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Moens F, Larsson A, De Blaiser A, Vandevijver G, Spreafico F, Nicolas JM, Lacombe L, Segregur D, Flanagan T, Berben P. Contribution of the Dynamic Intestinal Absorption Model (Diamod) to the Development of a Patient-Centric Drug Formulation. Mol Pharm 2023; 20:6197-6212. [PMID: 37955627 DOI: 10.1021/acs.molpharmaceut.3c00607] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Compound X is a weak basic drug targeting the early stages of Parkinson's disease, for which a theoretical risk assessment has indicated that elevated gastric pH conditions could potentially result in reduced plasma concentrations. Different in vitro dissolution methodologies varying in level of complexity and a physiologically based pharmacokinetic (PBPK) absorption model demonstrated that the dissolution, solubility, and intestinal absorption of compound X was indeed reduced under elevated gastric pH conditions. These observations were confirmed in a crossover pharmacokinetic study in Beagle dogs. As a result, the development of a formulation resulting in robust performance that is not sensitive to the exposed gastric pH levels is of crucial importance. The dynamic intestinal absorption MODel (Diamod), an advanced in vitro gastrointestinal transfer tool that allows to study the gastrointestinal dissolution and interconnected permeation of drugs, was selected as an in vitro tool for the formulation optimization activities given its promising predictive capacity and its capability to generate insights into the mechanisms driving formulation performance. Different pH-modifiers were screened for their potential to mitigate the pH-effect by decreasing the microenvironmental pH at the dissolution surface. Finally, an optimized formulation containing a clinically relevant dose of the drug and a functional amount of the selected pH-modifier was evaluated for its performance in the Diamod. This monolayer tablet formulation resulted in rapid gastric dissolution and supersaturation, inducing adequate intestinal supersaturation and permeation of compound X, irrespective of the gastric acidity level in the stomach. In conclusion, this study describes the holistic biopharmaceutics approach driving the development of a patient-centric formulation of compound X.
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Affiliation(s)
| | - Adam Larsson
- ProDigest BV, Technologiepark 82, 9052 Ghent, Belgium
| | | | | | | | - Jean-Marie Nicolas
- UCB Pharma SA, Early Solutions, Chemin du Foriest 1, 1420 Braine l'Alleud, Belgium
| | - Lucie Lacombe
- UCB Pharma SA, Product Design & Performance, Chemin du Foriest 1, 1420 Braine l'Alleud, Belgium
| | - Domagoj Segregur
- UCB Pharma SA, Product Design & Performance, Chemin du Foriest 1, 1420 Braine l'Alleud, Belgium
| | - Talia Flanagan
- UCB Pharma SA, Product Design & Performance, Chemin du Foriest 1, 1420 Braine l'Alleud, Belgium
| | - Philippe Berben
- UCB Pharma SA, Product Design & Performance, Chemin du Foriest 1, 1420 Braine l'Alleud, Belgium
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2
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de Waal T, Brouwers J, Berben P, Flanagan T, Tack J, Vandenberghe W, Vanuytsel T, Augustijns P. Characterization of Aspirated Duodenal Fluids from Parkinson's Disease Patients. Pharmaceutics 2023; 15:pharmaceutics15041243. [PMID: 37111729 PMCID: PMC10145225 DOI: 10.3390/pharmaceutics15041243] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/16/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
Parkinson's disease, one of the most common neurodegenerative diseases, may not only affect the motor system, but also the physiology of the gastrointestinal tract. Delayed gastric emptying, impaired motility and altered intestinal bacteria are well-established consequences of the disease, which can have a pronounced effect on the absorption of orally administered drugs. In contrast, no studies have been performed into the composition of intestinal fluids. It is not unlikely that Parkinson's disease also affects the composition of intestinal fluids, a critical factor in the in vitro and in silico simulation of drug dissolution, solubilization and absorption. In the current study, duodenal fluids were aspirated from Parkinson's disease (PD) patients and age-matched healthy controls (healthy controls, HC) consecutively in fasted and fed conditions. The fluids were then characterized for pH, buffer capacity, osmolality, total protein, phospholipids, bile salts, cholesterol and lipids. In a fasted state, the intestinal fluid composition was highly similar in PD patients and healthy controls. In general, the same was true for fed-state fluids, apart from a slightly slower and less pronounced initial change in factors directly affected by the meal (i.e., buffer capacity, osmolality, total protein and lipids) in PD patients. The absence of a fast initial increase for these factors immediately after meal intake, as was observed in healthy controls, might result from slower gastric emptying in PD patients. Irrespective of the prandial state, a higher relative amount of secondary bile salts was observed in PD patients, potentially indicating altered intestinal bacterial metabolism. Overall, the data from this study indicate that only minor disease-specific adjustments in small intestinal fluid composition should be considered when simulating intestinal drug absorption in PD patients.
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Affiliation(s)
- Tom de Waal
- Drug Delivery and Disposition, KU Leuven, 3000 Leuven, Belgium
| | | | - Philippe Berben
- Pharmaceutical Sciences, UCB Pharma SA, 1420 Braine-l'Alleud, Belgium
| | - Talia Flanagan
- Pharmaceutical Sciences, UCB Pharma SA, 1420 Braine-l'Alleud, Belgium
| | - Jan Tack
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, 3000 Leuven, Belgium
- Translational Research Center for Gastrointestinal Disorders, TARGID, KU Leuven, 3000 Leuven, Belgium
| | - Wim Vandenberghe
- Department of Neurology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Tim Vanuytsel
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, 3000 Leuven, Belgium
- Translational Research Center for Gastrointestinal Disorders, TARGID, KU Leuven, 3000 Leuven, Belgium
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Popkin ME, Goese M, Wilkinson D, Finnie S, Flanagan T, Campa C, Clinch A, Teasdale A, Lennard A, Cook G, Mohan G, Osborne MD. Chemistry Manufacturing and Controls Development, Industry Reflections on Manufacture, and Supply of Pandemic Therapies and Vaccines. AAPS J 2022; 24:101. [PMID: 36168002 PMCID: PMC9514697 DOI: 10.1208/s12248-022-00751-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/02/2022] [Indexed: 01/18/2023] Open
Abstract
This publication provides some industry reflections on experiences from the Chemistry, Manufacturing, and Controls (CMC) development and manufacture and supply of vaccines and therapies in response to the COVID-19 pandemic. It integrates these experiences with the outcomes from the collaborative work between industry and regulators in recent years on innovative science- and risk-based CMC strategies to the development of new, high-quality products for unmet medical needs. The challenges for rapid development are discussed and various approaches to facilitate accelerated development and global supply are collated for consideration. Relevant regulatory aspects are reviewed, including the role of Emergency Use/Conditional Marketing Authorizations, the dialogue between sponsors and agencies to facilitate early decision-making and alignment, and the value of improving reliance/collaborative assessment and increased collaboration between regulatory authorities to reduce differences in global regulatory requirements. Five areas are highlighted for particular consideration in the implementation of strategies for the quality-related aspects of accelerated development and supply: (1) the substantial need to advance reliance or collaborative assessment; (2) the need for early decision making and streamlined engagement between industry and regulatory authorities on CMC matters; (3) the need to further facilitate 'post-approval' changes; (4) fully exploiting prior and platform knowledge; and (5) review and potential revision of legal frameworks. The recommendations in this publication are intended to contribute to the discussion on approaches that can result in earlier and greater access to high-quality pandemic vaccines and therapies for patients worldwide but could also be useful in general for innovative medicines addressing unmet medical needs.
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Affiliation(s)
- Matthew E. Popkin
- grid.418236.a0000 0001 2162 0389GSK, David Jack Centre for R&D, Park Road, Ware, SG12 0DP UK
| | - Markus Goese
- grid.417570.00000 0004 0374 1269F. Hoffmann-La Roche Ltd, CH-4070 Basel, Switzerland
| | - Diane Wilkinson
- grid.417815.e0000 0004 5929 4381AstraZeneca, Derwent Building, Silk Road Business Park, Charter Way, Macclesfield, SK10 2NA UK
| | - Stuart Finnie
- grid.417815.e0000 0004 5929 4381AstraZeneca, Charter Way, Macclesfield, SK10 2NA UK
| | - Talia Flanagan
- grid.421932.f0000 0004 0605 7243UCB Pharma SA, 1420 Braine l’Alleud, Belgium
| | | | - Alexandra Clinch
- grid.418727.f0000 0004 5903 3819UCB Pharma, 208 Bath Road, Slough, SL1 3WE Berkshire UK
| | - Andrew Teasdale
- grid.417815.e0000 0004 5929 4381AstraZeneca, Chemical Development, Pharmaceutical Technology and Development, Operations, Charter Way, Macclesfield, Macclesfield, SK10 2NA UK
| | - Andrew Lennard
- grid.476413.3Amgen, 4, Uxbridge Business Park, Sanderson Road, Uxbridge, UB8 1DH UK
| | - Graham Cook
- grid.418566.80000 0000 9348 0090Pfizer Ltd., Walton Oaks, Dorking Road, Tadworth, KT20 7NS Surrey UK
| | - Ganapathy Mohan
- grid.417993.10000 0001 2260 0793Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486 USA
| | - Matthew D. Osborne
- grid.473059.cEli Lilly Kinsale Ltd, Dunderrow, Kinsale, P17 NY71 Co. Cork Ireland
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Martinez MN, Sinko B, Wu F, Flanagan T, Borbás E, Tsakalozou E, Giacomini KM. A Critical Overview of the Biological Effects of Excipients (Part I): Impact on Gastrointestinal Absorption. AAPS J 2022; 24:60. [DOI: 10.1208/s12248-022-00711-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/16/2022] [Indexed: 02/07/2023] Open
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Selen A, Müllertz A, Kesisoglou F, Ho RJY, Cook JA, Dickinson PA, Flanagan T. Correction to: Integrated Multi-stakeholder Systems Thinking Strategy: Decision-making with Biopharmaceutics Risk Assessment Roadmap (BioRAM) to Optimize Clinical Performance of Drug Products. AAPS J 2020; 23:7. [PMID: 33270171 DOI: 10.1208/s12248-020-00534-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A Correction to this paper has been published: https://doi.org/10.1208/s12248-020-00534-0.
