1
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Wang Y, Genina N, Müllertz A, Rantanen J. Binder jetting 3D printing in fabricating pharmaceutical solid products for precision medicine. Basic Clin Pharmacol Toxicol 2024; 134:325-332. [PMID: 38105694 DOI: 10.1111/bcpt.13974] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 12/19/2023]
Abstract
Current treatment strategies are moving towards patient-centricity, which emphasizes the need for new solutions allowing for medication tailored to a patient. This can be realized by precision medicine where patient diversity is considered during treatment. However, the broader use of precision medicine is restricted by the current technological solutions and rigid manufacturing of pharmaceutical products by mass production principles. Additive manufacturing of pharmaceutical products can provide a feasible solution to this challenge. In this review, a particular subtype of additive manufacturing, that is, binder jetting 3D printing, is introduced as a solution for fabricating pharmaceutical solid products that can be considered as precision medicine. Technical aspects, practical applications, unique advantages and challenges related to this technique are discussed, indicating that binder jetting 3D printing possesses the potential for fabricating already new product prototypes, where diversity in patient treatment in terms of the needs for specific drug type, dose and drug release can be accounted. To further advance this type of mass customization of pharmaceuticals, multidisciplinary research initiatives are needed not only to cover the engineering aspects but also to bridge these innovations with patient-centric perspectives.
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Affiliation(s)
- Yingya Wang
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk A/S, Bagsvaerd, Denmark
| | - Natalja Genina
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anette Müllertz
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jukka Rantanen
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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2
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Johnson K, Kuhn M. What they forgot to tell you about machine learning with an application to pharmaceutical manufacturing. Pharm Stat 2024. [PMID: 38415497 DOI: 10.1002/pst.2366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/31/2023] [Indexed: 02/29/2024]
Abstract
Predictive models (a.k.a. machine learning models) are ubiquitous in all stages of drug research, safety, development, manufacturing, and marketing. The results of these models are used inside and outside of pharmaceutical companies for the purpose of understanding scientific processes and for predicting characteristics of new samples or patients. While there are many resources that describe such models, there are few that explain how to develop a robust model that extracts the highest possible performance from the available data, especially in support of pharmaceutical applications. This tutorial will describe pitfalls and best practices for developing and validating predictive models with a specific application to a monitoring a pharmaceutical manufacturing process. The pitfalls and best practices will be highlighted to call attention to specific points that are not generally discussed in other resources.
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Affiliation(s)
| | - Max Kuhn
- Posit PBC, Boston, Massachusetts, USA
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3
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Fischer RP, Volpert A, Antonino P, Ahrens TD. Digital patient twins for personalized therapeutics and pharmaceutical manufacturing. Front Digit Health 2024; 5:1302338. [PMID: 38250053 PMCID: PMC10796488 DOI: 10.3389/fdgth.2023.1302338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Digital twins are virtual models of physical artefacts that may or may not be synchronously connected, and that can be used to simulate their behavior. They are widely used in several domains such as manufacturing and automotive to enable achieving specific quality goals. In the health domain, so-called digital patient twins have been understood as virtual models of patients generated from population data and/or patient data, including, for example, real-time feedback from wearables. Along with the growing impact of data science technologies like artificial intelligence, novel health data ecosystems centered around digital patient twins could be developed. This paves the way for improved health monitoring and facilitation of personalized therapeutics based on management, analysis, and interpretation of medical data via digital patient twins. The utility and feasibility of digital patient twins in routine medical processes are still limited, despite practical endeavors to create digital twins of physiological functions, single organs, or holistic models. Moreover, reliable simulations for the prediction of individual drug responses are still missing. However, these simulations would be one important milestone for truly personalized therapeutics. Another prerequisite for this would be individualized pharmaceutical manufacturing with subsequent obstacles, such as low automation, scalability, and therefore high costs. Additionally, regulatory challenges must be met thus calling for more digitalization in this area. Therefore, this narrative mini-review provides a discussion on the potentials and limitations of digital patient twins, focusing on their potential bridging function for personalized therapeutics and an individualized pharmaceutical manufacturing while also looking at the regulatory impacts.
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4
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Laky DJ, Casas-Orozco D, Abdi M, Feng X, Wood E, Reklaitis GV, Nagy ZK. Using PharmaPy with Jupyter Notebook to teach digital design in pharmaceutical manufacturing. Comput Appl Eng Educ 2023; 31:1662-1677. [PMID: 38314247 PMCID: PMC10838379 DOI: 10.1002/cae.22660] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 06/03/2023] [Indexed: 02/06/2024]
Abstract
The use of digital tools in pharmaceutical manufacturing has gained traction over the past two decades. Whether supporting regulatory filings or attempting to modernize manufacturing processes to adopt new and quickly evolving Industry 4.0 standards, engineers entering the workforce must exhibit proficiency in modeling, simulation, optimization, data processing, and other digital analysis techniques. In this work, a course that addresses digital tools in pharmaceutical manufacturing for chemical engineers was adjusted to utilize a new tool, PharmaPy, instead of traditional chemical engineering simulation tools. Jupyter Notebook was utilized as an instructional and interactive environment to teach students to use PharmaPy, a new, open-source pharmaceutical manufacturing process simulator. Students were then surveyed to see if PharmaPy was able to meet the learning objectives of the course. During the semester, PharmaPy's model library was used to simulate both individual unit operations as well as multiunit pharmaceutical processes. Through the initial survey results, students indicated that: (i) through Jupyter Notebook, learning Python and PharmaPy was approachable from varied coding experience backgrounds and (ii) PharmaPy strengthened their understanding of pharmaceutical manufacturing through active pharmaceutical ingredient process design and development.
