1
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Medina A, Dragulin-Otto S, Cox E, Fuentes N, Wang Y, Flores K, Lent I, Glasser L, Kwok SC, Donegan S, Brown MN, Siapkara A. Drug Product Development and Case Studies for User Centric Pediatric Protein-Based Therapeutics. J Pharm Sci 2024:S0022-3549(24)00260-0. [PMID: 39173743 DOI: 10.1016/j.xphs.2024.07.014] [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: 05/14/2024] [Revised: 07/12/2024] [Accepted: 07/13/2024] [Indexed: 08/24/2024]
Abstract
The user of a pediatric drug includes not only the patient, but also their caregiver and healthcare provider, including nurses, doctors, and pharmacists. Therefore, adopting a patient-centric approach that focuses on all users is critical for the development of pediatric drug products. This article outlines the quality target product profile parameters and a patient-centric approach for the development of pediatric proteinbased therapies. The use environment, formulation design, and preparation and in use stability considerations are described. An acceptability profile for the various routes of parenteral administration is described with a focus on pediatric age groups. Furthermore, a risk assessment approach is presented for the selection of excipients to be utilized in pediatric protein-based biopharmaceuticals. Several case studies are included which illustrate the selection of drug product parameters such as formulation, dose volume, and route of administration with the pediatric user in mind.
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Affiliation(s)
- Annette Medina
- Dosage Form Design and Development, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA.
| | - Sonia Dragulin-Otto
- Dosage Form Design and Development, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | - Emily Cox
- Dosage Form Design and Development, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | - Nathalie Fuentes
- Dosage Form Design and Development, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | - Yujing Wang
- Dosage Form Design and Development, Biopharmaceutical Development, AstraZeneca, Cambridge, UK
| | - Katiria Flores
- Injectable Drug Product Development, Product Development and Clinical Supply, Alexion AstraZeneca Rare Disease, New Haven, CT, USA
| | - Ian Lent
- Dosage Form Design and Development, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | - Lisa Glasser
- US Medical Affairs, Vaccines and Immune Therapies, BioPharmaceutical Medical, AstraZeneca, Wilmington, DE, USA
| | - Stanley C Kwok
- Dosage Form Design and Development, Biopharmaceutical Development, AstraZeneca, Gaithersburg, MD, USA
| | | | - Mary N Brown
- Early Respiratory and Immunology (R&I) Clinical Development, BioPharmaceuticals R&D, AstraZeneca, Boston, MA, USA
| | - Angeliki Siapkara
- CVRM Regulatory Affairs, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
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2
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Grzincic EM, Parikh T, Hong C, Rabiah NI, Yi L, Gupta S. Impact of Closed System Transfer Device (CSTD) Handling Procedure for Low-Transfer-Volume Dose Preparation of Biologic Drug Products. J Pharm Sci 2024; 113:1523-1535. [PMID: 38142969 DOI: 10.1016/j.xphs.2023.12.016] [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: 10/23/2023] [Revised: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 12/26/2023]
Abstract
Many challenges have been identified for ensuring compatibility of closed system transfer devices (CSTDs) with biologic drug products. One challenge is large hold-up volumes (HUVs) of CSTD components, which can be especially problematic with early-stage biologics when low transfer volumes smaller than the nominal fill volume may be used to achieve a wide range of doses with a single drug product configuration. Here, we identified possible CSTD handling techniques during dose preparation of a drug product requiring small volume transfers during reconstitution, intermediate dilution, and dilution in an IV bag, and systematically evaluated the impact of these handling procedures on the ability to deliver an accurate dose to the next step. We show that small changes to CSTD procedures can have a major impact on dose accuracy, depending on both CSTD HUVs and drug product-specific transfer volumes. We demonstrate that it is possible to craft CSTD instructions for use to mitigate these issues, and that the dose accuracy for specific drug product/CSTD combinations can be estimated using theoretical equations. Finally, we explored potential downsides of these mitigations. Our results emphasize key factors for consideration by both drug and CSTD manufacturers when assessing compatibility and providing CSTD instructions for use with biologics requiring low transfer volumes during dose preparation.