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Affiliation(s)
- Arzu Selen
- US Food and Drug Administration, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Office of Testing and Research, 10903 New Hampshire Ave., Silver Spring, MD, 20993, USA.
| | - Anette Müllertz
- Bioneer: FARMA, Department of Pharmacy, University of Copenhagen, 2100, Copenhagen, Denmark
| | - Filippos Kesisoglou
- Biopharmaceutics, Pharmaceutical Sciences and Clinical Supply, Merck & Co, Inc., West Point, PA, 19486, USA
| | | | - Jack A Cook
- Clinical Pharmacology Department, Global Product Development, Pfizer, Inc., Groton, CT, 06340, USA
| | - Paul A Dickinson
- Seda Pharmaceutical Development Services, Alderley Park, Alderley Edge, Cheshire, SK10 4TG, UK
| | - Talia Flanagan
- UCB Pharma S.A., Avenue de l'Industrie, 1420, Braine - l'Alleud, Belgium
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6
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Mitra A, Suarez-Sharp S, Pepin XJH, Flanagan T, Zhao Y, Kotzagiorgis E, Parrott N, Sharan S, Tistaert C, Heimbach T, Zolnik B, Sjögren E, Wu F, Anand O, Kakar S, Li M, Veerasingham S, Kijima S, Lima Santos GM, Ning B, Raines K, Rullo G, Mandula H, Delvadia P, Dressman J, Dickinson PA, Babiskin A. Applications of Physiologically Based Biopharmaceutics Modeling (PBBM) to Support Drug Product Quality: A Workshop Summary Report. J Pharm Sci 2020; 110:594-609. [PMID: 33152375 DOI: 10.1016/j.xphs.2020.10.059] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 09/22/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
This report summarizes the proceedings for Day 3 of the workshop titled "Current State and Future Expectations of Translational Modeling Strategies toSupportDrug Product Development, Manufacturing Changes and Controls". From a drug product quality perspective, patient-centric product development necessitates the development of clinically relevant drug product specifications (CRDPS). In this regard, Physiologically Based Biopharmaceutics modeling (PBBM) is a viable tool to establish links between in-vitro to in-vivo data, and support with establishing CRDPS. The theme of day 3 was practical applications of PBBM to support drug product quality. In this manuscript, case studies from US FDA, EMA and pharmaceutical industry on applications of PBBM in drug product quality are summarized which include 1) regulatory agency's perspectives on establishing the safe space and achieving study waivers, 2) model-informed risk assessment on the effects of acid reducing agents, bridging of dissolution methods, food effect, and formulation selection, and 3) understanding clinical formulation performance. Breakout session discussions focused on four topics - 1) terminologies related to physiologically based modeling in support of drug product quality, 2) regulatory harmonization on evidentiary standards, 3) CRDPS approaches and 4) bridging between biorelevant and quality control (QC) dissolution methods.
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Affiliation(s)
- Amitava Mitra
- Clinical Pharmacology and Pharmacometrics, Janssen Research & Development, Spring House, Pennsylvania.
| | | | - Xavier J H Pepin
- New Modalities and Parenteral Development, Pharmaceutical Technology & Development, Operations, AstraZeneca, Macclesfield, UK
| | - Talia Flanagan
- Pharmaceutical Development, UCB Pharma SA, Braine l'Alleud, Belgium
| | - Yang Zhao
- Division of Biopharmaceutics, Office of New Drug Products, Office of Pharmaceutical Quality (OPQ), Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, Maryland
| | - Evangelos Kotzagiorgis
- Pharmaceutical Quality Office, European Medicines Agency (EMA), Amsterdam, the Netherlands
| | - Neil Parrott
- Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Satish Sharan
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, Maryland
| | | | - Tycho Heimbach
- PK Sciences, Novartis Institutes for Biomedical Research, East Hanover, New Jersey
| | - Banu Zolnik
- Division of Biopharmaceutics, Office of New Drug Products, Office of Pharmaceutical Quality (OPQ), Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, Maryland
| | | | - Fang Wu
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, Maryland
| | - Om Anand
- Division of Biopharmaceutics, Office of New Drug Products, Office of Pharmaceutical Quality (OPQ), Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, Maryland
| | - Shefali Kakar
- PK Sciences, Novartis Institutes for Biomedical Research, East Hanover, New Jersey
| | - Min Li
- Division of Biopharmaceutics, Office of New Drug Products, Office of Pharmaceutical Quality (OPQ), Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, Maryland
| | - Shereeni Veerasingham
- Therapeutic Products Directorate, Health Products and Food Branch, Health Canada, Ottawa, Canada
| | - Shinichi Kijima
- Office of Advanced Evaluation with Electronic Data, Pharmaceuticals and Medical Devices Agency (PMDA), Tokyo, Japan
| | - Gustavo Mendes Lima Santos
- General Office of Medicines and Biological Products, Brazilian Health Regulatory Agency (Anvisa), Brasilia, Brazil
| | - Baoming Ning
- National Institutes for Food and Drug Control (NIFDC), Beijing, China
| | - Kimberly Raines
- Division of Biopharmaceutics, Office of New Drug Products, Office of Pharmaceutical Quality (OPQ), Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, Maryland
| | - Greg Rullo
- Regulatory Excellence, Oncology R&D, AstraZeneca, Gaithersburg, Maryland
| | - Haritha Mandula
- Division of Biopharmaceutics, Office of New Drug Products, Office of Pharmaceutical Quality (OPQ), Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, Maryland
| | - Poonam Delvadia
- Division of Biopharmaceutics, Office of New Drug Products, Office of Pharmaceutical Quality (OPQ), Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, Maryland
| | - Jennifer Dressman
- Fraunhofer Institute for Molecular Biology and Applied Ecology, and Goethe University, Frankfurt, Germany
| | - Paul A Dickinson
- Seda Pharmaceutical Development Services, Alderley Park, Alderley Edge, Cheshire, UK
| | - Andrew Babiskin
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, Maryland
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Ahmad A, Pepin X, Aarons L, Wang Y, Darwich AS, Wood JM, Tannergren C, Karlsson E, Patterson C, Thörn H, Ruston L, Mattinson A, Carlert S, Berg S, Murphy D, Engman H, Laru J, Barker R, Flanagan T, Abrahamsson B, Budhdeo S, Franek F, Moir A, Hanisch G, Pathak SM, Turner D, Jamei M, Brown J, Good D, Vaidhyanathan S, Jackson C, Nicolas O, Beilles S, Nguefack JF, Louit G, Henrion L, Ollier C, Boulu L, Xu C, Heimbach T, Ren X, Lin W, Nguyen-Trung AT, Zhang J, He H, Wu F, Bolger MB, Mullin JM, van Osdol B, Szeto K, Korjamo T, Pappinen S, Tuunainen J, Zhu W, Xia B, Daublain P, Wong S, Varma MV, Modi S, Schäfer KJ, Schmid K, Lloyd R, Patel A, Tistaert C, Bevernage J, Nguyen MA, Lindley D, Carr R, Rostami-Hodjegan A. IMI – Oral biopharmaceutics tools project – Evaluation of bottom-up PBPK prediction success part 4: Prediction accuracy and software comparisons with improved data and modelling strategies. Eur J Pharm Biopharm 2020; 156:50-63. [DOI: 10.1016/j.ejpb.2020.08.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/12/2020] [Accepted: 08/06/2020] [Indexed: 11/25/2022]
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Martir J, Flanagan T, Mann J, Fotaki N. Impact of Food and Drink Administration Vehicles on Paediatric Formulation Performance Part 2: Dissolution of Montelukast Sodium and Mesalazine Formulations. AAPS PharmSciTech 2020; 21:287. [PMID: 33063245 PMCID: PMC7561592 DOI: 10.1208/s12249-020-01815-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/08/2020] [Indexed: 11/30/2022] Open
Abstract
Paediatric medicines are not always age-appropriate, causing problems with dosing, acceptability and adherence. The use of food and drinks as vehicles for medicine co-administration is common practice, yet the impact on drug bioavailability, safety and efficacy remains unaddressed. The aim of this study was to use in vitro dissolution testing, under infant simulating conditions, to evaluate the effect of co-administration with vehicles on the dissolution performance of two poorly soluble paediatric drugs. Dissolution studies of mesalazine and montelukast formulations were conducted with mini-paddle apparatus on a two-stage approach: simulated gastric fluid followed by addition of simulated intestinal fluid. The testing scenarios were designed to reflect daily administration practices: direct administration of formulation; formulation co-administered with food and drinks, both immediately after mixing and 4 h after mixing. Drug dissolution was significantly affected by medicine co-administration with vehicles, compared to the direct administration of formulation. Furthermore, differences were observed on drug dissolution when the formulations were mixed with different vehicles of the same subtype. The time between preparation and testing of the drug-vehicle mixture also impacted dissolution behaviour. Drug dissolution was shown to be significantly affected by the physicochemical properties and composition of the vehicles, drug solubility in each vehicle and drug/formulation characteristics. Ultimately, in this study, we show the potential of age-appropriate in vitro dissolution testing as a useful biopharmaceutical tool for estimating drug dissolution in conditions relevant to the paediatric population. The setup developed has potential to evaluate the impact of medicine co-administration with vehicles on paediatric formulation performance.