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Affiliation(s)
- Daniel J. Laky
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana, USA
- Department of Chemical and Biological Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Daniel Casas-Orozco
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Mesfin Abdi
- Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, Food & Drug Administration, Silver Spring, Maryland, USA
| | - Xin Feng
- Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, Food & Drug Administration, Silver Spring, Maryland, USA
| | - Erin Wood
- Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, Food & Drug Administration, Silver Spring, Maryland, USA
| | - Gintaras V. Reklaitis
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Zoltan K. Nagy
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana, USA
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5
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Forster SP, Dippold E, Haser A, Emanuele D, Meier R. Integrated Continuous Wet Granulation and Drying: Process Evaluation and Comparison with Batch Processing. Pharmaceutics 2023; 15:2317. [PMID: 37765286 PMCID: PMC10537298 DOI: 10.3390/pharmaceutics15092317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The pharmaceutical industry is in the midst of a transition from traditional batch processes to continuous manufacturing. However, the challenges in making this transition vary depending on the selected manufacturing process. Compared with other oral solid dosage processes, wet granulation has been challenging to move towards continuous processing since traditional equipment has been predominantly strictly batch, instead of readily adapted to material flow such as dry granulation or tablet compression, and there have been few equipment options for continuous granule drying. Recently, pilot and commercial scale equipment combining a twin-screw wet granulator and a novel horizontal vibratory fluid-bed dryer have been developed. This study describes the process space of that equipment and compares the granules produced with batch high-shear and fluid-bed wet granulation processes. The results of this evaluation demonstrate that the equipment works across a range of formulations, effectively granulates and dries, and produces granules of similar or improved quality to batch wet granulation and drying.
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Affiliation(s)
| | | | - Abbe Haser
- Organon & Co., Inc., Jersey City, NJ 07302, USA
| | - Daniel Emanuele
- L.B. Bohle Maschinen und Verfahren GmbH, 59320 Ennigerloh, Germany
| | - Robin Meier
- L.B. Bohle Maschinen und Verfahren GmbH, 59320 Ennigerloh, Germany
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6
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Casas-Orozco D, Laky D, Mackey J, Reklaitis G, Nagy Z. Reaction kinetics determination and uncertainty analysis for the synthesis of the cancer drug lomustine. Chem Eng Sci 2023; 275:118591. [PMID: 38179266 PMCID: PMC10765472 DOI: 10.1016/j.ces.2023.118591] [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] [Indexed: 03/29/2023]
Abstract
Fast and reliable model development frameworks are required to support current trends in modernization of pharmaceutical processing, promoting the use of digital platforms to assist process design and operation. In this work, we use a parameter estimation framework built into the PharmaPy library to determine rate parameters and uncertainty regions of different mechanistic and semi-empirical kinetic expressions for the synthesis of the drug lomustine. The parameter estimation procedure was complemented by identifiability analysis, resulting in simplified reaction mechanisms. Comparison of parameters and their uncertainty in process design was demonstrated through design space analysis, showing important differences in model prediction and the extent of their corresponding design spaces. The results of this work can serve to analyze lomustine manufacturing processes that include separation and isolation steps, where parametric sensitivity is expected to propagate along the manufacturing line and impact process feasible operation, and attainment of critical quality attributes of the product.
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Verma V, Bade I, Karde V, Heng JYY. Experimental Elucidation of Templated Crystallization and Secondary Processing of Peptides. Pharmaceutics 2023; 15:pharmaceutics15041288. [PMID: 37111774 PMCID: PMC10142637 DOI: 10.3390/pharmaceutics15041288] [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: 03/31/2023] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
The crystallization of peptides offers a sustainable and inexpensive alternative to the purification process. In this study, diglycine was crystallised in porous silica, showing the porous templates' positive yet discriminating effect. The diglycine induction time was reduced by five-fold and three-fold upon crystallising in the presence of silica with pore sizes of 6 nm and 10 nm, respectively. The diglycine induction time had a direct relationship with the silica pore size. The stable form (α-form) of diglycine was crystallised in the presence of porous silica, with the diglycine crystals obtained associated with the silica particles. Further, we studied the mechanical properties of diglycine tablets for their tabletability, compactability, and compressibility. The mechanical properties of the diglycine tablets were similar to those of pure MCC, even with the presence of diglycine crystals in the tablets. The diffusion studies of the tablets using the dialysis membrane presented an extended release of diglycine through the dialysis membrane, confirming that the peptide crystal can be used for oral formulation. Hence, the crystallization of peptides preserved their mechanical and pharmacological properties. More data on different peptides can help us produce oral formulation peptides faster than usual.