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Affiliation(s)
- Elissa M Grzincic
- Biologics Drug Product Development, AbbVie, 1000 Gateway Blvd., South San Francisco, CA 94080, United States.
| | - Trusha Parikh
- Biologics Drug Product Development, AbbVie, 1000 Gateway Blvd., South San Francisco, CA 94080, United States
| | - Carolyn Hong
- Biologics Drug Product Development, AbbVie, 1000 Gateway Blvd., South San Francisco, CA 94080, United States
| | - Noelle I Rabiah
- Biologics Drug Product Development, AbbVie, 1000 Gateway Blvd., South San Francisco, CA 94080, United States
| | - Li Yi
- Biologics Drug Product Development, AbbVie, 1000 Gateway Blvd., South San Francisco, CA 94080, United States
| | - Supriya Gupta
- Biologics Drug Product Development, AbbVie, 1000 Gateway Blvd., South San Francisco, CA 94080, United States
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3
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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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4
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Wozniewski M, Besheer A, Huwyler J, Mahler HC, Levet V, Sediq AS. A Survey on Handling and Administration of Therapeutic Protein Products in German and Swiss Hospitals. J Pharm Sci 2024; 113:735-743. [PMID: 37722452 DOI: 10.1016/j.xphs.2023.09.010] [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: 05/15/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 09/20/2023]
Abstract
Protein products in hospitals often have to be compounded before administration to the patient. This may comprise reconstitution of lyophilizates, dilution, storage, and transport. However, the operations for compounding and administration in the hospital may lead to changes in product quality and possibly even impact patient safety. We surveyed healthcare practitioners from three clinical units using a questionnaire and open dialogue to document common procedures and their justification and to document differences in handling procedures. The survey covered dose compounding, transportation, storage and administration. One key observation was that drug vial optimization procedures were used for some products, e.g., use of one single-use vial for several patients. This included the use of spikes and needles or closed system transfer devices (CSTDs). Filters or light protection aids were used only when specified by the manufacturer. A further observation was a different handling of the overfill in pre-filled infusion containers, possibly impacting total dose. Lastly, we documented the complexity of infusion administration setups for administration of multiple drugs. In this case, flushing procedures or the placement and use of filters in the setup vary. Our study has revealed important differences in handling and administration practice. We propose that drug developers and hospitals should collaborate to establish unified handling procedures.
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Affiliation(s)
- Maximilian Wozniewski
- Drug Product Services, Lonza AG, Hochbergerstrasse 60G, 4057 Basel, Switzerland; Division of Pharmaceutical Technology, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland
| | - Ahmed Besheer
- Drug Product Services, Lonza AG, Hochbergerstrasse 60G, 4057 Basel, Switzerland
| | - Jörg Huwyler
- Division of Pharmaceutical Technology, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland
| | | | - Vincent Levet
- Drug Product Services, Lonza AG, Hochbergerstrasse 60G, 4057 Basel, Switzerland.
| | - Ahmad S Sediq
- Drug Product Services, Lonza AG, Hochbergerstrasse 60G, 4057 Basel, Switzerland
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5
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Wozniewski M, Besheer A, Sediq AS, Huwyler J, Mahler HC, Levet V. Characterization of Silicone from Closed System Transfer Devices and its Migration into Pharmaceutical Drug Products. J Pharm Sci 2024; 113:419-426. [PMID: 37989442 DOI: 10.1016/j.xphs.2023.11.012] [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: 10/13/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023]
Abstract
Closed System Transfer Devices (CSTDs) are increasingly used in healthcare settings to facilitate compounding of hazardous drugs but increasingly also therapeutic proteins. However, their use may significantly impact the quality of the sterile product. For example, contamination of the product solution may occur by leaching of silicone or particulates from the CSTDs. It was therefore the aim of the present study to identify and quantify the types of silicone oil in a panel of typically used CSTDs. Particles found after simulated CSTD compounding processes were evaluated using Light Obscuration and Micro-Flow Imaging and were confirmed to be silicone oil particles. The number of particulates shed from CTSDs was in single cases exceeding pharmacopeial limits for a final parenteral product. Using X-ray microtomography, lubrication was shown to be primarily applied at connecting parts of the CSTD. Quantitative and qualitative analysis by Fourier transform infrared spectroscopy (FTIR) revealed a total released amount between 0.8 and 16 mg per CSTD of polydimethylsiloxane or polymethyltrifluoropropylsiloxane per CSTD. While pronounced differences in total silicone content between CSTDs were observed, it did not fully correlate with particle contamination in the test solutions, potentially due to variations in CSTD design. The impact of typical surfactants in biological formulations on silicone migration into product was additionally evaluated. We conclude that CSTDs may compromise final product quality, as (different types of) silicone oil may be released from these devices and contaminate the administered product.