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Martir J, Flanagan T, Mann J, Fotaki N. In Vivo Predictive Dissolution Testing of Montelukast Sodium Formulations Administered with Drinks and Soft Foods to Infants. AAPS PharmSciTech 2020; 21:282. [PMID: 33051713 PMCID: PMC7554011 DOI: 10.1208/s12249-020-01825-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/22/2020] [Indexed: 12/26/2022] Open
Abstract
In vitro dissolution testing conditions that reflect and predict in vivo drug product performance are advantageous, especially for the development of paediatric medicines, as clinical testing in this population is hindered by ethical and technical considerations. The aim of this study was to develop an in vivo predictive dissolution test in order to investigate the impact of medicine co-administration with soft food and drinks on the dissolution performance of a poorly soluble compound. Relevant in vitro dissolution conditions simulating the in vivo gastrointestinal environment of infants were used to establish in vitro-in vivo relationships with corresponding in vivo data. Dissolution studies of montelukast formulations were conducted with mini-paddle apparatus on a two-stage approach: infant fasted-state simulated gastric fluid (Pi-FaSSGF; for 1 h) followed by either infant fasted-state or infant fed-state simulated intestinal fluid (FaSSIF-V2 or Pi-FeSSIF, respectively; for 3 h). The dosing scenarios tested reflected in vivo paediatric administration practices: (i.) direct administration of formulation; (ii.) formulation co-administered with vehicles (formula, milk or applesauce). Drug dissolution was significantly affected by co-administration of the formulation with vehicles compared with after direct administration of the formulation. Montelukast dissolution from the granules was significantly higher under fed-state simulated intestinal conditions in comparison with the fasted state and was predictive of the in vivo performance when the granules are co-administered with milk. This study supports the potential utility of the in vitro biorelevant dissolution approach proposed to predict in vivo formulation performance after co-administration with vehicles, in the paediatric population.
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Parrott N, Suarez-Sharp S, Kesisoglou F, Pathak SM, Good D, Wagner C, Dallmann A, Mullin J, Patel N, Riedmaier AE, Mitra A, Raines K, Butler J, Kakhi M, Li M, Zhao Y, Tsakalozou E, Flanagan T, Dressman J, Pepin X. Best Practices in the Development and Validation of Physiologically Based Biopharmaceutics Modeling. A Workshop Summary Report. J Pharm Sci 2020; 110:584-593. [PMID: 33058891 DOI: 10.1016/j.xphs.2020.09.058] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 08/30/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 12/16/2022]
Abstract
This workshop report summarizes the proceedings of Day 2 of a three-day workshop on "Current State and Future Expectations of Translational Modeling Strategies toSupportDrug Product Development, Manufacturing Changes and Controls". From a drug product quality perspective, physiologically based biopharmaceutics modeling (PBBM) is a tool to link variations in the drug product quality attributes to in vivo outcomes enabling the establishment of clinically relevant drug product specifications (CRDPS). Day 2 of the workshop focused on best practices in developing, verifying and validating PBBM. This manuscript gives an overview of podium presentations and summarizes breakout (BO) session discussions related to (1) challenges and opportunities for using PBBM to assess the clinical impact of formulation and manufacturing changes on the in vivo performance of a drug product, (2) best practices to account for parameter uncertainty and variability during model development, (3) best practices in the development, verification and validation of PBBM and (4) opportunities and knowledge gaps related to leveraging PBBM for virtual bioequivalence simulations.
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Affiliation(s)
- Neil Parrott
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd. Grenzacherstrasse 124, CH-4070 Basel, Switzerland.
| | | | | | | | - David Good
- Biopharmaceutics, Bristol-Myers Squibb, New Brunswick, NJ, USA
| | - Christian Wagner
- Pharmaceutical Technologies, Chemical and Pharmaceutical Development, Merck KGaA, Darmstadt, Germany
| | - André Dallmann
- Clinical Pharmacometrics, Research & Development, Pharmaceuticals, Bayer AG, Leverkusen, Germany
| | - James Mullin
- Simulations Plus Inc., 42505 10th Street West, Lancaster, CA 93534, USA
| | | | | | - Amitava Mitra
- Clinical Pharmacology and Pharmacometrics, Janssen Research & Development, Spring House, PA, USA
| | - Kimberly Raines
- Division of Biopharmaceutics, Office of New Drug Products, Office of Pharmaceutical Quality (OPQ), Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, MD, USA
| | - James Butler
- Biopharmaceutics, Drug Product Design & Dev, GlaxoSmithKline R&D, Ware, UK
| | - Maziar Kakhi
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Min Li
- Division of Biopharmaceutics, Office of New Drug Products, Office of Pharmaceutical Quality (OPQ), Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, MD, USA
| | - Yang Zhao
- Division of Biopharmaceutics, Office of New Drug Products, Office of Pharmaceutical Quality (OPQ), Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, MD, USA
| | - Eleftheria Tsakalozou
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Talia Flanagan
- Pharmaceutical Development, UCB Pharma SA, Braine l'Alleud, Belgium
| | - Jennifer Dressman
- Fraunhofer Institute of Translational Medicine and Pharmacology, Carl-von-Noorden-Platz 9, 60596 Frankfurt am Main, Germany
| | - Xavier Pepin
- New Modalities and Parenteral Development, Pharmaceutical Technology & Development, Operations, AstraZeneca, Macclesfield, UK
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Martir J, Flanagan T, Mann J, Fotaki N. BCS-based biowaivers: Extension to paediatrics. Eur J Pharm Sci 2020; 155:105549. [PMID: 32941998 DOI: 10.1016/j.ejps.2020.105549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/11/2020] [Revised: 08/25/2020] [Accepted: 09/11/2020] [Indexed: 12/25/2022]
Abstract
A BCS-based biowaiver allows extrapolation of drug product bioequivalence (when applicable) based on the BCS class of the drug and in vitro dissolution testing. Drug permeability and solubility considerations for adult BCS might not apply directly to paediatric subpopulations and bridging of adult and paediatric formulations should be undertaken with caution. The aims of this study were to: (i.) identify compounds which would change drug solubility classification in the paediatric population, and (ii.) to assess the risk of extending BCS-based biowaiver criteria into paediatric products of these compounds. Amoxicillin, prednisolone, and amlodipine were selected as the model compounds. Dissolution studies of IR formulations of these compounds were conducted with USP II (paddle) and mini-paddle apparatus, in media of three pHs (pH 1.2, 4.5 and 6.8). Three dissolution setups were tested: (1) 'typical' BCS-based biowaiver conditions, (2) "BE" setup derived from BE study protocols (volume: 250 mL), and (3) "paediatric" setup based on representative volume for the paediatric population (50 mL). Results revealed that extension of regulated BCS-based biowaiver criteria for paediatric application is not as simple as scaling down volumes. It was further shown that BCS-based biowaiver criteria should not be applied when there is the risk of change of the drug solubility class, from the adult to paediatric populations. A deeper knowledge of the paediatric gastrointestinal environment is still lacking and would assist in refining the biopharmaceutical tools needed to appropriately evaluate formulation performance across age groups. This would potentially reduce the number of clinical studies required and speed up formulation development.
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Affiliation(s)
- J Martir
- Department of Pharmacy and Pharmacology, University of Bath, Bath, United Kingdom
| | - T Flanagan
- Oral Product Development, Pharmaceutical Technology & Development, Operations, AstraZeneca, Macclesfield, UK; Currently at UCB Pharma, Chemin du Foriest, B - 1420 Braine-l'Alleud, Belgium
| | - J Mann
- Oral Product Development, Pharmaceutical Technology & Development, Operations, AstraZeneca, Macclesfield, UK
| | - N Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, United Kingdom.
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Selen A, Müllertz A, Kesisoglou F, Ho RJY, Cook JA, Dickinson PA, Flanagan T. Integrated Multi-stakeholder Systems Thinking Strategy: Decision-making with Biopharmaceutics Risk Assessment Roadmap (BioRAM) to Optimize Clinical Performance of Drug Products. AAPS J 2020; 22:97. [PMID: 32719954 DOI: 10.1208/s12248-020-00470-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/04/2020] [Indexed: 12/20/2022]
Abstract
Decision-making in drug development benefits from an integrated systems approach, where the stakeholders identify and address the critical questions for the system through carefully designed and performed studies. Biopharmaceutics Risk Assessment Roadmap (BioRAM) is such a systems approach for application of systems thinking to patient focused and timely decision-making, suitable for all stages of drug discovery and development. We described the BioRAM therapy-driven drug delivery framework, strategic roadmap, and integrated risk assessment instrument (BioRAM Scoring Grid) in previous publications (J Pharm Sci 103:3377-97, 2014; J Pharm Sci 105:3243-55, 2016). Integration of systems thinking with pharmaceutical development, manufacturing, and clinical sciences and health care is unique to BioRAM where the developed strategy identifies the system and enables risk characterization and balancing for the entire system. Successful decision-making process in BioRAM starts with the Blueprint (BP) meetings. Through shared understanding of the system, the program strategy is developed and captured in the program BP. Here, we provide three semi-hypothetical examples for illustrating risk-based decision-making in high and moderate risk settings. In the high-risk setting, which is a rare disease area, two completely alternate development approaches are considered (gene therapy and small molecule). The two moderate-risk examples represent varied knowledge levels and drivers for the programs. In one moderate-risk example, knowledge leveraging opportunities are drawn from the manufacturing knowledge and clinical performance of a similar drug substance. In the other example, knowledge on acute tolerance patterns for a similar mechanistic pathway is utilized for identifying markers to inform the drug release profile from the dosage form with the necessary "flexibility" for dosing. All examples illustrate implementation of the BioRAM strategy for leveraging knowledge and decision-making to optimize the clinical performance of drug products for patient benefit.