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Affiliation(s)
- Vivek Verma
- Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK
| | - Isha Bade
- Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK
| | - Vikram Karde
- Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK
| | - Jerry Y Y Heng
- Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK
- Institute for Molecular Science and Engineering, Imperial College London, London SW7 2AZ, UK
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8
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Sundarkumar V, Nagy ZK, Reklaitis GV. Developing a machine learning enabled integrated formulation and process design framework for a pharmaceutical dropwise additive manufacturing printer. AIChE J 2023; 69:e17990. [PMID: 38222318 PMCID: PMC10785158 DOI: 10.1002/aic.17990] [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: 08/25/2022] [Accepted: 11/13/2022] [Indexed: 12/14/2022]
Abstract
The pharmaceutical manufacturing sector needs to rapidly evolve to absorb the next wave of disruptive industrial innovations - Industry 4.0. This involves incorporating technologies like artificial intelligence, smart factories and 3D printing to automate, miniaturize and personalize the production processes. The goal of this study is to build a formulation and process design (FPD) framework for a pharmaceutical 3D printing technique called drop-on-demand (DoD) printing. FPD can automate the determination of formulation properties and printing conditions (input conditions) for DoD operation that can guarantee production of drug products with desired functional attributes. This study proposes to build the FPD framework in two parts: the first part involves building a machine learning model to simulate the forward problem - predicting DoD operation based on input conditions and the second part seeks to solve and experimentally validate the inverse problem - predicting input conditions that can yield desired DoD operation.
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Affiliation(s)
- Varun Sundarkumar
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana 47906, USA
| | - Zoltan K Nagy
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana 47906, USA
| | - Gintaras V Reklaitis
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana 47906, USA
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9
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Ferlak J, Guzenda W, Osmałek T. Orodispersible Films-Current State of the Art, Limitations, Advances and Future Perspectives. Pharmaceutics 2023; 15. [PMID: 36839683 DOI: 10.3390/pharmaceutics15020361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/04/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
Orodispersible Films (ODFs) are drug delivery systems manufactured with a wide range of methods on a big scale or for customized medicines and small-scale pharmacy. Both ODFs and their fabrication methods have certain limitations. Many pharmaceutical companies and academic research centers across the world cooperate in order to cope with these issues and also to find new formulations for a wide array of APIs what could make their work profitable for them and beneficial for patients as well. The number of pending patent applications and granted patents with their innovative approaches makes the progress in the manufacturing of ODFs unquestionable. The number of commercially available ODFs is still growing. However, some of them were discontinued and are no longer available on the markets. This review aims to summarize currently marketed ODFs and those withdrawn from sale and also provides an insight into recently published studies concerning orodispersible films, emphasizing of utilized APIs. The work also highlights the attempts of scientific communities to overcome ODF's manufacturing methods limitations.
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10
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Chen X, Wang S, Wu J, Duan S, Wang X, Hong X, Han X, Li C, Kang D, Wang Z, Zheng A. The Application and Challenge of Binder Jet 3D Printing Technology in Pharmaceutical Manufacturing. Pharmaceutics 2022; 14:2589. [PMID: 36559082 PMCID: PMC9786002 DOI: 10.3390/pharmaceutics14122589] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/04/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Three-dimensional (3D) printing is an additive manufacturing technique that creates objects under computer control. Owing to the rapid advancement of science and technology, 3D printing technology has been widely utilized in processing and manufacturing but rarely used in the pharmaceutical field. The first commercial form of Spritam® immediate-release tablet was approved by FDA in 2015, which promoted the advancement of 3D printing technology in pharmaceutical development. Three-dimensional printing technology is able to meet individual treatment demands with customized size, shape, and release rate, which overcomes the difficulties of traditional pharmaceutical technology. This paper intends to discuss the critical process parameters of binder jet 3D printing technology, list its application in pharmaceutical manufacturing in recent years, summarize the still-open questions, and demonstrate its great potential in the pharmaceutical industry.
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Affiliation(s)
- Xuejun Chen
- Pharmaceutical Experiment Center, College of Pharmacy, Yanbian University, Yanji 133002, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China
| | - Shanshan Wang
- College of Biotechnology, Tianjin University of Science and Technology, Tianjin 300457, China
| | - Jie Wu
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing 100853, China
| | - Shuwei Duan
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing 100853, China
| | - Xiaolong Wang
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Kidney Diseases, Beijing 100853, China
| | - Xiaoxuan Hong
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China
| | - Xiaolu Han
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China
| | - Conghui Li
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China
| | - Dongzhou Kang
- Pharmaceutical Experiment Center, College of Pharmacy, Yanbian University, Yanji 133002, China
| | - Zengming Wang
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China
| | - Aiping Zheng
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China
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11
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Zhong S, Liang S, Zhong Y, Zheng Y, Wang F. Measure on innovation efficiency of China's pharmaceutical manufacturing industry. Front Public Health 2022; 10:1024997. [PMID: 36504962 PMCID: PMC9731224 DOI: 10.3389/fpubh.2022.1024997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022] Open
Abstract
Pharmaceutical manufacturing industry is an important industry to ensure human life safety. The innovation efficiency is a significant factor to stimulate the development of pharmaceutical manufacturing industry. At present, there are few studies on the innovation efficiency of pharmaceutical manufacturing industry. To fill this gap, this paper estimates the innovation efficiency of China's pharmaceutical manufacturing industry in 23 provinces of China from 2010 to 2020 based on the super-network SBM model and Global-Malmquist index. The results show that: (1) From the perspective of efficiency of research and development stage (ERDS), the ERDS of China shows an increasing trend, with the most prominent growth in the western region. (2) From the perspective of efficiency of economic transformation stage (EETS), although there are fluctuations in the EETS, the overall development is good. The EETS of the central region and western region is better than that of the eastern region. (3) By comparing the efficiency of the two stages, it is found that the change direction of the efficiency of the two stages is not necessarily the same in some provinces.