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Affiliation(s)
- Maximilian Wozniewski
- Drug Product Services, Lonza AG, Hochbergerstrasse 60G, 4057 Basel, Switzerland; Division of Pharmaceutical Technology, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland
| | - Ahmed Besheer
- Drug Product Services, Lonza AG, Hochbergerstrasse 60G, 4057 Basel, Switzerland
| | - Ahmad S Sediq
- Drug Product Services, Lonza AG, Hochbergerstrasse 60G, 4057 Basel, Switzerland
| | - Jörg Huwyler
- Division of Pharmaceutical Technology, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland
| | | | - Vincent Levet
- Drug Product Services, Lonza AG, Hochbergerstrasse 60G, 4057 Basel, Switzerland.
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6
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Sampathkumar K, Kerwin BA. Roadmap for Drug Product Development and Manufacturing of Biologics. J Pharm Sci 2024; 113:314-331. [PMID: 37944666 DOI: 10.1016/j.xphs.2023.11.004] [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: 09/13/2023] [Revised: 11/04/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023]
Abstract
Therapeutic biology encompasses different modalities, and their manufacturing processes may be vastly different. However, there are many similarities that run across the different modalities during the drug product (DP) development process and manufacturing. Similarities include the need for Quality Target Product Profile (QTTP), analytical development, formulation development, container/closure studies, drug product process development, manufacturing and technical requirements set out by numerous regulatory documents such as the FDA, EMA, and ICH for pharmaceuticals for human use and other country specific requirements. While there is a plethora of knowledge on studies needed for development of a drug product, there is no specific guidance set out in a phase dependent manner delineating what studies should be completed in alignment with the different phases of clinical development from pre-clinical through commercialization. Because of this reason, we assembled a high-level drug product development and manufacturing roadmap. The roadmap is applicable across the different modalities with the intention of providing a unified framework from early phase development to commercialization of biologic drug products.
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Affiliation(s)
- Krishnan Sampathkumar
- SSK Biosolutions LLC, 14022 Welland Terrace, North Potomac, MD 20878, USA; Currently at Invetx, Inc., One Boston Place, Suite 3930, 201 Washington Street, Boston, MA 02108, USA
| | - Bruce A Kerwin
- Kerwin BioPharma Consulting LLC, 14138 Farmview Ln NE, Bainbridge Island, WA 98110, USA; Coriolis Scientific Advisory Board, Coriolis Pharma, Fraunhoferstr. 18 b, 82152 Martinsried, Germany.
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7
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Fast J, Christian T, Crul M, Jiskoot W, Nejadnik MR, Medina A, Radwick A, Sreedhara A, Tole H. Use of Closed System Transfer Devices (CSTDs) with Protein-Based Therapeutic Drugs-A Non-Solution for a Non-Problem? J Pharm Sci 2024; 113:298-305. [PMID: 37984700 DOI: 10.1016/j.xphs.2023.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Jonas Fast
- Pharmaceutical Development, F. Hoffmann-La Roche Ltd. CH-4070 Basel, Switzerland.
