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Chamberlain P, Hammond DS, Arumugam B, Bradley A. Six-year cumulative treatment effect and treatment efficacy of a dual focus myopia control contact lens. Ophthalmic Physiol Opt 2024; 44:199-205. [PMID: 37897105 DOI: 10.1111/opo.13240] [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: 06/27/2023] [Revised: 09/29/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
PURPOSE Accumulated axial growth observed during a 6-year clinical trial of a dual focus myopia control contact lens was used to explore different approaches to assess treatment efficacy. METHODS Axial length measurements from 170 eyes in a 6-year clinical trial of a dual focus myopia control lens (MiSight 1 day, CooperVision) were analysed. Treatment groups comprised one having undergone 6 years of treatment and the other (the initial control group) having 3 years of treatment after 3 years of wearing a single vision control lens. Efficacy was assessed by comparing accumulated ocular growth during treatment to that expected of untreated myopic and emmetropic eyes. The impact of treatment on delaying axial growth was quantified by comparing the increased time required to reach criterion growths for treated eyes and survivor analysis approaches. RESULTS When compared to the predicted accumulated growth of untreated eyes, 6 years of treatment reduced growth by 0.52 mm, while 3 years of treatment initiated 3 years later reduced growth by 0.19 mm. Accumulated differences between the growth of treated and untreated myopic eyes ranged between 67% and 52% of the untreated myopic growth, and between 112% and 86% of the predicted difference in growth between untreated myopic and age-matched emmetropic eyes. Treated eyes took almost 4 years longer to reach their final accumulated growth than untreated eyes. Treatment increased the time to reach criterion growths by 2.3-2.7 times. CONCLUSION Estimated growth of age-matched emmetropic and untreated myopic eyes provided evidence of an accumulated slowing in axial elongation of 0.52 mm over 6 years, and the treated growth remained close to that expected of emmetropic eyes. Six years of dual focus myopia control delayed the time to reach the final growth level by almost 4 years.
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Lumb E, Sulley A, Logan NS, Jones D, Chamberlain P. Six years of wearer experience in children participating in a myopia control study of MiSight® 1 day. Cont Lens Anterior Eye 2023; 46:101849. [PMID: 37156658 DOI: 10.1016/j.clae.2023.101849] [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] [Received: 10/12/2022] [Revised: 04/12/2023] [Accepted: 04/16/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE To evaluate the experience of children wearing soft contact lenses (CLs) during a trial of MiSight® 1 day (omafilcon A, CooperVision, Inc.), a dual-focus myopia-control daily disposable CL. METHODS A 3-year, double-masked, randomised trial (Part 1) comparing experiences with MiSight 1 day and a single-vision control (Proclear® 1 day, omafilcon A, CooperVision, Inc.) of neophyte, myopic children (ages 8-12). Treatment (n = 65) and control (n = 70) participants received lenses at sites in Canada, Portugal, Singapore, and the UK. Successful participants completing Part 1 were invited to continue for a further 3 years wearing the dual-focus CL (Part 2), and 85 participants completed the 6-year study. Children and parent questionnaires were conducted at baseline, 1 week, 1 month, and every 6 months until the 60-month visit, with children only also completing questionnaires at 66 and 72 months. RESULTS Throughout the study, children reported high satisfaction with handling (≥89% top 2 box [T2B]), comfort (≥94% T2B), vision (≥93% T2B for various activities), and overall satisfaction (≥97% T2B). Ratings for comfort and vision were not significantly different between lens groups, visits, or study parts and did not change when children switched to dual-focus CLs. Ratings for 'really easy' or 'kind of easy' application improved from the outset for the neophytes (57% at 1-week follow-up and 85% at 1-month follow-up) and remained high throughout the study (visit: P = 0.007; part: P = 0.0004). Overall satisfaction improved in Part 2 (P = 0.04). Wearing times increased in Part 2 (14 vs. 13 hrs/weekday; 13 vs. 12 hrs/day on weekends; P < 0.001); there were no differences between groups. CONCLUSIONS Children adapted rapidly to full-time wear, rated lenses highly, and rarely reported issues. The dual-focus optics included in the MiSight® 1 day lenses successfully achieved myopia control without lowering subjective ratings when fitted to neophytes or children refitted from single-vision CLs.