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Affiliation(s)
- Shen Zhong
- School of Finance, Harbin University of Commerce, Harbin, Heilongjiang, China
| | - Shuqi Liang
- School of Finance, Harbin University of Commerce, Harbin, Heilongjiang, China
| | - Yuxin Zhong
- Department of Neurology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yunying Zheng
- Department of Neurology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Fengjun Wang
- Department of Neurology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China,*Correspondence: Fengjun Wang
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12
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Abdelraheem A, Tukra R, Kazarin P, Sinanis MD, Topp EM, Alexeenko A, Peroulis D. Statistical electromagnetics for industrial pharmaceutical lyophilization. PNAS Nexus 2022; 1:pgac052. [PMID: 36741428 PMCID: PMC9896896 DOI: 10.1093/pnasnexus/pgac052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/04/2022] [Accepted: 05/02/2022] [Indexed: 02/07/2023]
Abstract
Lyophilization is a common unit operation in pharmaceutical manufacturing but is a prolonged vacuum drying process with poor energy utilization. Microwave-assisted vacuum drying has been investigated to accelerate the lyophilization process. However, the literature lacks methodical approaches that consider the lyophilizer, the lyophilizate, the microwave power uniformity, the resulting heat uniformity, and the scalability. We present a microwave-vacuum drying method based on the statistical electromagnetics theory. The method offers an optimum frequency selection procedure that accounts for the lyophilizer and the lyophilizate. The 2.45 GHz frequency conventionally utilized is proven to be far from optimum. The method is applied in a microwave-assisted heating configuration to pharmaceutical excipients (sucrose and mannitol) and different myoglobin formulations in a lab-scale lyophilizer. At 18 GHz frequency and 60 W microwave power, the method shows nearly three times speed-up in the primary drying stage of sucrose relative to the conventional lyophilization cycle for typical laboratory batches. The uniformity of the microwave power inside the chamber is controlled within ± 1 dB. The resulting heating uniformity measured through residual moisture analysis shows 12.7% of normalized SD of moisture level across the batch in a microwave-assisted cycle as opposed to 15.3% in the conventional cycle. Conventional and microwave lyophilized formulations are characterized using solid-state hydrogen-deuterium exchange-mass spectrometry (ssHDX-MS), solid-state Fourier transform infrared spectroscopy (ssFTIR), circular dichroism (CD), and accelerated stability testing (AST). Characterization shows comparable protein structure and stability. Heat and mass transfer simulations quantify further effects of optimal volumetric heating via the high-frequency statistical microwave heating.
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Affiliation(s)
- Ahmed Abdelraheem
- Birck Nanotechnology Center, Purdue University, 1205 W State St, West Lafayette, 47907 IN, USA,School of Electrical and Computer Engineering, Purdue University, Electrical Engineering Building, 465, Northwestern Ave, West Lafayette, 47907 IN, USA,Electronic Engineering Department, Military Technical College, Al-Khalifa Al-Mamoon Street Kobry Elkobbah, Cairo, Egypt
| | - Rishabh Tukra
- Birck Nanotechnology Center, Purdue University, 1205 W State St, West Lafayette, 47907 IN, USA,Department of Industrial and Physical Pharmac, College of Pharmacy, Purdue University, Heine (Robert E.) Pharmacy Bldg, 575 W Stadium Ave, West Lafayette, 47907 IN, USA
| | - Petr Kazarin
- Birck Nanotechnology Center, Purdue University, 1205 W State St, West Lafayette, 47907 IN, USA,School of Aeronautics and Astronautics, Purdue University, 701 W Stadium Ave, West Lafayette, 47907 IN, USA
| | - Michael D Sinanis
- Birck Nanotechnology Center, Purdue University, 1205 W State St, West Lafayette, 47907 IN, USA,School of Electrical and Computer Engineering, Purdue University, Electrical Engineering Building, 465, Northwestern Ave, West Lafayette, 47907 IN, USA
| | - Elizabeth M Topp
- Birck Nanotechnology Center, Purdue University, 1205 W State St, West Lafayette, 47907 IN, USA,Department of Industrial and Physical Pharmac, College of Pharmacy, Purdue University, Heine (Robert E.) Pharmacy Bldg, 575 W Stadium Ave, West Lafayette, 47907 IN, USA,National Institute for Bioprocessing Research and Training, Blackrock, Co. Dublin A94 X099, Ireland
| | | | - Dimitrios Peroulis
- Birck Nanotechnology Center, Purdue University, 1205 W State St, West Lafayette, 47907 IN, USA,School of Electrical and Computer Engineering, Purdue University, Electrical Engineering Building, 465, Northwestern Ave, West Lafayette, 47907 IN, USA
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13
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Abstract