| | | | - Mirjam Crul
- Amsterdam University Medical Center, Department of Clinical Pharmacology and Pharmacy, Amsterdam, the Netherlands
| | - Wim Jiskoot
- Division of BioTherapeutics, Leiden University, the Netherlands; Coriolis Pharma, Martinsried, Germany
| | - M Reza Nejadnik
- Department of Pharmaceutical Sciences & Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, USA
| | - Annette Medina
- Dosage Form Design and Development, AstraZeneca, Gaithersburg, MD, USA
| | | | | | - Hugh Tole
- Occupational Health, Hygiene &Toxicology, Genentech Inc., Little Falls, NJ, USA
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8
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Wuchner K, Brown HC, Canal F, Bonvin D, Goldhammer C, Hebting H, Huon C, Kuhn SM, Mudumala PR, Neuhold K, Riesop D, Steffen JS, Woelfle F. Industry perspective on a holistic container closure integrity approach to parenteral combination products. Eur J Pharm Biopharm 2024; 194:20-35. [PMID: 37981109 DOI: 10.1016/j.ejpb.2023.11.010] [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: 09/17/2023] [Revised: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 11/21/2023]
Abstract
Biologics are being developed more and more as parenteral combination products with drug delivery devices. The maintenance of sterility is imperative for such medical devices throughout their life cycle. Therefore, the container closure integrity (CCI) should, preferably, be built into the overall process, and not just demonstrated during the final testing of the combination product. The integrity is an important Critical Quality Attribute (CQA) and in the scope of specific considerations and studies during the combination product life cycle i.e., design robustness, assembly processes, storage (to end of shelf life), and shipping prior to patient use. The goal of this paper is to summarize an industry holistic approach to ensure CCI, for a combination product, and to build a scientifically based justification that Quality (in terms of CCI) is built into the overall process. Current analytical approaches used for characterization or Good Manufacturing Practice (GMP) CCI testing during combination product development will be described. However, the use of quality by design (QbD) during product development can reduce or eliminate routine batch level or stability testing of the combination product.
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Affiliation(s)
- Klaus Wuchner
- Janssen R&D, BTDS Analytical Development, Hochstrasse 201, 8200 Schaffhausen, Switzerland.
| | - Helen C Brown
- F.Hoffmann-La Roche Ltd, Devices and Packaging Development (PTDE-D), Grenzacherstrasse-124, 4070 Basel, Switzerland
| | - Fabiana Canal
- Merck KGaA, Primary Packaging and Device CoE, via Luigi Einaudi, 11, 00012 Guidonia Montecelio, Rome, Italy
| | - Debora Bonvin
- Janssen R&D, BTDS Analytical Development, Hochstrasse 201, 8200 Schaffhausen, Switzerland
| | | | - Henri Hebting
- Lilly France S.A.S, Global Platforms Technical Support, ZA - 2 rue du Colonel Lilly, BP 70419 Fegersheim, 67412 Illkirch Cedex, France
| | - Carine Huon
- Sanofi, Medical Device Development, 1051, Boulevard Industriel, 76580 Le Trait, France
| | - Sebastian M Kuhn
- Boehringer Ingelheim Pharma GmbH & Co.KG, Analytical Development Biologicals, Birkendorfer Str. 65, 88397 Biberach, Germany
| | - Prudvi Raj Mudumala
- Novartis Pharma AG, Global Device & Packaging Development, Fabrikstrasse 4, 4056 Basel, Switzerland
| | - Karen Neuhold
- Janssen R&D, BTDS Analytical Development, Hochstrasse 201, 8200 Schaffhausen, Switzerland
| | - David Riesop
- AbbVie Deutschland GmbH & Co KG, Bio Drug Product Development Germany, Knollstrasse 50, 67061 Ludwigshafen, Germany
| | - Jean-Sebastien Steffen
- Lonza AG, Drug Product Services, Combination Product and Primary Packaging Development, Hochbergerstrasse 60G, 4057 Basel, Switzerland
| | - Florian Woelfle
- Boehringer Ingelheim Pharma GmbH & Co.KG, Analytical Development Biologicals, Birkendorfer Str. 65, 88397 Biberach, Germany
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9
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Simal I, Bauters T, Paepens C, Clottens N, Ramaut P, Kestens E. Developing a flowchart to evaluate the use of Closed System Drug-Transfer Devices with monoclonal antibodies: Focus on the clinical trial setting. J Oncol Pharm Pract 2023; 29:2014-2022. [PMID: 37680124 DOI: 10.1177/10781552231199412] [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] [Indexed: 09/09/2023]
Abstract
