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Clapham D, Belissa E, Inghelbrecht S, Pensé-Lhéritier AM, Ruiz F, Sheehan L, Shine M, Vallet T, Walsh J, Tuleu C. A Guide to Best Practice in Sensory Analysis of Pharmaceutical Formulations. Pharmaceutics 2023; 15:2319. [PMID: 37765288 PMCID: PMC10535428 DOI: 10.3390/pharmaceutics15092319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/25/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
It is well established that treatment regime compliance is linked to the acceptability of a pharmaceutical formulation, and hence also to therapeutic outcomes. To that end, acceptability must be assessed during the development of all pharmaceutical products and especially for those intended for paediatric patients. Although acceptability is a multifaceted concept, poor sensory characteristics often contribute to poor patient acceptability. In particular, poor taste is often cited as a major reason for many patients, especially children, to refuse to take their medicine. It is thus important to understand and, as far as possible, optimise the sensory characteristics and, in particular, the taste/flavour/mouthfeel of the formulation throughout the development of the product. Sensory analysis has been widely practiced, providing objective data concerning the sensory aspects of food and cosmetic products. In this paper, we present proposals concerning how the well-established principles of sensory analysis can best be applied to pharmaceutical product development, allowing objective, scientifically valid, sensory data to be obtained safely. We briefly discuss methodologies that may be helpful in reducing the number of samples that may need to be assessed by human volunteers. However, it is only possible to be sure whether or not the sensory characteristics of a pharmaceutical product are non-aversive to potential users by undertaking sensory assessments in human volunteers. Testing is also required during formulation assessment and to ensure that the sensory characteristics remain acceptable throughout the product shelf life. We provide a risk assessment procedure to aid developers to define where studies are low risk, the results of a survey of European regulators on their views concerning such studies, and detailed guidance concerning the types of sensory studies that can be undertaken at each phase of product development, along with guidance about the practicalities of performing such sensory studies. We hope that this guidance will also lead to the development of internationally agreed standards between industry and regulators concerning how these aspects should be measured and assessed throughout the development process and when writing and evaluating regulatory submissions. Finally, we hope that the guidance herein will help formulators as they seek to develop better medicines for all patients and, in particular, paediatric patients.
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Affiliation(s)
- David Clapham
- Independent Researcher, Bishop’s Stortford CM23 4FQ, UK
| | | | | | | | - Fabrice Ruiz
- ClinSearch, 92240 Malakoff, France; (F.R.); (T.V.)
| | - Liz Sheehan
- SRL Pharma, T12 XF62 Cork, Ireland; (L.S.); (M.S.)
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Belissa E, Vallet T, Laribe-Caget S, Chevallier A, Chedhomme FX, Abdallah F, Bachalat N, Belbachir SA, Boulaich I, Bloch V, Delahaye A, Depoisson M, Wojcicki AD, Gibaud S, Grancher AS, Guinot C, Lachuer C, Lechowski L, Leglise P, Mahiou A, Meaume S, Michel C, Michelon H, Orven Y, Perquy I, Piccoli M, Rabus M, Ribemont AC, Rwabihama JP, Trouvin JH, Ruiz F, Boudy V. Acceptability of oral liquid pharmaceutical products in older adults: palatability and swallowability issues. BMC Geriatr 2019; 19:344. [PMID: 31810442 PMCID: PMC6898963 DOI: 10.1186/s12877-019-1337-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 10/31/2019] [Indexed: 12/13/2022] Open
Abstract
Background In institutional care, oral liquid pharmaceutical products are widely prescribed for older patients, especially for those with swallowing disorders. As medicines acceptability is a key factor for compliance in the older population, this study investigated the acceptability of oral liquid pharmaceutical products in this targeted population. Methods An observational, multicenter, prospective study was conducted in eight geriatric hospitals and eight nursing homes in France. Observers reported several behaviours/events describing the many aspects of acceptability for various pharmaceutical products’ uses in patients aged 65 and older. Acceptability scores of oral liquid pharmaceutical products were obtained using an acceptability reference framework (CAST - ClinSearch Acceptability Score Test®): a 3D-map summarizing the different users’ behaviors, with two clusters defining the positively and negatively accepted profiles materialized by the green and red zones, respectively. Results Among 1288 patients included in the core study and supporting the acceptability reference framework, 340 assessments were related to the administration of an oral liquid pharmaceutical product. The mean age of these patients was 87 (Range [66-104y]; SD = 6.7), 68% were women and 16% had swallowing disorders. Globally, the oral liquid pharmaceutical products were classified as “positively accepted,” the barycenter of the 340 assessments, along with the entire confidence ellipses surrounding it, were positioned on the green zone of the map. Sub-populations presenting a different acceptability profile have also been identified. For patients with swallowing disorders, the oral liquid pharmaceutical products were classified as “negatively accepted,” the barycenter of the 53 assessments along with 87% of its confidence ellipses were associated with this profile. A gender difference was observed for unflavored oral liquids. In women, they were classified “negatively accepted,” the barycenter of the 68 assessments with 75% of its confidence ellipses were located in the red zone, while they were classified “positively accepted” in men. Conclusion This study showed that oral liquid pharmaceutical products are a suboptimal alternative to solid oral dosage forms in patients with swallowing disorders. To ensure an optimal acceptability, prescribers should also consider the presence of a taste-masker in these oral liquids. As highlighted herein, palatability remains crucial in older populations, especially for women.