BACKGROUND Concerns about strategic supplies and quality have increased the scrutiny of the countries where US pharmaceuticals are made. OBJECTIVE To examine the locations of manufacturers of brand name, biological, and generic drugs over 10 years. METHODS This longitudinal descriptive study used publicly available data from US government Web sites, including the Food and Drug Administration (FDA) Drug Establishments list, FDA National Drug Code Directory, FDA Orange Book, FDA Purple Book, and the National Institutes of Health DailyMed Drug Labels. These data were collected from 2011 to 2020. RESULTS Brand name drug manufacturing in the United States and Europe decreased from 89% in 2011 to 79% in 2020. Biological manufacturing in the United States decreased, while that in Western European countries increased; 100% of biological manufacturing was done in the United States or Europe in 2011 and decreased to 93% by 2020. Generic manufacturing in India increased from 21% to 51%, while US manufacturing decreased from 52% to 35% from 2011 to 2020. These analyses were limited to publicly available data, and the results could be affected by the accuracy and completeness of the data. CONCLUSIONS AND RELEVANCE Brand name drugs and biologicals are primarily made in the United States and Europe. Generic drugs are increasingly made in India, but the United States remains a major supplier. If the country of origin for pharmaceuticals is important, these findings support supply chain concerns for generic drugs. We recommend that product containers and official labeling prominently include the manufacturer and location for active pharmaceutical ingredients and finished dosage forms.
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Affiliation(s)
- Randy C Hatton
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
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14
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Huang YS, Sheriff MZ, Bachawala S, Gonzalez M, Nagy ZK, Reklaitis GV. Application of MHE-based NMPC on a Rotary Tablet Press under Plant-Model Mismatch. Int Symp Process Syst Eng 2022; 49:2149-2154. [PMID: 36790937 PMCID: PMC9923513 DOI: 10.1016/b978-0-323-85159-6.50358-4] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Active control strategies play a vital role in modern pharmaceutical manufacturing. Automation and digitalization are revolutionizing the pharmaceutical industry and are particularly important in the shift from batch operations to continuous operation. Active control strategies provide real-time corrective actions when departures from quality targets are detected or even predicted. Under the concept of Quality-by-Control (QbC), a three-level hierarchical control structure can be applied to achieve effective setpoint tracking and disturbance rejection in the tablet manufacturing process through the development and implementation of a moving horizon estimation-based nonlinear model predictive control (MHE-NMPC) framework. When MHE is coupled with NMPC, historical data in the past time window together with real-time data from the sensor network enable model parameter updating and control. The adaptive model in the NMPC strategy compensates for process uncertainties, further reducing plant-model mismatch effects. The frequency and constraints of parameter updating in the MHE window should be determined cautiously to maintain control robustness when sensor measurements are degraded or unavailable. The practical applicability of the proposed MHE-NMPC framework is demonstrated via using a commercial scale tablet press, Natoli NP-400, to control tablet properties, where the nonlinear mechanistic models used in the framework can predict the essential powder properties and provide physical interpretations.
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Affiliation(s)
- Yan-Shu Huang
- Davidson School of Chemial Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - M Ziyan Sheriff
- Davidson School of Chemial Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Sunidhi Bachawala
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Marcial Gonzalez
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907, USA
- Ray W. Herrick Laboratories, Purdue University, West Lafayette, IN 47907, USA
| | - Zoltan K Nagy
- Davidson School of Chemial Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Gintaras V Reklaitis
- Davidson School of Chemial Engineering, Purdue University, West Lafayette, IN 47907, USA
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15
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Lee J, Song C, Noh I, Song S, Rhee YS. Hot-Melt 3D Extrusion for the Fabrication of Customizable Modified-Release Solid Dosage Forms. Pharmaceutics 2020; 12:pharmaceutics12080738. [PMID: 32764499 PMCID: PMC7464107 DOI: 10.3390/pharmaceutics12080738] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/24/2020] [Accepted: 08/03/2020] [Indexed: 12/15/2022] Open
Abstract
In this work, modified-release solid dosage forms were fabricated by adjusting geometrical properties of solid dosage forms through hot-melt 3D extrusion (3D HME). Using a 3D printer with air pressure driving HME system, solid dosage forms containing ibuprofen (IBF), polyvinyl pyrrolidone (PVP), and polyethylene glycol (PEG) were printed by simultaneous HME and 3D deposition. Printed solid dosage forms were evaluated for their physicochemical properties, dissolution rates, and floatable behavior. Results revealed that IBF content in the solid dosage form could be individualized by adjusting the volume of solid dosage form. IBF was dispersed as amorphous state with enhanced solubility and dissolution rate in a polymer solid dosage form matrix. Due to absence of a disintegrant, sustained release of IBF from printed solid dosage forms was observed in phosphate buffer at pH 6.8. The dissolution rate of IBF was dependent on geometric properties of the solid dosage form. The dissolution rate of IBF could be modified by merging two different geometries into one solid dosage form. In this study, the 3D HME process showed high reproducibility and accuracy for preparing dosage forms. API dosage and release profile were found to be customizable by modifying or combining 3D modeling.