OBJECTIVE Available guidelines are ambiguous about safe handling monoclonal antibodies (MABs) and whether or not to use a Closed System Drug-Transfer Device (CSTD). In this article we want to describe a standardized working method on handling MABs in a clinical trial setting. DATA SOURCES The current workflow at the clinical trial unit of the Ghent University Hospital was critically analyzed, after which an extensive literature review was performed using the National Institute for Occupational Safety and Health Working Group guidelines and the database PubMed (Keywords: monoclonal antibodies, closed system transfer devices, safety guidelines, safe handling, management, administration, (bio)compatibility, volume loss, contamination, clinical trial unit. Period: 2020-2022). DATA SUMMARY Literature data are ambiguous. CSTDs can reduce cross-contamination and minimize exposure to potential hazardous drugs for healthcare professionals. However, in recent years more questions have been raised about their in-use compatibility and their impact on final product quality. This makes the debate on implementing CSTDs a hot topic in daily pharmacy practice and demands a holistic and standardized approach when deciding whether or not to use a CSTD when handling MABs. In a clinical trial setting, where safety data are frequently not available and the compatibility of CSTDs and investigational product is often unknown, this poses additional challenges that need to be taken into account. CONCLUSION We developed a flowchart which standardizes the use of a CSTD when handling MABs. It allows other healthcare professionals and clinical trial sponsors to define and evaluate the necessary criteria when standardizing the position of a CSTD in their safe handling procedures.
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Affiliation(s)
- Ine Simal
- Pharmacy Department, Ghent University Hospital, Ghent, Belgium
| | - Tiene Bauters
- Pharmacy Department, Ghent University Hospital, Ghent, Belgium
| | | | - Nele Clottens
- Pharmacy Department, Ghent University Hospital, Ghent, Belgium
| | - Pieter Ramaut
- Pharmacy Department, Ghent University Hospital, Ghent, Belgium
| | - Els Kestens
- Pharmacy Department, Ghent University Hospital, Ghent, Belgium
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10
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Mason BD, Lowe K, Dong J, Salamat-Miller N. A Practical Tool for Risk-Based In-use Compatibility Assessments. J Pharm Sci 2023; 112:2938-2946. [PMID: 37558095 DOI: 10.1016/j.xphs.2023.07.026] [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: 12/05/2022] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/11/2023]
Abstract
In drug development, in-use compatibility studies are crucial steps to ensure that the critical quality attributes of the drug product are maintained when in contact with administration components. But once the drug is in clinical trials, unanticipated variations in these components can stretch limited resources and lengthen timelines to market, as these changes must be assessed and approved to ensure continued patient safety. It's desirable to use a science-based risk evaluation to determine the extent of data and testing needed in these situations, but there is no standard for how such evaluations are done. We have developed an Excel™-based semi-quantitative risk assessment tool to determine whether in-use testing is needed when drug delivery sites or components are changed during a clinical trial. We developed the tool based on our multi-company experience with compatibility studies for many types of drug products targeted for various geographic regions. We have employed the tool as a means to expedite decision-making and, if appropriate, reduce testing in low-risk situations. The tool can save significant time and effort (our estimate is approximately at least 6-9 months off the development cycle) and can minimize pitfalls in clinical administration. While we have designed the tool for our drug products and for use with parenteral dosing regimens, the tool can be adapted for other situations as needed. It will be especially useful for companies with more limited resources.
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Affiliation(s)
- Bruce D Mason
- Drug Product and Device Development, Takeda Pharmaceuticals U.S.A., Inc. 200 Shire Way, Lexington, MA 02421, USA
| | - Kris Lowe
- Drug Product and Device Development, Takeda Pharmaceuticals U.S.A., Inc. 200 Shire Way, Lexington, MA 02421, USA
| | - Jinquan Dong
- Drug Product and Device Development, Takeda Pharmaceuticals U.S.A., Inc. 200 Shire Way, Lexington, MA 02421, USA
| | - Nazila Salamat-Miller
- Drug Product and Device Development, Takeda Pharmaceuticals U.S.A., Inc. 200 Shire Way, Lexington, MA 02421, USA.