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Affiliation(s)
- Arzu Selen
- US Food and Drug Administration, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Office of Testing and Research, 10903 New Hampshire Ave., Silver Spring, Maryland, 20993, USA.
| | - Anette Müllertz
- Bioneer: FARMA, Department of Pharmacy, University of Copenhagen, 2100, Copenhagen, Denmark
| | - Filippos Kesisoglou
- Biopharmaceutics, Pharmaceutical Sciences and Clinical Supply, Merck & Co, Inc., West Point, Pennsylvania, 19486, USA
| | - Rodney J Y Ho
- University of Washington, Seattle, Washington, 98195, USA
| | - Jack A Cook
- Clinical Pharmacology Department, Global Product Development, Pfizer, Inc., Groton, Connecticut, 06340, USA
| | - Paul A Dickinson
- Seda Pharmaceutical Development Services, Alderley Park, Alderley Edge, Cheshire, SK10 4TG, UK
| | - Talia Flanagan
- UCB Pharma S.A., Avenue de l'Industrie, 1420, Braine - l'Alleud, Belgium
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Zarmpi P, Flanagan T, Meehan E, Mann J, Østergaard J, Fotaki N. Biopharmaceutical implications of excipient variability on drug dissolution from immediate release products. Eur J Pharm Biopharm 2020; 154:195-209. [PMID: 32681966 DOI: 10.1016/j.ejpb.2020.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 07/02/2020] [Accepted: 07/13/2020] [Indexed: 12/13/2022]
Abstract
Elucidating the impact of excipient variability on oral product performance in a biopharmaceutical perspective would be beneficial and allow excipient implementation on Quality by Design (QbD) approaches. The current study investigated the impact of varying viscosity of binders (hypromellose (HPMC)) and superdisintegrants (sodium starch glycolate (SSG)) and particle size distribution of lubricants (magnesium stearate (MgSt)) on the in vitro dissolution of a highly and a poorly soluble drug from immediate release formulations. Compendial (pharmacopoeia buffers) and biorelevant (media simulating the gastrointestinal fluids) media and the USP 2 and USP 4 apparatuses were used to assess the exerted excipient effects on drug dissolution. Real-time dissolution UV imaging provided mechanistic insights into disintegration and dissolution of the immediate release formulations. Varying the viscosity type of HPMC or SSG did not significantly affect drug dissolution irrespective of the compound used. Faster drug dissolution was observed when decreasing the particle size of MgSt for the highly soluble drug. The use of real-time dissolution UV Imaging revealed the influential role of excipient variability on tablet disintegration, as for the highly soluble drug, tablets containing high viscosity HPMC or low particle size MgSt disintegrated faster as compared to the control tablets while for the poorly soluble drug, slower tablet disintegration was observed when increasing the viscosity of the HPMC as compared to the control tablets. Changes in drug dissolution when varying excipients may be anticipated if the excipient change has previously affected drug solubility. The use of multivariate data analysis revealed the influential biopharmaceutical factors such as critical excipient types/properties, drug aqueous solubility, medium/hydrodynamic characteristics affecting the impact of excipient variability on in vitro drug dissolution.
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Affiliation(s)
- P Zarmpi
- Department of Pharmacy and Pharmacology, University of Bath, Bath, United Kingdom
| | - T Flanagan
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, United Kingdom; Currently at UCB Pharma, Chemin du Foriest, B - 1420 Braine-l'Alleud, Belgium
| | - E Meehan
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, United Kingdom
| | - J Mann
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, United Kingdom
| | - J Østergaard
- Department of Pharmacy, Faculty of Health and Medicinal Sciences, University of Copenhagen, Denmark
| | - N Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, United Kingdom.
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Martir J, Flanagan T, Mann J, Fotaki N. Impact of Food and Drink Administration Vehicles on Paediatric Formulation Performance: Part 1-Effects on Solubility of Poorly Soluble Drugs. AAPS PharmSciTech 2020; 21:177. [PMID: 32592045 PMCID: PMC7373161 DOI: 10.1208/s12249-020-01722-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022] Open
Abstract
Food and drinks are commonly used to facilitate administration of
paediatric medicines to improve palatability and enhance patient compliance.
However, the impact of this practice on drug solubility and on oral drug
bioavailability is not usually studied. Based on recommended strategies for oral
administration of paediatric medicines with food and drink vehicles, the aims of
this study were (i) to measure the physicochemical properties of (soft) food and
drink vehicles, commonly mixed with paediatric medicines prior to administration,
and (ii) to assess the impact of the co-administered vehicles on the solubility of
two poorly soluble paediatric drugs. Montelukast (sodium) and mesalazine were
selected as the model compounds. Distinct differences were observed between the
physicochemical properties (i.e. pH, surface
tension, osmolality, viscosity and buffer capacity) and macronutrient composition
(i.e. fat, sugar and protein content) of the
different soft foods and drinks, not only among vehicle type but also within
vehicles of the same subtype. Solubility studies of the two model compounds in
selected drinks and soft foods resulted in considerably different drug solubility
values in each vehicle. The solubility of the drugs was significantly affected by
the vehicle physicochemical properties and macronutrient composition, with the
solubility of montelukast being driven by the pH, fat and protein content of the
vehicles and the solubility of mesalazine by vehicle osmolality, viscosity and sugar
content. This vehicle-dependent impact on drug solubility could compromise its
bioavailability, and ultimately affect the safety and/or efficacy of the drug and
should be taken into consideration during paediatric product development.
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Zarmpi P, Flanagan T, Meehan E, Mann J, Fotaki N. Impact of Magnesium Stearate Presence and Variability on Drug Apparent Solubility Based on Drug Physicochemical Properties. AAPS J 2020; 22:75. [PMID: 32440810 PMCID: PMC7242257 DOI: 10.1208/s12248-020-00449-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 03/20/2020] [Indexed: 11/30/2022]
Abstract
Excipients are major components of oral solid dosage forms, and changes in their critical material attributes (excipient variability) and/or amount (excipient variation) in pharmaceutical formulations may present a challenge for product performance. Understanding the biopharmaceutical factors affecting excipient performance is recommended for the successful implementation of excipient variability on Quality by Design (QbD) approaches. The current study investigated the impact of magnesium stearate (MgSt) variability on the apparent solubility of drugs with a wide range of physicochemical properties (drug ionization, drug lipophilicity, drug aqueous solubility). Compendial and biorelevant media were used to assess the role of gastrointestinal (GI) conditions on the excipient effects on drug apparent solubility. The lipophilic nature of MgSt decreased the apparent solubility of most compounds. The reduction in drug apparent solubility was more pronounced for highly soluble and/or highly ionized drugs and in presence of more highly crystalline or smaller particle size MgSt. The use of multivariate data analysis revealed the critical physicochemical and biopharmaceutical factors and the complex nature of excipient variability on the reduction in drug apparent solubility. The construction of a roadmap combining drug, excipient and medium characteristics allowed the identification of the cases where the presence of excipient or excipient variability may present risks for oral drug performance.
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Affiliation(s)
- P Zarmpi
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK
| | - T Flanagan
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, UK.,UCB Pharma, Chemin du Foriest, B-1420, Braine-l'Alleud, Belgium
| | - E Meehan
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, UK
| | - J Mann
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, UK
| | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK.
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Martir J, Flanagan T, Mann J, Fotaki N. Co-administration of Paediatric Medicines with Food and Drinks in the Context of Their Physicochemical Properties-a Global Perspective on Practices and Recommendations. AAPS J 2020; 22:54. [PMID: 32133550 PMCID: PMC7056676 DOI: 10.1208/s12248-020-0432-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 02/12/2020] [Indexed: 12/16/2022]
Abstract
Medicine co-administration with food or drink vehicles is a common administration practice in paediatrics. The aims of this review were (i) to describe the current recommended strategies for co-administration of paediatric medicines with food and drinks (vehicles); (ii) to compare current administration recommendations from different countries; and (iii) to obtain a global perspective on the rationale behind the choice of recommended vehicle, in the context of the physicochemical properties of the drug and formulation. This study used a defined search strategy on the practices of paediatric medicine co-administration with vehicles, recommended in a commonly used paediatric and neonatal handbook, in addition to the information previously gathered from UK formularies. Logistic regression analysis was performed to further understand the biopharmaceutical basis of the choice of recommended vehicle for medicine co-administration. Differences were identified in the type of vehicles globally recommended for medicine co-administration. Ultimately, a statistical model was developed which provided an understanding on which vehicle is recommended for use with drugs/formulations, with basis on their biopharmaceutical properties. Overall, this review highlights the areas where further information is needed to support standardised procedures and guide the recommendation of age-appropriate and acceptable vehicles for use in the co-administration of paediatric medicines. Unified requirements are needed for harmonisation of the practice of medicine co-administration with vehicles. In vitro and/or in silico tools should be developed to evaluate the potential clinical outcomes of this practice during paediatric drug development.
