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Pendsey S, James S, Garrett TJ, Nord AB, Pendsey S, Malmodin D, Karlsson G, Maniam J, Atkinson MA, Forsander G, Ogle GD. Insulin thermostability in a real-world setting. Lancet Diabetes Endocrinol 2023; 11:310-312. [PMID: 37003280 DOI: 10.1016/s2213-8587(23)00028-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/05/2023] [Accepted: 01/19/2023] [Indexed: 04/03/2023]
Affiliation(s)
- Sanket Pendsey
- Diabetes Research Education and Management Trust, Nagpur, India
| | - Steven James
- Life for a Child, Diabetes NSW & ACT, Sydney, NSW 2037, Australia; University of the Sunshine Coast, Petrie, QLD, Australia
| | | | | | - Sharad Pendsey
- Diabetes Research Education and Management Trust, Nagpur, India
| | | | - Göran Karlsson
- University of Gothenburg, Gothenburg, Sweden; Science for Life Laboratory, Gothenburg, Sweden
| | - Jayanthi Maniam
- Life for a Child, Diabetes NSW & ACT, Sydney, NSW 2037, Australia
| | | | - Gun Forsander
- University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Graham D Ogle
- Life for a Child, Diabetes NSW & ACT, Sydney, NSW 2037, Australia.
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Lorbetskie B, Bigelow S, Walrond L, Klein AV, Loo SM, Green N, Rosu-Myles M, Zhang X, Lu H, Girard M, Sauvé S. Regulatory Verification by Health Canada of Content in Recombinant Human Insulin, Human Insulin Analog, and Porcine Insulin Drug Products in the Canadian Market Using Validated Pharmacopoeial Methods Over Nonvalidated Approaches. J Diabetes Sci Technol 2023:19322968231159360. [PMID: 36912012 DOI: 10.1177/19322968231159360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
BACKGROUND For diabetes mellitus treatment plans, the consistency and quality of insulin drug products are crucial for patient well-being. Because biologic drugs, such as insulin, are complex heterogeneous products, the methods for drug product evaluation should be carefully validated for use. As such, these criteria are rigorously evaluated and monitored by national authorities. Consequently, reports that describe significantly lower insulin content than their label claims are a concern. This issue was raised by a past publication analyzing insulin drug products available in Canada, and, as a result, consumers and major patient organizations have requested clarification. METHODS To address these concerns, this study independently analyzed insulin drug products purchased from local Canadian pharmacies-including human insulin, insulin analogs, and porcine insulin-by compendial and noncompendial reversed-phase high-performance liquid chromatography (RP-HPLC) methods. RESULTS We demonstrated the importance of using methods fit for purpose when assessing insulin quality. In a preliminary screen, the expected insulin peak was seen in all products except two insulin analogs-insulin detemir and insulin degludec. Further investigation showed that this was not caused by low insulin content but insufficient solvent conditions, which demonstrated the necessity for methods to be adequately validated for product-specific use. When drug products were appropriately assessed for content using the validated type-specific compendial RP-HPLC methods for insulin quantitation, values agreed with the label claim content. CONCLUSIONS Because insulin drug products are used daily by over a million Canadians, it is important that researchers and journals present data using methods fit for purpose and that readers evaluate such reports critically.
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Affiliation(s)
- Barry Lorbetskie
- Biologic and Radiopharmaceutical Drugs Directorate, Health Canada, Ottawa, ON, Canada
| | - Stewart Bigelow
- Biologic and Radiopharmaceutical Drugs Directorate, Health Canada, Ottawa, ON, Canada
| | - Lisa Walrond
- Biologic and Radiopharmaceutical Drugs Directorate, Health Canada, Ottawa, ON, Canada
| | - Agnes V Klein
- Biologic and Radiopharmaceutical Drugs Directorate, Health Canada, Ottawa, ON, Canada
| | - Shih-Miin Loo
- Biologic and Radiopharmaceutical Drugs Directorate, Health Canada, Ottawa, ON, Canada
| | - Nancy Green
- Biologic and Radiopharmaceutical Drugs Directorate, Health Canada, Ottawa, ON, Canada
| | - Michael Rosu-Myles
- Biologic and Radiopharmaceutical Drugs Directorate, Health Canada, Ottawa, ON, Canada
| | - Xu Zhang
- Biologic and Radiopharmaceutical Drugs Directorate, Health Canada, Ottawa, ON, Canada
| | - Huixin Lu
- Biologic and Radiopharmaceutical Drugs Directorate, Health Canada, Ottawa, ON, Canada
| | - Michel Girard
- Biologic and Radiopharmaceutical Drugs Directorate, Health Canada, Ottawa, ON, Canada
| | - Simon Sauvé
- Biologic and Radiopharmaceutical Drugs Directorate, Health Canada, Ottawa, ON, Canada
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Garrett TJ, Feizbakhsh Bazargani S, Harmon T, Kruse J, Atkinson P, Quinlivan EP, Ang L, Hirsch IB, Laffel L, Pietropaolo M, Haller MJ, Atkinson MA. Commercially Available Insulin Products Demonstrate Consistency With Product Labeling Throughout All Seasons in the U.S. Diabetes Care 2022; 45:e166-e168. [PMID: 36102751 DOI: 10.2337/dc22-0972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/29/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Timothy J Garrett
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL
| | - Sina Feizbakhsh Bazargani
- Department of Chemistry, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL
| | - Taylor Harmon
- Department of Chemistry, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL
| | - Jordan Kruse
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL
| | | | - Eoin P Quinlivan
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL
| | - Lynn Ang
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Irl B Hirsch
- Endocrine and Diabetes Care Center, University of Washington Medical Center-Roosevelt, Seattle, WA
| | - Lori Laffel
- Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Massimo Pietropaolo
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX
| | - Michael J Haller
- Department of Pediatrics, College of Medicine, University of Florida Diabetes Institute, Gainesville, FL
| | - Mark A Atkinson
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL.,Insulin for Life USA, Gainesville, FL.,Department of Pediatrics, College of Medicine, University of Florida Diabetes Institute, Gainesville, FL
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Landgraf R, Aberle J. Hundert Jahre – Insulin bleibt aktuell und notwendig. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1386-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
ZusammenfassungIn der Behandlung des Typ-1-Diabetes ist die Therapie mit Insulin auch 100 Jahre nach seiner Entdeckung weiterhin eine lebensnotwendige Therapie. Der pharmakologische Fortschritt hat die Behandlung erheblich erleichtert und nähert sich der physiologischen Insulin-Sekretion zunehmend an. In der Behandlung des Typ-2-Diabetes hingegen ist die Insulin-Therapie bei den meisten Patienten zunächst nicht notwendig. Lebensstil-Interventionen und moderne Nicht-Insulin Antidiabetika können häufig zu einer lang andauernden Kontrolle der Erkrankung führen. Die Heterogenität des Typ-2-Diabetes führt jedoch dazu, dass einige Patienten früh von einer Insulin-Therapie profitieren. Auch beim Typ-2-Diabetes können moderne Insulin Präparate die Insulin-Behandlung deutlich erleichtern, auch in Kombination mit anderen Antidiabetika. Einleitung und Begleitung einer Insulin-Therapie gehören somit weiterhin zu den Kernaufgaben der Diabetologie.
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Affiliation(s)
| | - Jens Aberle
- Endokrinologie und Diabetologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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