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11
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Martínez CS, Amery L, De Paoli G, Elofsson U, Fureby AM, Kwok S, López-Cabezas C, Rosenberger M, Schoenau C, Wahlgren M, Paulsson M. Examination of the Protein Drug Supply Chain in a Swedish University Hospital: Focus on Handling Risks and Mitigation Measures. J Pharm Sci 2023; 112:2799-2810. [PMID: 37160226 DOI: 10.1016/j.xphs.2023.05.003] [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: 03/30/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 05/11/2023]
Abstract
Protein drugs, such as monoclonal antibodies, have proved successful in treating cancer and immune system diseases. The structural complexity of these molecules requires careful handling to ensure integrity and stability of the drug. In this study, a failure mode and effects analysis was performed based on a Gemba Walk method in a Swedish University Hospital. The Gemba Walk is focused on pharmacists observing the actual supply process steps from distributor, pharmacy cleanroom to patient administration. Relevant protein drugs are chosen based on sales statistics within the hospital and the corresponding wards were observed. Further is the Double Diamond design method used to identify major risks and deliver mitigation strategies. The study identified potential stress factors such as temperature, shock by impact, shaking, vibration and light exposure. There were also risks associated with porters' and healthcare professionals' lack of awareness and access to information. These risk factors may cause loss of efficacy and quality of the protein drug, potentially leading to patient safety concerns. In this study, a simulation is also performed to list measures that theoretically should be in place to ensure the quality of the protein drug, for example validated and protocol-based compounding in cleanroom, training and validated transports.
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Affiliation(s)
- Clàudia Sabaté Martínez
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden; Faculty of Pharmacy and Food Science, University of Barcelona, Spain
| | - Leanne Amery
- Late Stage Formulation Sciences, BioPharmaceuticals Development, Dosage Form Design & Development, AstraZeneca, Granta Park, Cambridge, UK
| | - Giorgia De Paoli
- MEMO Research, Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Ninewells Hospital, Dundee, UK
| | - Ulla Elofsson
- RISE Research Institute of Sweden, Stockholm, Sweden
| | | | - Stanley Kwok
- Late Stage Formulation Sciences, BioPharmaceuticals Development, Dosage Form Design & Development, AstraZeneca, One MedImmune Way, Gaithersburg, MD 20878, USA
| | | | - Marika Rosenberger
- Sanofi-Aventis Deutschland GmbH, Biologics Drug Product Development & Manufacturing, Industriepark Hoechst, K703. Brüningstr. 50, 65926 Frankfurt am Main, Germany
| | - Christian Schoenau
- Sanofi-Aventis Deutschland GmbH, Biologics Drug Product Development & Manufacturing, Industriepark Hoechst, K703. Brüningstr. 50, 65926 Frankfurt am Main, Germany
| | - Marie Wahlgren
- Department of Food Technology, Lund University, P.O. Box 124, 22100 Lund, Sweden
| | - Mattias Paulsson
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden.
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12
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Blümel M, Liu J, de Jong I, Weiser S, Fast J, Litowski J, Shuman M, Mehta SB, Amery L, Tan DCT, Jia F, Shekhawat D, Dagallier C, Emamzadeh M, Medina A, Santos C, Gasser F, Urban C. Current Industry Best Practice on in-use Stability and Compatibility Studies for Biological Products. J Pharm Sci 2023; 112:2332-2346. [PMID: 37160227 DOI: 10.1016/j.xphs.2023.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/03/2023] [Accepted: 05/03/2023] [Indexed: 05/11/2023]
Abstract
Evaluating the in-use stability of a biological product including its compatibility with administration components allows to define handling instructions and potential hold times that retain product quality during dose preparation and administration. The intended drug product usage may involve the dilution of drug formulation into admixtures for infusion and exposure to new interfaces of administration components like intravenous (iv) bags, syringes, and tubing. In-use studies assess the potential impact on product quality by simulating drug handling throughout the defined in-use period. Considering the wide range of in-use conditions and administration components available globally, only limited guidance is available from regulators on expected in-use stability data. A working group reviewed and consolidated industry approaches to assess physicochemical stability of traditional protein-based biological products during clinical development and for commercial use. The insights compiled in this review article can be leveraged across the industry and encompass topics such as representative drug product material and administration components, testing conditions, quality attributes evaluated and respective acceptance criteria, applied quality standards, and regulatory requirements. These practices may help companies in the study design, and they may inform discussions with global regulators.
