flow Microscopy Imaging Is Sensitive to Characteristics of Subvisible Particles in Peginesatide Formulations Associated With Severe Adverse Reactions. J Pharm Sci 2018; 107:1313-1321. [PMID: 29409840 DOI: 10.1016/j.xphs.2018.01.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/26/2017] [Accepted: 01/17/2018] [Indexed: 01/01/2023]
Abstract
The presence of subvisible particles in formulations of therapeutic proteins is a risk factor for adverse immune responses. Although the immunogenic potential of particulate contaminants likely depends on particle structural characteristics (e.g., composition, size, and shape), exact structure-immunogenicity relationships are unknown. Images recorded by flow imaging microscopy reflect information about particle morphology, but flow microscopy is typically used to determine only particle size distributions, neglecting information on particle morphological features that may be immunologically relevant. We recently developed computational techniques that utilize the Kullback-Leibler divergence and multidimensional scaling to compare the morphological properties of particles in sets of flow microscopy images. In the current work, we combined these techniques with expectation maximization cluster analyses and used them to compare flow imaging microscopy data sets that had been collected by the U.S. Food and Drug Administration after severe adverse drug reactions (including 7 fatalities) were observed in patients who had been administered some lots of peginesatide formulations. Flow microscopy images of particle populations found in the peginesatide lots associated with severe adverse reactions in patients were readily distinguishable from images of particles in lots where severe adverse reactions did not occur.
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Affiliation(s)
- Austin L Daniels
- Center for Pharmaceutical Biotechnology, Department of Chemical and Biological Engineering, University of Colorado, Boulder, Colorado 80309-0596
| | - Theodore W Randolph
- Center for Pharmaceutical Biotechnology, Department of Chemical and Biological Engineering, University of Colorado, Boulder, Colorado 80309-0596.
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Immunogenicity of Structurally Perturbed Hen Egg Lysozyme Adsorbed to Silicone Oil Microdroplets in Wild-Type and Transgenic Mouse Models. J Pharm Sci 2017; 106:1519-1527. [DOI: 10.1016/j.xphs.2017.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 02/02/2017] [Accepted: 02/06/2017] [Indexed: 11/18/2022]
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