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Affiliation(s)
- Joana Martir
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Talia Flanagan
- Pharmaceutical Technology and Development, Astra Zeneca, Macclesfield, UK.,Currently at UCB Pharma, Chemin du Foriest, B - 1420, Braine-l'Alleud, Belgium
| | - James Mann
- Pharmaceutical Technology and Development, Astra Zeneca, Macclesfield, UK
| | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
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Zarmpi P, Flanagan T, Meehan E, Mann J, Fotaki N. Biopharmaceutical Understanding of Excipient Variability on Drug Apparent Solubility Based on Drug Physicochemical Properties: Case Study-Hypromellose (HPMC). AAPS J 2020; 22:49. [PMID: 32072317 PMCID: PMC7028811 DOI: 10.1208/s12248-019-0411-1] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/21/2019] [Indexed: 02/07/2023]
Abstract
Identification of the biopharmaceutical risks of excipients and excipient variability on oral drug performance can be beneficial for the development of robust oral drug formulations. The current study investigated the impact of Hypromellose (HPMC) presence and varying viscosity type, when used as a binder in immediate release formulations, on the apparent solubility of drugs with wide range of physicochemical properties (drug ionization, drug lipophilicity, drug aqueous solubility). The role of physiological conditions on the impact of excipients on drug apparent solubility was assessed with the use of pharmacopoeia (compendial) and biorelevant media. Presence of HPMC affected drug solubility according to the physicochemical properties of studied compounds. The possible combined effects of polymer adsorption (drug shielding effect) or the formation of a polymeric viscous layer around drug particles may have retarded drug dissolution leading to reduced apparent solubility of highly soluble and/or highly ionized compounds and were pronounced mainly at early time points. Increase in the apparent solubility of poorly soluble low ionized drugs containing a neutral amine group was observed which may relate to enhanced drug solubilization or reduced drug precipitation. The use of multivariate data analysis confirmed the importance of drug physicochemical properties on the impact of excipients on drug apparent solubility and revealed that changes in HPMC material properties or amount may not be critical for oral drug performance when HPMC is used as a binder. The construction of a roadmap combining drug, excipient, and medium characteristics allowed the identification of the cases where HPMC presence may present risks in oral drug performance and bioavailability.
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Affiliation(s)
- P Zarmpi
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - T Flanagan
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, UK.,UCB Pharma, Chemin du Foriest, 1420, Braine-l'Alleud, Belgium
| | - E Meehan
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, UK
| | - J Mann
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, UK
| | - N Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
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Zarmpi P, Flanagan T, Meehan E, Mann J, Fotaki N. Biopharmaceutical Understanding of Excipient Variability on Drug Apparent Solubility Based on Drug Physicochemical Properties. Case Study: Superdisintegrants. AAPS J 2020; 22:46. [PMID: 32048079 PMCID: PMC7012964 DOI: 10.1208/s12248-019-0406-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/06/2019] [Indexed: 01/28/2023]
Abstract
The presence of different excipient types/brands in solid oral dosage forms may affect product performance and drug bioavailability. Understanding the biopharmaceutical implications of superdisintegrant variability (changes in material properties), variation (changes in excipient amount) and interchangeability (use of different excipient types with the same intended functionality) in oral drug performance would be beneficial for the development of robust final dosage forms. The current study investigated the impact of superdisintegrants (sodium starch glycolate, croscarmellose sodium, crospovidone) on the apparent solubility of drugs with different physicochemical properties (drug ionisation, drug lipophilicity, drug aqueous solubility). Compendial and biorelevant media were used to assess the impact of gastrointestinal conditions on the effects of excipient on drug apparent solubility. For the majority of compounds, changes in drug apparent solubility were not observed in superdisintegrant presence, apart from the cases of highly ionised compounds (significant decrease in drug solubility) and/or compounds that aggregate/precipitate in solution (significant increase in drug solubility). Excipient variability did not greatly affect the impact of excipients on drug apparent solubility. The use of multivariate data analysis identified the biopharmaceutical factors affecting excipient performance. The construction of roadmaps revealed that superdisintegrants may be of low risk for the impact of excipients on oral drug performance based on drug solubility alone; superdisintegrants activity could still be a risk for oral bioavailability due to their effects on tablet disintegration.
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Affiliation(s)
- Panagiota Zarmpi
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK
| | - Talia Flanagan
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, UK.,UCB Pharma, Chemin du Foriest, B-1420, Braine-l'Alleud, Belgium
| | - Elizabeth Meehan
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, UK
| | - James Mann
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, UK
| | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK.
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Zarmpi P, Flanagan T, Meehan E, Mann J, Fotaki N. Surface dissolution UV imaging for characterization of superdisintegrants and their impact on drug dissolution. Int J Pharm 2020; 577:119080. [PMID: 31988030 DOI: 10.1016/j.ijpharm.2020.119080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 12/15/2022]
Abstract
Superdisintegrants are a key excipient used in immediate release formulations to promote fast tablet disintegration, therefore understanding the impact of superdisintegrant variability on product performance is important. The current study examined the impact of superdisintegrant critical material attributes (viscosity for sodium starch glycolate (SSG), particle size distribution (PSD) for croscarmellose sodium (CCS)) on their performance (swelling) and on drug dissolution using surface dissolution UV imaging. Acidic and basic pharmacopoeia (compendial) media were used to assess the role of varying pH on superdisintegrant performance and its effect on drug dissolution. A highly soluble (paracetamol) and a poorly soluble (carbamazepine) drug were used as model compounds and drug compacts and drug-excipient compacts were prepared for the dissolution experiments. The presence of a swelled SSG or CCS layer on the compact surface, due to the fast excipient hydration capacity, upon contact with dissolution medium was visualized. The swelling behaviour of superdisintegrants depended on excipient critical material attributes and the pH of the medium. Drug dissolution was faster in presence compared to superdisintegrant absence due to improved compact wetting or compact disintegration. The improvement in drug dissolution was less pronounced with increasing SSG viscosity or CCS particle size. Drug dissolution was slightly more complete in basic compared to acidic conditions in presence of the studied superdisintegrants for the highly soluble drug attributed to the increased excipient hydration capacity and the fast drug release through the swelled excipient structure. The opposite was observed for the poorly soluble drug as potentially the improvement in drug dissolution was compromised by drug release from the highly swelled structure. The use of multivariate data analysis revealed the influential role of excipient and drug properties on the impact of excipient variability on drug dissolution.
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Affiliation(s)
- P Zarmpi
- Department of Pharmacy and Pharmacology, University of Bath, Bath, United Kingdom
| | - T Flanagan
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, United Kingdom
| | - E Meehan
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, United Kingdom
| | - J Mann
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, United Kingdom
| | - N Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, United Kingdom.
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Segregur D, Flanagan T, Mann J, Moir A, Karlsson EM, Hoch M, Carlile D, Sayah-Jeanne S, Dressman J. Impact of Acid-Reducing Agents on Gastrointestinal Physiology and Design of Biorelevant Dissolution Tests to Reflect These Changes. J Pharm Sci 2019; 108:3461-3477. [DOI: 10.1016/j.xphs.2019.06.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/25/2019] [Accepted: 06/25/2019] [Indexed: 02/07/2023]
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Flanagan T. Potential for pharmaceutical excipients to impact absorption: A mechanistic review for BCS Class 1 and 3 drugs. Eur J Pharm Biopharm 2019; 141:130-138. [PMID: 31128247 DOI: 10.1016/j.ejpb.2019.05.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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: 09/24/2018] [Revised: 03/14/2019] [Accepted: 05/21/2019] [Indexed: 01/06/2023]
Abstract
The potential for certain excipients to impact drug absorption is the subject of numerous publications. Reflecting this, current Biopharmaceutics Classification System (BCS) guidelines place restrictions on the level of change in excipients to be eligible for a BCS biowaiver. The degree of change permitted between test and reference formulations varies between BCS Class 1 and 3, and also across different regulatory authorities. This article reviews the literature evidence for excipients to impact drug absorption, with a particular focus on identifying effects which may be important for BCS Class 1 and 3 compounds and formulations. Literature examples were categorised according to the mechanism by which the excipient was believed to impact drug absorption, and the relevance of these mechanisms for compounds within BCS Class 1 and 3 was assessed. The likelihood of using the excipient in solid oral immediate release formulations (i.e. formulation types which would be eligible for BCS biowaivers) was also considered. Using this mechanistic and risk-based approach, potential critical excipients for BCS Class 1 and 3 compounds were identified. Based on the literature data, there are only a limited number of mechanisms by which excipients could affect the absorption of a BCS Class 3 drug. For BCS1, absorption is very unlikely to be affected by excipient changes. For many of these excipients, there is no in vivo evidence of such an effect having occurred. The risk can be mitigated to a large extent by applying some compound-specific understanding of the absorption site, rate and mechanism of the particular API under consideration.
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Affiliation(s)
- Talia Flanagan
- Pharmaceutical Technology and Development, AstraZeneca R&D, Macclesfield, Cheshire, UK.