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Affiliation(s)
- Emilie Belissa
- Département Recherche et Développement Pharmaceutique, Agence Générale des Equipements et Produits de Santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), 7 rue du Fer à Moulin, 75005, Paris, France
| | - Thibault Vallet
- ClinSearch, 110 avenue Pierre Brossolette, 92240, Malakoff, France
| | - Sandra Laribe-Caget
- Hôpital Rothschild, Groupe Hospitalier Universitaire Est Parisien, AP-HP, 5 rue Santerre, 75012, Paris, France
| | - Alain Chevallier
- Hôpital Broca, Groupe Hospitalier Universitaire Paris Centre, AP-HP, 54-56 rue Pascal, 75013, Paris, France
| | - François-Xavier Chedhomme
- Hôpital Broca, Groupe Hospitalier Universitaire Paris Centre, AP-HP, 54-56 rue Pascal, 75013, Paris, France
| | - Fattima Abdallah
- Hôpital Joffre Dupuytren, Groupe Hospitalier Universitaire Henri Mondor, AP-HP, 1 rue Eugène Delacroix, 91210, Draveil, France
| | - Nathalie Bachalat
- Hôpital Joffre Dupuytren, Groupe Hospitalier Universitaire Henri Mondor, AP-HP, 1 rue Eugène Delacroix, 91210, Draveil, France
| | - Sid-Ahmed Belbachir
- Hôpital René Muret, Groupe Hospitalier Universitaire Paris Seine-Saint-Denis, AP-HP, avenue du Dr Schaeffner, 93270, Sevran, France
| | - Imad Boulaich
- Hôpital Joffre Dupuytren, Groupe Hospitalier Universitaire Henri Mondor, AP-HP, 1 rue Eugène Delacroix, 91210, Draveil, France
| | - Vanessa Bloch
- Hôpital Fernand Widal, Groupe Hospitalier Universitaire Saint-Louis - Lariboisière - Fernand-Widal, AP-HP, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Anne Delahaye
- Hôpital Sainte Périne, Groupe Hospitalier Universitaire Paris Ile-de-France Ouest, AP-HP, 11 rue Chardon Lagache, 75016, Paris, France
| | - Mathieu Depoisson
- Hôpital Vaugirard, Groupe Hospitalier Universitaire Paris Ouest, AP-HP, 10 rue Vaugelas, 75015, Paris, France
| | - Amélie Dufaÿ Wojcicki
- Département Recherche et Développement Pharmaceutique, Agence Générale des Equipements et Produits de Santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), 7 rue du Fer à Moulin, 75005, Paris, France
| | - Stéphane Gibaud
- Centre Hospitalier de l'Ouest Vosgien, 1280 avenue division Leclerc, 88300, Neufchâteau, France
| | - Anne-Sophie Grancher
- Hôpital Rothschild, Groupe Hospitalier Universitaire Est Parisien, AP-HP, 5 rue Santerre, 75012, Paris, France
| | - Caroline Guinot
- Hôpital Fernand Widal, Groupe Hospitalier Universitaire Saint-Louis - Lariboisière - Fernand-Widal, AP-HP, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Celia Lachuer
- Hôpital Joffre Dupuytren, Groupe Hospitalier Universitaire Henri Mondor, AP-HP, 1 rue Eugène Delacroix, 91210, Draveil, France
| | - Laurent Lechowski
- Hôpital Sainte Périne, Groupe Hospitalier Universitaire Paris Ile-de-France Ouest, AP-HP, 11 rue Chardon Lagache, 75016, Paris, France
| | - Patrick Leglise
- Hôpital Joffre Dupuytren, Groupe Hospitalier Universitaire Henri Mondor, AP-HP, 1 rue Eugène Delacroix, 91210, Draveil, France
| | - Abdel Mahiou
- Hôpital René Muret, Groupe Hospitalier Universitaire Paris Seine-Saint-Denis, AP-HP, avenue du Dr Schaeffner, 93270, Sevran, France
| | - Sylvie Meaume
- Hôpital Rothschild, Groupe Hospitalier Universitaire Est Parisien, AP-HP, 5 rue Santerre, 75012, Paris, France
| | - Corinne Michel
- Hôpital René Muret, Groupe Hospitalier Universitaire Paris Seine-Saint-Denis, AP-HP, avenue du Dr Schaeffner, 93270, Sevran, France
| | - Hugues Michelon
- Hôpital Sainte Périne, Groupe Hospitalier Universitaire Paris Ile-de-France Ouest, AP-HP, 11 rue Chardon Lagache, 75016, Paris, France
| | - Yann Orven