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16
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Abstract
In this work, a novel risk-based methodology for lot release is proposed. Its objective is to assess the risk that a lot declared to have passed truly meets product specifications. The methodology consists of 3 parts: adaptive sample size determination, estimation of the probability that the product was within specifications, and the lot-release decision. The methodology provides a probabilistic statement about the true quality of the batch. Having a probability estimate is the essential condition of risk-based decision-making. We demonstrate the proposed methodology on experimental data generated from 17 immediate-release solid oral drug products from a number of different manufacturers with 5 to 10 lots per manufacturer.
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Affiliation(s)
- Linas Mockus
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana 47907-2100.
| | - Gintaras Reklaitis
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana 47907-2100
| | - Kenneth Morris
- The Arnold and Marie Schwartz College of Pharmacy, Long Island University, Brooklyn, New York 11201-8423
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17
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Zhou ZH, Deng Y, Wu KY, Tan QW, Zhou XL, Song DL, Huang FX, Zeng WH. [Source Profiles of VOCs Associated with Typical Industrial Processes in Chengdu]. Huan Jing Ke Xue 2019; 40:3949-3961. [PMID: 31854857 DOI: 10.13227/j.hjkx.201903009] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The characteristics of volatile organic compound (VOCs) species from various production procedures of wood-based panel production and other industrial processes in Chengdu were analyzed through gas chromatography-mass spectrometry (GC-MS) and other methods specified in national standards after the emissions of typical enterprises of wood-based panel production, pharmaceutical manufacturing, chemical production and other industrial processes in Chengdu had been sampled using sampling bottles and SUMMA canisters. Generally, the process of wood-based panel production includes glue making, glue mixing, sorting, and hot pressing, whereas the process of pharmaceutical manufacturing includes workshop production and wastewater treatment. The results showed that the main contribution species of VOCs in wood-based panel production and pharmaceutical manufacturing is oxygenated VOCs (OVOCs), accounting for more than 50% of the total VOCs emitted. The species from organized and unorganized emissions of formaldehyde manufacturing differed significantly. The main species of organized emissions was OVOCs, and that of unorganized emissions was halohydrocarbons. Emissions of VOCs from coating manufacturing were strongly correlated with the raw materials, and the corresponding emission species were composed mainly of aromatics and OVOCs. Except for glue mixing, the main species of VOCs in other process procedures of wood-based panel production was formaldehyde, with emission proportion of more than 50%. The primary species of VOCs in various processes of pharmaceutical manufacturing was ethanol; however 1,4-dioxane, ethyl acetate, and toluene were also important species. Moreover, the main VOCs from formaldehyde manufacturing were composed mainly of acetone and ethanol, and those of coating manufacturing were aromatic hydrocarbons such as p-xylene. The ozone formation potential was to characterize the reactivity of pollution sources in VOCs from wood-based panel production, pharmaceutical manufacturing, and chemical production. The results showed that the species of VOCs in different industries contributed similarly to the reactivity and that these species were mainly high-activity species such as formaldehyde, ethanol, and other OVOCs as well as some aromatic hydrocarbons. Therefore, supervision and regulation of enterprises of industrial processes is required with a focus on species with relatively large ozone formation potential. In addition, it is necessary to analyze the emission characteristics and chemical mechanism of various industries and to control O3 generation from the sources.
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Affiliation(s)
- Zi-Hang Zhou
- Chengdu Key Laboratory of Air Pollution Research, Chengdu Academy of Environmental Sciences, Chengdu 610072, China
| | - Ye Deng
- Chengdu Key Laboratory of Air Pollution Research, Chengdu Academy of Environmental Sciences, Chengdu 610072, China
| | - Ke-Ying Wu
- Chengdu Key Laboratory of Air Pollution Research, Chengdu Academy of Environmental Sciences, Chengdu 610072, China
| | - Qin-Wen Tan
- Chengdu Key Laboratory of Air Pollution Research, Chengdu Academy of Environmental Sciences, Chengdu 610072, China
| | - Xiao-Ling Zhou
- Chengdu Key Laboratory of Air Pollution Research, Chengdu Academy of Environmental Sciences, Chengdu 610072, China
| | - Dan-Lin Song
- Chengdu Key Laboratory of Air Pollution Research, Chengdu Academy of Environmental Sciences, Chengdu 610072, China
| | - Feng-Xia Huang
- Chengdu Key Laboratory of Air Pollution Research, Chengdu Academy of Environmental Sciences, Chengdu 610072, China
| | - Wen-Hao Zeng
- Chengdu Key Laboratory of Air Pollution Research, Chengdu Academy of Environmental Sciences, Chengdu 610072, China
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18
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Bejarano A, Hewa Nadungodage C, Wang F, Catlin AC, Hoag SW. Decision Support for Excipient Risk Assessment in Pharmaceutical Manufacturing. AAPS PharmSciTech 2019; 20:223. [PMID: 31214878 DOI: 10.1208/s12249-019-1440-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 05/31/2019] [Indexed: 12/28/2022] Open
Abstract
Excipients have always been a key input into pharmaceutical products, profoundly affecting product quality. Currently, most of our knowledge of excipient critical quality attributes is empirical, gained through experience, and shared through publications and other sources. The behavior of excipients is complicated, with many different failure modes that depend on the type of dosage form. Even within the same dosage form, there can be multiple failure modes depending on the manufacturing method. This complex behavior creates many possible combinations to assess when designing a formulation or evaluating regulatory submissions. Formulation science could be improved if data from different sources could be made widely available through an interactive system using a consistent, structured format to help formulators and regulators assess the risk of excipient usage for a particular dosage form with a particular manufacturing method. This paper describes a decision support system that was created for assessing excipient risk in different types of formulations and considering different types of manufacturing methods, dosage forms, and excipient functionality. The Excipient Risk Assessment System consists of a database that stores knowledge about factors that affect formulation design and a decision support processor that manages selections for creating formulation scenarios and assigning risk. Formulation and risk assessment data are provided by formulation science experts. This enables the system to assess compatibility among excipients, functionality, dosage forms, and manufacturing methods selected for formulations. The interface guides users through the creation of formulation scenarios and displays customized, interactive risk assessment reports for users to search and explore.