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Affiliation(s)
- Markus Blümel
- Novartis Pharma AG, Biologics Analytical Development, Lichtstrasse 35, CH-4056 Basel, Switzerland.
| | - Jing Liu
- Seagen Inc., Pharmaceutical Sciences, 21717 30th Drive S.E., Building 3. Bothell, WA, 98021, USA.
| | - Isabella de Jong
- Genentech (A Member of the Roche Group), Pharmaceutical Development, 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Sarah Weiser
- Pfizer; Biotherapeutics Pharmaceutical Sciences, 1 Burtt Road, Andover, MA 01810, USA
| | - Jonas Fast
- F. Hoffmann-La Roche Ltd., Pharmaceutical Development & Supplies, PTD Biologics Europe, Grenzacherstrasse 124, CH, 4070 Basel, Switzerland
| | - Jennifer Litowski
- Amgen Inc., Process Development, 360 Binney St., Cambridge, MA, 02141, USA
| | - Melissa Shuman
- GSK, Strategic External Development, Sterile Drug Product Operations, 1250 S. Collegeville Road Collegeville, PA, 19426, USA
| | - Shyam B Mehta
- Teva Branded Pharmaceutical Products, Drug Product Development and Operations, 145 Brandywine Pkwy, West Chester, PA 19380, USA
| | - Leanne Amery
- AstraZeneca, Dosage Form Design and Development, Aaron Klug Building, Granta Park, Cambridge, Cambridgeshire, CB21 6GH, UK
| | | | - Feng Jia
- Biogen, Biologics Drug Product, 225 Binney Street, Cambridge, MA, 02142, USA
| | - Dushyant Shekhawat
- Eli Lilly and Company, Bioproduct Research and Development, Indianapolis, IN, 46285, USA
| | - Camille Dagallier
- Sanofi, Biologics Drug Product Development, 1 impasse des ateliers, 94403 Vitry-Sur-Seine, France
| | - Mina Emamzadeh
- AstraZeneca, Dosage Form Design and Development, Aaron Klug Building, Granta Park, Cambridge, Cambridgeshire, CB21 6GH, UK
| | - Annette Medina
- AstraZeneca, Dosage Form Design and Development, One Medimmune Way, Gaithersburg, MD, 20878, USA
| | - Camilla Santos
- Amgen Inc., Product Quality, 40 Technology Way, West Greenwich, RI, 02817, USA
| | - Florian Gasser
- Novartis Pharma AG, Biologics Analytical Development, Biochemiestrasse 10, 6336 Langkampfen, Austria
| | - Christian Urban
- Sanofi, Biologics Drug Product Development, Industriepark Höchst, D-65926 Frankfurt am Main, Germany
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Part I: Significant reduction of lyophilization process times by using novel matrix based scaffolds. Eur J Pharm Biopharm 2023; 184:248-261. [PMID: 36529257 DOI: 10.1016/j.ejpb.2022.12.008] [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: 09/18/2022] [Revised: 12/02/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
To improve the long-term stability of drugs with limited stability (e.g., biologicals such as monoclonal antibodies, antibody drug conjugates or peptides), some pharmaceuticals endure a lengthy and cost-intensive process called lyophilization. While the shelf life of lyophilized drugs may be prolonged compared to their liquid form, the drawbacks come in the form of intensified manufacturing, preparation, and dosing efforts. The use of glass vials as the primary container unit for lyophilized products hinders their complication-free, fast and flexible use, as they require a skilled healthcare professional and an aseptic environment in which to prepare them. The feasibility of substituting glass vials with novel container designs offering the complete transfer of the lyophilizate cake into modern administration devices, while reducing the economic footprint of the lyophilization process, was investigated. The lyophilization process of a monoclonal antibody solution was studied by assessing primary drying conditions, homogeneity of the drying process, and critical quality attributes after successful lyophilization. The creation of novel container designs utilized vacuum-forming to generate confined containers with removable bottoms and rapid prototyping, including subtractive and additive manufacturing methods, to generate porous 3D structures for drug housing. The novel container designs generated lyophilizates twice as fast and achieved a threefold faster reconstitution compared to their vial counterparts, without adaptation of the processing conditions. We conclude that the use of intermediate process containers offers significant relief for healthcare professionals in terms of reduced probability of handling errors, while drug manufacturers benefit from the accelerated processing times, increased batch homogeneity, and sustainability.