- Hôpital Vaugirard, Groupe Hospitalier Universitaire Paris Ouest, AP-HP, 10 rue Vaugelas, 75015, Paris, France
| | - Ines Perquy
- Hôpital Broca, Groupe Hospitalier Universitaire Paris Centre, AP-HP, 54-56 rue Pascal, 75013, Paris, France
| | - Matthieu Piccoli
- Hôpital Broca, Groupe Hospitalier Universitaire Paris Centre, AP-HP, 54-56 rue Pascal, 75013, Paris, France
| | - Maïté Rabus
- Hôpital Joffre Dupuytren, Groupe Hospitalier Universitaire Henri Mondor, AP-HP, 1 rue Eugène Delacroix, 91210, Draveil, France
| | - Annie-Claude Ribemont
- Hôpital Joffre Dupuytren, Groupe Hospitalier Universitaire Henri Mondor, AP-HP, 1 rue Eugène Delacroix, 91210, Draveil, France
| | - Jean-Paul Rwabihama
- Hôpital Joffre Dupuytren, Groupe Hospitalier Universitaire Henri Mondor, AP-HP, 1 rue Eugène Delacroix, 91210, Draveil, France
| | - Jean-Hugues Trouvin
- Département Recherche et Développement Pharmaceutique, Agence Générale des Equipements et Produits de Santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), 7 rue du Fer à Moulin, 75005, Paris, France
| | - Fabrice Ruiz
- ClinSearch, 110 avenue Pierre Brossolette, 92240, Malakoff, France
| | - Vincent Boudy
- Département Recherche et Développement Pharmaceutique, Agence Générale des Equipements et Produits de Santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), 7 rue du Fer à Moulin, 75005, Paris, France.
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Danion F, Belissa E, Peytavin G, Thierry E, Lanternier F, Scemla A, Lortholary O, Delelis O, Avettand-Fenoel V, Duvivier C. Non-virological response to a dolutegravir-containing regimen in a patient harbouring a E157Q-mutated virus in the integrase region. J Antimicrob Chemother 2015; 70:1921-3. [PMID: 25670643 DOI: 10.1093/jac/dkv012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F Danion
- APHP-Hôpital Necker-Enfants malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Paris, France Université Paris Descartes, Sorbonne Paris Cité, Paris, France IHU Imagine, Paris, France
| | - E Belissa
- AP-HP, Groupe Hospitalier Xavier Bichat-Claude Bernard, UF 301 Laboratoire de Pharmaco-Toxicologie, F-75018 Paris, France
| | - G Peytavin
- AP-HP, Groupe Hospitalier Xavier Bichat-Claude Bernard, UF 301 Laboratoire de Pharmaco-Toxicologie, F-75018 Paris, France INSERM, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - E Thierry
- Laboratoire de Biologie et Pharmacologie Appliquée, Centre National de la Recherche Scientifique UMR8113, Cachan, France
| | - F Lanternier
- APHP-Hôpital Necker-Enfants malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Paris, France Université Paris Descartes, Sorbonne Paris Cité, Paris, France IHU Imagine, Paris, France
| | - A Scemla
- APHP-Hôpital Necker-Enfants malades, Service de Néphrologie et Transplantation Adulte, Paris, France Université Paris Descartes, Sorbonne Paris Cité, RTRS Centaure, Labex Transplantex, Paris, France
| | - O Lortholary
- APHP-Hôpital Necker-Enfants malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Paris, France Université Paris Descartes, Sorbonne Paris Cité, Paris, France IHU Imagine, Paris, France
| | - O Delelis
- Laboratoire de Biologie et Pharmacologie Appliquée, Centre National de la Recherche Scientifique UMR8113, Cachan, France
| | - V Avettand-Fenoel
- APHP-Hôpital Necker-Enfants malades, Service de Virologie, Paris, France Université Paris Descartes, Sorbonne Paris Cité, EA7327 Paris, France
| | - C Duvivier
- APHP-Hôpital Necker-Enfants malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Paris, France Université Paris Descartes, Sorbonne Paris Cité, Paris, France IHU Imagine, Paris, France
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