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19
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Rohde E, Pachler K, Gimona M. Manufacturing and characterization of extracellular vesicles from umbilical cord-derived mesenchymal stromal cells for clinical testing. Cytotherapy 2019; 21:581-592. [PMID: 30979664 DOI: 10.1016/j.jcyt.2018.12.006] [Citation(s) in RCA: 122] [Impact Index Per Article: 24.4] [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: 08/31/2018] [Revised: 11/21/2018] [Accepted: 12/14/2018] [Indexed: 02/07/2023]
Abstract
Extracellular vesicles (EVs) derived from mesenchymal stromal cells (MSCs) may deliver therapeutic effects that are comparable to their parental cells. MSC-EVs are promising agents for the treatment of a variety of diseases. To reach the intermediate goal of clinically testing safety and efficacy of EVs, strategies should strive for efficient translation of current EV research. On the basis of our in vitro an in vivo findings regarding the biological actions of EVs and our experience in manufacturing biological stem cell therapeutics for routine use and clinical testing, we discuss strategies of manufacturing and quality control of umbilical cord-derived MSC-EVs. We introduce guidelines of good manufacturing practice and their practicability along the path from the laboratory to the patient. We present aspects of manufacturing and final product quality testing and highlight the principle of "The process is the product." The approach presented in this perspective article may facilitate translational research during the development of complex biological EV-based therapeutics in a very early stage of manufacturing as well as during early clinical safety and proof-of-concept testing.
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Affiliation(s)
- Eva Rohde
- GMP Laboratory, Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Paracelsus Medical University (PMU), Salzburg, Austria; Department of Transfusion Medicine, Paracelsus Medical University (PMU), Salzburg, Austria; Celericon Therapeutics G.m.b.H., Paracelsus Medical University (PMU), Salzburg, Austria.
| | - Karin Pachler
- GMP Laboratory, Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Paracelsus Medical University (PMU), Salzburg, Austria; Department of Transfusion Medicine, Paracelsus Medical University (PMU), Salzburg, Austria; Research Program Nanovesicular Therapies, Paracelsus Medical University (PMU), Salzburg, Austria
| | - Mario Gimona
- GMP Laboratory, Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Paracelsus Medical University (PMU), Salzburg, Austria; Department of Transfusion Medicine, Paracelsus Medical University (PMU), Salzburg, Austria; Research Program Nanovesicular Therapies, Paracelsus Medical University (PMU), Salzburg, Austria; Celericon Therapeutics G.m.b.H., Paracelsus Medical University (PMU), Salzburg, Austria
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20
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Haring AP, Tong Y, Halper J, Johnson BN. Programming of Multicomponent Temporal Release Profiles in 3D Printed Polypills via Core-Shell, Multilayer, and Gradient Concentration Profiles. Adv Healthc Mater 2018; 7:e1800213. [PMID: 29888441 DOI: 10.1002/adhm.201800213] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [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: 02/27/2018] [Revised: 04/20/2018] [Indexed: 02/03/2023]
Abstract
Additive manufacturing (AM) appears poised to provide novel pharmaceutical technology and controlled release systems, yet understanding the effects of processing and post-processing operations on pill design, quality, and performance remains a significant barrier. This paper reports a study of the relationship between programmed concentration profile and resultant temporal release profile using a 3D printed polypill system consisting of a Food and Drug Administration (FDA) approved excipient (Pluronic F-127) and therapeutically relevant dosages of three commonly used oral agents for treatment of type 2 diabetes (300-500 mg per pill). A dual-extrusion hydrogel microextrusion process enables the programming of three unique concentration profiles, including core-shell, multilayer, and gradient structures. Experimental and computational studies of diffusive mass transfer processes reveal that programmed concentration profiles are dynamic throughout both pill 3D printing and solidification. Spectrophotometric assays show that the temporal release profiles could be selectively programmed to exhibit delayed, pulsed, or constant profiles over a 5 h release period by utilizing the core-shell, multilayer, and gradient distributions, respectively. Ultimately, this work provides new insights into the mass transfer processes that affect design, quality, and performance of spatially graded controlled release systems, as well as demonstrating the potential to create disease-specific polypill technology with programmable temporal release profiles.