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Shen Z, Lee CA, Valdez S, Yang X, Wilson DM, Flanagan T, Gillen M. Effects of Food and Antacids on Pharmacokinetics and Pharmacodynamics of Lesinurad, a Selective Urate Reabsorption Inhibitor. Clin Pharmacol Drug Dev 2019; 8:647-656. [PMID: 30748125 DOI: 10.1002/cpdd.663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 06/11/2018] [Accepted: 01/20/2019] [Indexed: 02/03/2023]
Abstract
Two clinical studies were performed in healthy volunteers to investigate food and antacid effects on lesinurad, a novel selective uric acid reabsorption inhibitor approved for treatment of hyperuricemia associated with gout in combination with xanthine oxidase inhibitors. Study 1 evaluated a high-fat, high-calorie meal or high doses of antacids (3000 mg calcium carbonate or 1600 mg magnesium hydroxide/1600 mg aluminum hydroxide) on the pharmacokinetics (PK) and pharmacodynamics (PD) of 400 mg oral lesinurad. Study 2 evaluated low doses of antacids (1250 mg calcium carbonate or 800 mg magnesium hydroxide/800 mg aluminum hydroxide) on the PK and PD of 400 mg lesinurad. Food did not alter the plasma AUC of lesinurad and only reduced its Cmax by 18%. In the fasted conditions, high-dose calcium carbonate reduced the Cmax and AUC of lesinurad by 54% and 38%, respectively, whereas high-dose magnesium hydroxide/aluminum hydroxide reduced Cmax and AUC by 36% and 31%, respectively. Food enhanced the maximum serum urate (sUA)-lowering effect of lesinurad by approximately 20% despite reducing the Cmax of lesinurad. High-dose calcium carbonate decreased the urate-lowering effect approximately 20% in the first 6 hours, whereas high-dose magnesium hydroxide/aluminum hydroxide reduced the effect by 26%. Low-dose calcium carbonate or magnesium hydroxide/aluminum hydroxide in the presence of food did not significantly affect plasma lesinurad Cmax and AUC or the sUA lowering and renal handling of uric acid. In summary, study results suggest food did not meaningfully alter lesinurad PK and PD. High doses of antacids reduced lesinurad AUC up to 40% and reduced the lesinurad uric acid-lowering effect.
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Flanagan T, Mann J. Dissolution Universal Strategy Tool (DUST): A Tool to Guide Dissolution Method Development Strategy. DISSOLUT TECHNOL 2019. [DOI: 10.14227/dt260319p6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Martinez MN, Bhoopathy S, Carlert S, Cirit M, Fahmy R, Flanagan T, Forbes B, Jamei M, Khan MA, Lukacova V, Mochel JP, Pepin X, Pade D, Reppas C, Sinko PJ, Sperry D, Tsinman K, Vertzoni M. Workshop Report: USP Workshop on Exploring the Science of Drug Absorption. DISSOLUT TECHNOL 2019. [DOI: 10.14227/dt260319p38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Grady H, Elder D, Webster GK, Mao Y, Lin Y, Flanagan T, Mann J, Blanchard A, Cohen MJ, Lin J, Kesisoglou F, Hermans A, Abend A, Zhang L, Curran D. Industry's View on Using Quality Control, Biorelevant, and Clinically Relevant Dissolution Tests for Pharmaceutical Development, Registration, and Commercialization. J Pharm Sci 2017; 107:34-41. [PMID: 29074376 DOI: 10.1016/j.xphs.2017.10.019] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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: 08/27/2017] [Revised: 10/12/2017] [Accepted: 10/13/2017] [Indexed: 12/28/2022]
Abstract
This article intends to summarize the current views of the IQ Consortium Dissolution Working Group, which comprises various industry companies, on the roles of dissolution testing throughout pharmaceutical product development, registration, commercialization, and beyond. Over the past 3 decades, dissolution testing has evolved from a routine and straightforward test as a component of end-product release into a comprehensive set of tools that the developer can deploy at various stages of the product life cycle. The definitions of commonly used dissolution approaches, how they relate to one another and how they may be applied in modern drug development, and life cycle management is described in this article. Specifically, this article discusses the purpose, advantages, and limitations of quality control, biorelevant, and clinically relevant dissolution methods.
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Affiliation(s)
- Haiyan Grady
- Pharmaceutical Sciences, Takeda Development Center Americas Inc., One Takeda Parkway, Deerfield, Illinois 60015.
| | - David Elder
- David P Elder Consultancy, Hertford, Hertfordshire SG14 2DE, UK
| | - Gregory K Webster
- Research and Development, AbbVie Inc., North Chicago, Illinois 60064
| | - Yun Mao
- Pharmaceutical Sciences and Clinical Supply, Merck & Co., Inc., West Point, Pennsylvania 19486
| | - Yiqing Lin
- Analytical Development, Biogen Inc., Cambridge, Massachusetts 02142
| | - Talia Flanagan
- Pharmaceutical Technology and Development, AstraZeneca R&D, Macclesfield, Cheshire, UK
| | - James Mann
- Pharmaceutical Technology and Development, AstraZeneca R&D, Macclesfield, Cheshire, UK
| | - Andy Blanchard
- Worldwide Research and Development, Global Chemistry and Manufacturing Controls, Pfizer Inc., Eastern Point Road, Groton, Connecticut 06340
| | - Michael J Cohen
- Worldwide Research and Development, Global Chemistry and Manufacturing Controls, Pfizer Inc., Eastern Point Road, Groton, Connecticut 06340
| | - Judy Lin
- Biologics Technical Development and Manufacturing, Novartis, East Hanover, New Jersey 07936
| | - Filippos Kesisoglou
- Pharmaceutical Sciences and Clinical Supply, Merck & Co., Inc., West Point, Pennsylvania 19486
| | - Andre Hermans
- Pharmaceutical Sciences and Clinical Supply, Merck & Co., Inc., West Point, Pennsylvania 19486
| | - Andreas Abend
- Pharmaceutical Sciences and Clinical Supply, Merck & Co., Inc., West Point, Pennsylvania 19486
| | - Limin Zhang
- Drug Product Science and Technology, Bristol Myers Squibb Company, New Brunswick, New Jersey 08903
| | - David Curran
- Analytical Sciences and Development, GlaxoSmithKline, King of Prussia Pennsylvania 19406
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Hermans A, Abend AM, Kesisoglou F, Flanagan T, Cohen MJ, Diaz DA, Mao Y, Zhang L, Webster GK, Lin Y, Hahn DA, Coutant CA, Grady H. Approaches for Establishing Clinically Relevant Dissolution Specifications for Immediate Release Solid Oral Dosage Forms. AAPS J 2017; 19:1537-1549. [DOI: 10.1208/s12248-017-0117-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 06/16/2017] [Indexed: 12/22/2022]
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Lennernäs H, Lindahl A, Van Peer A, Ollier C, Flanagan T, Lionberger R, Nordmark A, Yamashita S, Yu L, Amidon GL, Fischer V, Sjögren E, Zane P, McAllister M, Abrahamsson B. In Vivo Predictive Dissolution (IPD) and Biopharmaceutical Modeling and Simulation: Future Use of Modern Approaches and Methodologies in a Regulatory Context. Mol Pharm 2017; 14:1307-1314. [DOI: 10.1021/acs.molpharmaceut.6b00824] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- H. Lennernäs
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - A. Lindahl
- Medical Products Agency, Uppsala, Sweden
| | - A. Van Peer
- Janssen
Research and Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - C. Ollier
- Sanofi US, 55 Corporate Drive, Bridgewater, New Jersey 08807, United States
| | | | - R. Lionberger
- Office of Research
and Standards, Office of Generic Drugs, Center for Drug Evaluation
and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland 20993, United States
| | | | - S. Yamashita
- Faculty
of Pharmaceutical Sciences, Setsunan University, Nagaotoge-cho 45-1, Hirakata, Osaka 573-0101, Japan
| | - L. Yu
- Food and Drug Administration, Center for Drug Evaluation and Research, Silver Spring, Maryland 20993, United States
| | - G. L. Amidon
- College of Pharmacy, University of Michigan, Ann Arbor, Michigan 48109-1065, United States
| | - V. Fischer
- Drug Metabolism and Pharmacokinetics, Research & Development, AbbVie, North Chicago, Illinois 60064, United States
| | - E. Sjögren
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - P. Zane
- Sanofi US, 55 Corporate Drive, Bridgewater, New Jersey 08807, United States
| | - M. McAllister
- Pharmaceutical Development, GlaxoSmithKline, New
Frontiers Science Park, Harlow, Essex CM19
5AW, United Kingdom
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Zarmpi P, Flanagan T, Meehan E, Mann J, Fotaki N. Biopharmaceutical aspects and implications of excipient variability in drug product performance. Eur J Pharm Biopharm 2017; 111:1-15. [DOI: 10.1016/j.ejpb.2016.11.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/02/2016] [Accepted: 11/07/2016] [Indexed: 12/29/2022]
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Hedderson MM, Ferrara A, Avalos LA, Van den Eeden SK, Gunderson EP, Li DK, Altschuler A, Woo S, Rowell S, Choudhary V, Xu F, Flanagan T, Schaefer C, Croen LA. The Kaiser Permanente Northern California research program on genes, environment, and health (RPGEH) pregnancy cohort: study design, methodology and baseline characteristics. BMC Pregnancy Childbirth 2016; 16:381. [PMID: 27899076 PMCID: PMC5129213 DOI: 10.1186/s12884-016-1150-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 01/16/2016] [Accepted: 11/08/2016] [Indexed: 11/16/2022] Open
Abstract
Background Exposures during the prenatal period may have lasting effects on maternal and child health outcomes. To better understand the effects of the in utero environment on children’s short- and long-term health, large representative pregnancy cohorts with comprehensive information on a broad range of environmental influences (including biological and behavioral) and the ability to link to prenatal, child and maternal health outcomes are needed. The Research Program on Genes, Environment and Health (RPGEH) pregnancy cohort at Kaiser Permanente Northern California (KPNC) was established to create a resource for conducting research to better understand factors influencing women’s and children’s health. Recruitment is integrated into routine clinical prenatal care at KPNC, an integrated health care delivery system. We detail the study design, data collection, and methodologies for establishing this cohort. We also describe the baseline characteristics and the cohort’s representativeness of the underlying pregnant population in KPNC. Methods While recruitment is ongoing, as of October 2014, the RPGEH pregnancy cohort included 16,977 pregnancies (53 % from racial and ethnic minorities). RPGEH pregnancy cohort participants consented to have blood samples obtained in the first trimester (mean gestational age 9.1 weeks ± 4.2 SD) and second trimester (mean gestational age 18.1 weeks ± 5.5 SD) to be stored for future use. Women were invited to complete a questionnaire on health history and lifestyle. Information on women’s clinical and health assessments before, during and after pregnancy and women and children’s health outcomes are available in the health system’s electronic health records, which also allows long-term follow-up. Discussion This large, racially- and ethnically-diverse cohort of pregnancies with prenatal biospecimens and clinical data is a valuable resource for future studies on in utero environmental exposures and maternal and child perinatal and long term health outcomes. The baseline characteristics of RPGEH Pregnancy Cohort demonstrate that it is highly representative of the underlying population living in the broader community in Northern California. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-1150-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M M Hedderson
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA.