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Tekin K, Karadoğan M, Kismet K. A review of medical devices used for safe chemotherapy applications: Focus on ONCOERA ® IV GROUP products. J Oncol Pharm Pract 2022; 29:709-721. [PMID: 36572993 DOI: 10.1177/10781552221147694] [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] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The healthcare workers and the workers in the manufacturing industry of chemotherapy drugs are exposed to the "hazardous" effects of these drugs during production, transportation, distribution, administration, and disposal. In order to be protected from these harmful effects, personal protective equipment and medical devices providing safe applications are used. The aim of the present article is to review of medical devices used for safe chemotherapy applications in line with the information obtained from the literature. DATA SOURCES The international and national reliable sources, were used in the literature review for data analysis by using the keywords including chemotherapy, chemotherapy drugs, antineoplastic drugs, cytotoxic drugs, hazardous drugs, exposure to chemotherapy drugs, side effects of chemotherapy drugs, closed-system drug transfer devices, healthcare staff, needle-free devices, needle-free connectors, surface contamination, and phthalates. DATA SUMMARY In order to minimize cytotoxic drug exposure, international standards were developed in the mid-1980s stating that all cytotoxic drugs should be prepared preferably in a ventilated biological safety cabinet, nurses dealing with the use of these drugs should use appropriate personal protective equipment, and in case of cytotoxic drug spillage, predefined cleaning and decontamination protocols should be followed. Although the risk of acute and long-term toxic effects in healthcare workers has decreased in recent years with these applications in the preparation and administration of cancer drugs, measurable contamination occurs in the workplace. A large number of medical devices have been developed for minimizing this type of contamination with chemotherapy drugs. In this article, these medical devices have been reviewed in detail under subtitles of closed system transfer devices, needle-free devices, and valve technology. CONCLUSIONS Until the results of the evaluations to be made in new studies prove the opposite, the use of these devices with additional protection measures taken, especially during the application of dangerous drugs, is of great importance in terms of patient and employee safety.
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Affiliation(s)
- Kemal Tekin
- Q MEN Informatics Software Consulting Education Ltd, Ankara, Turkey
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15
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Narhi LO, Chou DK, Christian TR, Gibson S, Jagannathan B, Jiskoot W, Jordan S, Sreedhara A, Waxman L, Das TK. Stress Factors in Primary Packaging, Transportation and Handling of Protein Drug Products and Their Impact on Product Quality. J Pharm Sci 2022; 111:887-902. [DOI: 10.1016/j.xphs.2022.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/15/2022] [Accepted: 01/16/2022] [Indexed: 12/15/2022]
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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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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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18
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An Industry Perspective on the Challenges of Using Closed System Transfer Devices with Biologics and Communication Guidance to Healthcare Professionals. J Pharm Sci 2021; 110:2329-2335. [PMID: 33617871 DOI: 10.1016/j.xphs.2021.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 11/20/2022]
Abstract
Closed system transfer devices (CSTDs) have been used with hazardous drugs for several decades. The goal of this whitepaper is to increase awareness among healthcare professionals, device manufacturers, regulators, and pharmaceutical/biotech companies on the potential issues around the use of CSTDs with biologic drug products to allow their informed use in clinics. Specifically, we discuss the key topics related to the use of CSTDs with biologics products, including components and materials of construction, a breakdown of regulatory, technical, clinical site-related risks and challenges associated with the use of CSTDs with biological products, gathered from stakeholder discussion at the IQ CSTD workshop, and considerations on current testing requirements and communication strategies to drive further dialog on the appropriate use of CSTDs. Given the technical challenges of using CSTDs with biologics, coupled with the current regulations surrounding CSTD approval and proper use, as well as a need for alignment and standardization to enable a consistent strategy for compatibility testing and communication of incompatibilities, it is recommended that global health authorities and other stakeholders seek to understand these issues, in order to alleviate these problems and keep healthcare workers and patients safe from harm.
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