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Affiliation(s)
- Alexander P. Haring
- Department of Industrial and Systems Engineering Macromolecules Innovation Institute Virginia Tech Blacksburg VA 24061 USA
| | - Yuxin Tong
- Department of Industrial and Systems Engineering Virginia Tech Blacksburg VA 24061 USA
| | - Justin Halper
- Department of Industrial and Systems Engineering Virginia Tech Blacksburg VA 24061 USA
| | - Blake N. Johnson
- Department of Industrial and Systems Engineering Department of Chemical Engineering Department of Materials Science and Engineering Macromolecules Innovation Institute, Virginia Tech Blacksburg VA 24061 USA
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21
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Chetcuti M, Serracino-Inglott A, Flores G, Borg JJ. Pharmaceutical issues during the review of European Marketing Authorisation Applications in Malta . Pharm Dev Technol 2017; 23:561-572. [PMID: 28758819 DOI: 10.1080/10837450.2017.1360348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to identify pharmaceutical issues encountered during regulatory review in European Procedures. A database of issues from Day 70 assessment reports of 150 EU procedures was compiled; most procedures were for generics (108). Frequencies of common deficiencies have been calculated and summarised for use of all stakeholders. Out of the 150 procedures reviewed, covering 309 products, a total of 4796 concerns were identified. Of these concerns, 167 were Potential Serious Risks to Public Health, 67 were raised on drug substance and 100 on the drug product. The distribution of total concerns was as follows: 2168 concerns on drug substance and 2584 on drug product. Most concerns raised were on control of drug substance and drug product (834 & 626 for 3.2.S.4 and 3.2.P.5, respectively), followed by concerns on the manufacturing (482 & 564 for 3.2.S.2 and 3.2.P.3, respectively) and stability 147 & 398 for 3.2.S.7 and 3.2.P.8, respectively). In conclusion, the frequencies and trends of identified deficiencies together with their impact were discussed from a regulatory point of view. The main findings indicate that applicants would benefit from following published guidelines so that delays in the registration of medicines could be avoided.
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Affiliation(s)
- Michael Chetcuti
- a Medicines Authority, Sir Temi Zammit Buildings , Malta Life Sciences Park , San Ġwann , Malta
| | - Anthony Serracino-Inglott
- a Medicines Authority, Sir Temi Zammit Buildings , Malta Life Sciences Park , San Ġwann , Malta.,b Department of Pharmacy , University of Malta , Tal-Qroqq , Malta
| | - Gavril Flores
- a Medicines Authority, Sir Temi Zammit Buildings , Malta Life Sciences Park , San Ġwann , Malta
| | - John J Borg
- a Medicines Authority, Sir Temi Zammit Buildings , Malta Life Sciences Park , San Ġwann , Malta.,c Pharmacy Department, Faculty of Biology , University of Tor Vergata , Rome , Italy
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22
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Beninger P. Opportunities for Collaboration at the Interface of Pharmacovigilance and Manufacturing. Clin Ther 2017; 39:702-712. [PMID: 28366594 DOI: 10.1016/j.clinthera.2017.03.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 01/26/2017] [Revised: 03/03/2017] [Accepted: 03/09/2017] [Indexed: 10/19/2022]
Abstract
A case can be made that much common ground exists between pharmacovigilance and pharmaceutical manufacturing. Of the 8 major US statutes that shaped the pharmaceutical industry since early in the 20th Century, 7 followed fatally catastrophic events related to the use of a manufactured product, and 1 followed the discovery of a counterfeit product. To facilitate an understanding of the interplay between pharmacovigilance and manufacturing, it is convenient to divide manufacturing into 3 categories: (1) upstream sourcing of materials: pharmacovigilance plays an important role when adverse event clusters are seen during routine vigilance detection processes and the suspicion turns to possibly contaminated source material, (2) the manufacturing process itself: pharmacovigilance may be called on to conduct a health hazard evaluation if a manufacturing deviation is detected after product release (the assessment can inform the depth of a recall), and (3) downstream distribution and product use: there is only light regulation of the interval between product distribution after manufacturing release and just before administration to patients, a time during which product may be subject to an out-of-specification determination for environmental controls or subject to malfeasant activities, such as counterfeit substitution or product diversion. Recently introduced statutory remedies, including the FDA Safety and Innovation Act and the Drug Supply Chain Security Act in the United States and the Falsified Medicines Directive (directive 2011/62/EC) in the European Union, can provide capabilities to support pharmacovigilance signal management activities that have the potential to reduce the risk to patients of experiencing adverse events caused by counterfeit, diverted, or tampered product.
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Affiliation(s)
- Paul Beninger
- Public Health & Community Medicine, Tufts University School of Medicine, Boston, Massachusetts.
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