| | - A Ferrara
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - L A Avalos
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - S K Van den Eeden
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - E P Gunderson
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - D K Li
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - A Altschuler
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - S Woo
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - S Rowell
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - V Choudhary
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - F Xu
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - T Flanagan
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - C Schaefer
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - L A Croen
- Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
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Flanagan T, Martin P, Gillen M, Mathews D, Lisbon E, Kruusmägi M. Effects of ranitidine (antacid), food, and formulation on the pharmacokinetics of fostamatinib: results from five phase I clinical studies. Eur J Clin Pharmacol 2016; 73:185-195. [PMID: 27858108 DOI: 10.1007/s00228-016-2156-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 10/30/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Fostamatinib is an orally dosed phosphate prodrug that is cleaved by intestinal alkaline phosphatase to the active metabolite R406. Clinical studies were performed to assess the effect of food and ranitidine on exposure, to support in vitro-in vivo relationships (IVIVR) understanding and formulation transitions and to investigate absolute oral bioavailability. METHODS A series of in vitro dissolution and clinical pharmacokinetic studies were performed to support the design and introduction of a new formulation, understand the impact of changes in in vitro dissolution on in vivo performance for two fostamatinib formulations, to characterize the effects of food and ranitidine on exposure, and determine the absolute oral bioavailability. RESULTS The in vivo performance of fostamatinib was generally insensitive to changes in in vitro dissolution performance, although marked slowing of the dissolution rate did impact exposures. Food and ranitidine had minor effects on R406 exposure that were not considered clinically relevant. The absolute oral bioavailability of fostamatinib was 54.6 %. CONCLUSIONS The absolute oral bioavailability of fostamatinib was ~55 %. Food and ranitidine had minor effects on R406 exposure. An in vitro dissolution versus clinical performance relationship was determined that supported formulation transitions.
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Affiliation(s)
- Talia Flanagan
- AstraZeneca Pharmaceuticals, Alderley Park, Macclesfield, Cheshire, SK10 4TF, UK
| | - Paul Martin
- Sandoz, Industriestrasse 25, Holzkirchen, Germany.
| | | | - David Mathews
- Quintiles Inc., 6700 W. 115th St, Overland Park, KS, 66211, USA
| | - Eleanor Lisbon
- Quintiles Inc., 6700 W. 115th St, Overland Park, KS, 66211, USA
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Dickinson PA, Kesisoglou F, Flanagan T, Martinez MN, Mistry HB, Crison JR, Polli JE, Cruañes MT, Serajuddin AT, Müllertz A, Cook JA, Selen A. Optimizing Clinical Drug Product Performance: Applying Biopharmaceutics Risk Assessment Roadmap (BioRAM) and the BioRAM Scoring Grid. J Pharm Sci 2016; 105:3243-3255. [DOI: 10.1016/j.xphs.2016.07.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/20/2016] [Accepted: 07/26/2016] [Indexed: 01/22/2023]
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Martir J, Flanagan T, Mann J, Fotaki N. Recommended strategies for the oral administration of paediatric medicines with food and drinks in the context of their biopharmaceutical properties: a review. ACTA ACUST UNITED AC 2016; 69:384-397. [PMID: 27704550 DOI: 10.1111/jphp.12635] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 04/26/2016] [Accepted: 08/10/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVES This review focuses on the recommended strategies for the oral administration of paediatric medicines with food in the context of their biopharmaceutical properties. KEY FINDINGS Acceptability of oral medicines in young patients is more challenging than in adult patients. Mixing oral dosage forms with foods and drinks is sometimes suggested to administer a specific dose and enhance compliance in the paediatric population. In this review, the strategies for the co-administration of paediatric medicines with food and drinks are discussed. Current administration practices as reported by healthcare professionals and parents/carers are compared with the relevant guidelines. Differences in the type of vehicles recommended to be used and actually used in current practice were identified. Correlations of the type of food recommended, the type of formulation and the drug's biopharmaceutical classification system (BCS) class were performed and revealed that recommendations should be made on a case-by-case basis. SUMMARY The propensity for physiochemical or bioavailability changes that may occur from the co-administration of medicines with food and drinks in the paediatric population should be considered, and harmonisation of the recommended administration strategies is needed.
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Affiliation(s)
- Joana Martir
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - Talia Flanagan
- Pharmaceutical Technology and Development, Astra Zeneca, Macclesfield, UK
| | - James Mann
- Pharmaceutical Technology and Development, Astra Zeneca, Macclesfield, UK
| | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
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Batchelor H, Ernest T, Flanagan T, Klein S, Turner R, Storey D. Evaluation of the need for and criteria within a paediatric biopharmaceutics classification system: Results of a survey. Int J Pharm 2016. [DOI: 10.1016/j.ijpharm.2016.06.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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34
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Flanagan T, Van Peer A, Lindahl A. Use of physiologically relevant biopharmaceutics tools within the pharmaceutical industry and in regulatory sciences: Where are we now and what are the gaps? Eur J Pharm Sci 2016; 91:84-90. [DOI: 10.1016/j.ejps.2016.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 06/01/2016] [Accepted: 06/05/2016] [Indexed: 11/30/2022]
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Batchelor H, Ernest T, Flanagan T, Klein S, Turner R, Fotaki N, Storey D. Towards the development of a paediatric biopharmaceutics classification system: Results of a survey of experts. Int J Pharm 2016; 511:1151-7. [PMID: 27349792 DOI: 10.1016/j.ijpharm.2016.06.115] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 03/03/2016] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 11/29/2022]
Abstract
The aim of this research survey was to understand current global thinking around the need for and development of a paediatric biopharmaceutics classification system (pBCS) to be used for the development of paediatric medicines and regulatory purposes (e.g. Biowaivers). A literature review highlighted the paucity of data in this area and therefore a survey was developed to better understand this topic to identify areas of common thinking and highlight future research needs. Global experts in paediatric biopharmaceutics were identified from existing networks and public forums. An online survey was developed and circulated broadly to maximise participation. Sixty individuals (including academics, health care professionals, pharmaceutical industry scientists and regulators) completed the survey, bringing together their views on the need for a pBCS. The results highlighted that the area of greatest concern was the definition of BCS II and IV drugs within this population and additional research is required to generate evidence to underpin this issue. In questions relating to permeability and dissolution consensus was generally reached within the expert population suggesting that little additional research is required to define suitable criteria. More than 90% of those experts who participated agreed that a pBCS would be useful for paediatric populations with a greater need identified for the younger populations (newborn and infants compared to adolescents). The results presented will facilitate further discussion and research into the evidence to underpin a relevant pBCS. These results highlight the need for additional evidence and guidance in this area.
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Affiliation(s)
- Hannah Batchelor
- School of Pharmacy, Institute of Clinical Sciences, Robert Aitken Building, University of Birmingham, Edgbaston, B15 2TT, UK.
| | - Terry Ernest
- GlaxoSmithKline, New Frontiers Science Park, Third Avenue, Harlow, Essex CM19 5AW, UK
| | - Talia Flanagan
- Pharmaceutical Development, AstraZeneca R&D, Macclesfield, UK
| | - Sandra Klein
- Department of Pharmacy, Ernst Moritz Arndt University, Greifswald, Germany
| | | | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
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Fotaki N, Gray V, Krämer J, Diaz D, Flanagan T, Grove G. Dissolution Highlights from the 2015 AAPS Annual Meeting in Orlando. DISSOLUT TECHNOL 2016. [DOI: 10.14227/dt230216p42] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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37
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Rabbie SC, Flanagan T, Martin PD, Basit AW. Inter-subject variability in intestinal drug solubility. Int J Pharm 2015; 485:229-34. [DOI: 10.1016/j.ijpharm.2015.03.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/03/2015] [Accepted: 03/04/2015] [Indexed: 12/11/2022]
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Sjögren E, Abrahamsson B, Augustijns P, Becker D, Bolger MB, Brewster M, Brouwers J, Flanagan T, Harwood M, Heinen C, Holm R, Juretschke HP, Kubbinga M, Lindahl A, Lukacova V, Münster U, Neuhoff S, Nguyen MA, Peer AV, Reppas C, Hodjegan AR, Tannergren C, Weitschies W, Wilson C, Zane P, Lennernäs H, Langguth P. In vivo methods for drug absorption – Comparative physiologies, model selection, correlations with in vitro methods (IVIVC), and applications for formulation/API/excipient characterization including food effects. Eur J Pharm Sci 2014; 57:99-151. [DOI: 10.1016/j.ejps.2014.02.010] [Citation(s) in RCA: 196] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 02/15/2014] [Accepted: 02/17/2014] [Indexed: 01/11/2023]
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Flanagan T. Author's response. Aust J Physiother 2014; 47:147-148. [PMID: 26364128 DOI: 10.1016/s0004-9514(14)60307-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
I am grateful to Andrew Leaver in his role as chairman of the NSW Chapter of Musculoskeletal Physiotherapy Australia for raising issues pertinent to our paper. It is this interest that encourages debate and helps to evolve further the ideas on a topic that has not been investigated previously.
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Dinkelspiel H, Flanagan T, Kinney W, Fetterman B, Lorey T, Castle P. Consequences of lengthening cervical cancer screening intervals on mammography rates. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bathurst J, Williams C, Hild E, Quinones R, Keating A, Foreman N, Gore L, Macy M, Flanagan T, Peltz A, Giller R. Efficacy Of Meropenem Antibacterial Prophylaxis Following Myeloablative Pediatric Hematopoietic Stem Cell Transplant (HSCT). Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Affiliation(s)
- T Flanagan
- Transport Accident Commission, Australia.
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Parry J, Temperton H, Flanagan T, Gerhadt L. An evaluation of the impact of the introduction of "non-smoking" areas on trade and customer satisfaction in 11 public houses in Staffordshire. Tob Control 2001; 10:199-200. [PMID: 11428376 PMCID: PMC1747537 DOI: 10.1136/tc.10.2.199a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Passman D, Flanagan T, Wrigley-Howe S, Darch R. First-wave schemes. New wave of ideas. Health Serv J 1997; 107:suppl 5. [PMID: 10174014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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45
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Flanagan T, Mitchner B, Weyl-Feyling D, Laros RK. The cost of teaching residents outpatient obstetrics and gynecology in a university medical center. Obstet Gynecol 1995; 86:1014-7. [PMID: 7501324 DOI: 10.1016/0029-7844(95)00321-h] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To quantify the cost of teaching residents ambulatory obstetrics and gynecology, expressed as the difference in revenue generated between a faculty physician practicing as a private practitioner and a faculty physician serving as a resident supervisor. METHOD Outpatient revenue generated by faculty generalists and residents was analyzed. The net gain in revenue was calculated per half-day session for faculty and residents by subtracting contractual allowances and expenses from gross patient charges. Net revenue gain per half-day clinical session per year for a faculty member practicing as a private practitioner was compared with that of a faculty member functioning as a supervisor. The net gain for the faculty supervisor was based on the revenue generated by the residents supervised. RESULTS The faculty member serving as a private practitioner generated a net gain per session per year of $23,947. The faculty member acting as supervisor for two residents per session generated a net gain or loss per session per year of -$9678, -$972, and $15,542 for first-, second-, and third-year residents, respectively. The cost of teaching, expressed as the difference in the net gain of a faculty member as private practitioner and the net gain of a faculty member as supervisor, for first-, second-, and third-year residents was $33,625, $24,919, and $8405, respectively, per session per year. CONCLUSION This analysis shows that first-year residents are an expense to the practice site, second-year residents are close to breaking even, and third-year residents begin to generate a net gain.
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Affiliation(s)
- T Flanagan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California-San Francisco, USA
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46
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Grandy DK, Leduc R, Makam H, Flanagan T, Diliberto EJ, Civelli O, Viveros OH. Nucleotide and deduced amino acid sequence of bovine adrenal medulla chromogranin B (secretogranin I). Cell Mol Neurobiol 1992; 12:185-92. [PMID: 1350945 DOI: 10.1007/bf00713372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
1. A novel 1745-dalton pyroglutamyl peptide (BAM-1745)6 was recently isolated and characterized from bovine adrenal medulla chromaffin granules. Its amino acid sequence was found to be 93% identical to residues 580-593 of human chromogranin B (secretogranin I). 2. Based on this sequence a degenerate oligonucleotide probe was synthesized and used to identify a 2.4-kb bovine adrenal medulla chromogranin B cDNA. 3. The deduced polypeptide is 647 amino acids long and begins with a putative signal sequence of 20 residues as in the human, rat, and mouse proteins. Also conserved in the bovine protein is a tyrosine residue which may be sulfated, two N-terminal cysteines, and many paired basic amino acids which may serve as sites of posttranslational processing. The peptide BAM-1745 is flanked by paired basic amino acids and therefore is most likely a product of posttranslational processing. Bovine chromogranin B is 67, 58, and 58% identical to the human, rat, and mouse chromogranin B proteins, respectively. 4. The carboxyl terminus of bovine chromogranin B, including BAM-1745, was found to be the most conserved region of the polypeptide and may identify it as an important functional domain.
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Affiliation(s)
- D K Grandy
- Vollum Institute for Advanced Biomedical Research, Oregon Health Sciences University, Portland 97021
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Abstract
The hypothesis of the present study is that axillofemoral bypass grafting for acute vascular occlusion has results significantly inferior to an elective procedure. We reviewed 53 patients undergoing primary axillofemoral bypass grafting at the University of Virginia from 1984 to 1989. We found that patients who were admitted with acute vascular occlusion had a higher incidence of perioperative complications (63% vs 26%, p = 0.001), perioperative mortality (26% vs 3%, p less than 0.05), lower graft patency at 1 year (60% vs 90%, p less than 0.05), lower rate of freedom from reoperation in first year (50% vs 82%, p less than 0.01), and lower rates of limb salvage (76% vs 94%, p less than 0.05) than patients undergoing axillofemoral bypass grafting for chronic symptoms or conditions. These two groups did not differ in any of the other risk factors or perioperative characteristics examined. We conclude axillofemoral bypass grafting performed for indications other than acute vascular occlusion is associated with acceptable morbidity, mortality, graft patency, and limb salvage rates.
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Affiliation(s)
- J M Agee
- Department of Surgery, University of Virginia Medical Center, Charlottesville
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48
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Abstract
Paraplegia after thoracic aortic aneurysm repair has an incidence of 2.2% to 24%. Oxygen-derived free radicals after reperfusion of an ischemic spinal cord may be partly responsible for neuronal destruction. We studied the effects of polyethylene glycol-conjugated superoxide dismutase (PEG-SOD), a free radical scavenger, as a way of increasing spinal cord tolerance to ischemia. Thirty rabbits underwent 40 minutes of aortic occlusion (a known model of paraplegia). Ten of these animals received 25,000 U/kg of PEG-SOD 24 hours before aortic occlusion and two additional doses of 10,000 U/kg, one before and one subsequent to spinal ischemia. Ten animals received superoxide dismutase in the same dosages as those receiving PEG-SOD. Ten control animals received placebo. All animals were studied for 96 hours, at which time a final neurological examination was performed and the results were recorded. Of the 10 animals treated with PEG-SOD, 2 were completely paralyzed whereas 8 had less (7) or no (1) neurological impairment. Eight of the 10 control animals and 9 of the 10 animals receiving superoxide dismutase were completely paralyzed. None of the control animals or animals receiving superoxide dismutase had a normal neurological examination (p less than or equal to 0.05). Treatment with PEG-SOD before and during occlusion increased the rabbit spinal cord tolerance to a 40-minute ischemic insult. Scavenging free radicals may lessen experimental spinal cord injury.
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Affiliation(s)
- J M Agee
- Department of Surgery, University of Virginia Health Sciences Center, Charlottesville
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Flanagan T, Taylor L, Poulter L, Viveros OH, Diliberto EJ. A novel 1745-dalton pyroglutamyl peptide derived from chromogranin B is in the bovine adrenomedullary chromaffin vesicle. Cell Mol Neurobiol 1990; 10:507-23. [PMID: 1982622 DOI: 10.1007/bf00712845] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
1. Following the recent demonstration of a glutaminyl cyclase activity localized in adrenomedullary chromaffin vesicles, an assay was developed to isolate and characterize posttranslationally modified peptides from this tissue which contain pyroglutamate. This assay consisted of spectrometric identification of peptides before and after enzymatic removal of pyroglutamyl residues. 2. Using this procedure, a pyroglutamyl peptide (BAM-1745) was isolated and sequenced and was shown to be a significant component of adrenomedullary secretory vesicles. 3. A computer search through the Swiss-Prot protein sequence database revealed a 93% identity of BAM-1745 and a fragment of human chromogranin B (Gln580-Tyr593).
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Affiliation(s)
- T Flanagan
- Division of Medicinal Biochemistry, Wellcome Research Laboratories, Research Triangle Park, North Carolina 27709
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50
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Abstract
Talc pleurodesis is an effective means of preventing recurrent pneumothorax. We have successfully applied talc pleurodesis with thoracoscopy in children with cystic fibrosis presenting with pneumothorax. However, little is known about the effects of talc pleurodesis on lung compliance in growing children. Therefore, six young pigs (10 weeks old, weighing 15 +/- 1 kg) were prepared for study. In each pig, one hemithorax underwent thoracoscopy and talc pleurodesis (TALC). The other hemithorax underwent either thoracoscopy alone or no procedure (CONTROL). Dynamic and static respiratory mechanics were studied 5 and 10 weeks later. Air flow and airway pressure were measured to calculate dynamic transpulmonary and transrespiratory compliance, and static transpulmonary compliance. At 5 weeks, dynamic transpulmonary and transrespiratory compliance were less in the TALC lungs when compared with CONTROL lungs. At 10 weeks, the differences in dynamic transpulmonary and transrespiratory compliance between the TALC and CONTROL lungs had resolved. Static compliance was lower in the TALC lungs than in the CONTROL lungs at both 5 and 10 weeks, but this was significant only at 10 weeks. There was an improvement in static compliance in the TALC lungs between 5 and 10 weeks, but this only approached significance. At autopsy, there were marked adhesions and pleural thickening in the talc lungs. Histological examination demonstrated no differences in lung parenchyma between the TALC lungs and the CONTROL lungs. Talc pleurodesis causes a temporary impairment in dynamic transpulmonary and transrespiratory compliance that resolves with time and growth. Static compliance is more persistently compromised, but a trend toward improvement with time and growth exists.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- E D McGahren
- Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22908
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