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Affiliation(s)
- Elizabeth Lumb
- CooperVision International Ltd., Delta Park, Concorde Way, Segensworth North, Fareham PO15 5RL, UK.
| | - Anna Sulley
- CooperVision International Ltd., Chandler's Ford, Eastleigh SO53 4TE, United Kingdom
| | - Nicola S Logan
- School of Optometry, Aston University, Birmingham B4 7ET, United Kingdom
| | - Debbie Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, 200 University Avenue W, Waterloo, ON N2L 3G1, Canada
| | - Paul Chamberlain
- CooperVision Inc., 5870 Stoneridge Drive, Pleasanton, CA 94588, United States
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Wessels H, von Richter O, Velinova M, Höfler J, Chamberlain P, Kromminga A, Lehnick D, Roth K. Pharmacokinetic and pharmacodynamic similarity of biosimilar natalizumab (PB006) to its reference medicine: a randomized controlled trial. Expert Opin Biol Ther 2023; 23:1287-1297. [PMID: 38044885 DOI: 10.1080/14712598.2023.2290530] [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] [Received: 11/10/2023] [Accepted: 11/29/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND PB006 (Polpharma Biologics S.A; marketed as Tyruko®, Sandoz) is an approved biosimilar to natalizumab (Tysabri®; Biogen [ref-NTZ]). This multicenter, double-blind, randomized, single-dose study was conducted to demonstrate pharmacokinetic/pharmacodynamic (PK/PD) similarity between PB006 and ref-NTZ. RESEARCH DESIGN AND METHODS Healthy participants (N = 453) were randomized to receive 3 mg/kg infusion of PB006, US-licensed, or EU-approved ref-NTZ before an 85-day follow-up. Primary PK endpoint was total natalizumab serum concentration over time; secondary PK endpoints explored concentration changes. Primary PD endpoints compared CD19+ cell counts and percentage α4-integrin receptor saturation, per natalizumab's mechanism of action. Secondary PD endpoints explored serum changes in sVCAM-1 and sMAdCAM-1, CD34+, and CD19+ cells. Safety, tolerability, and immunogenicity were assessed. RESULTS The primary PK endpoint was met, with 90% confidence intervals (CIs) of the geometric mean for serum test/reference ratios contained within a prespecified margin (0.8-1.25). All primary PD endpoints were met, with 90% and 95% CIs within this similarity margin for baseline-adjusted CD19+ cell counts and percentage α4-integrin receptor saturation. All secondary endpoints were similarly contained, except sVCAM. No notable differences in safety, tolerability, or immunogenicity were observed. CONCLUSION Similarity was confirmed, with PB006 demonstrating PK/PD behavior consistent with that of ref-NTZ. CLINICAL TRIAL REGISTRATION EudraCT number 2019-003874-15.
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Affiliation(s)
| | | | - Maria Velinova
- Early Development Services, ICON, Groningen, The Netherlands
| | | | | | | | - Dirk Lehnick
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Ramasubramanian V, Logan NS, Jones S, Meyer D, Jaskulski M, Rickert M, Chamberlain P, Arumugam B, Bradley A, Kollbaum PS. Myopia Control Dose Delivered to Treated Eyes by a Dual-focus Myopia-control Contact Lens. Optom Vis Sci 2023; 100:376-387. [PMID: 37097975 PMCID: PMC10317304 DOI: 10.1097/opx.0000000000002021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/26/2023] Open
Abstract
PURPOSE This study examined the optical impact of a DF contact lens during near viewing in a sample of habitual DF lens wearing children. METHODS Seventeen myopic children aged 14 to 18 years who had completed 3 or 6 years of treatment with a DF contact lens (MiSight 1 Day; CooperVision, Inc., San Ramon, CA) were recruited and fit bilaterally with the DF and a single-vision (Proclear 1 Day; CooperVision, Inc.) contact lens. Right eye wavefronts were measured using a pyramidal aberrometer (Osiris; CSO, Florence, Italy) while children accommodated binocularly to high-contrast letter stimuli at five target vergences. Wavefront error data were used to compute pupil maps of refractive state. RESULTS During near viewing, children wearing single-vision lenses accommodated on average to achieve approximate focus in the pupil center but, because of combined accommodative lag and negative spherical aberration, experienced up to 2.00 D of hyperopic defocus in the pupil margins. With DF lenses, children accommodated similarly achieving approximate focus in the pupil center. When viewing three near distances (0.48, 0.31, and 0.23 m), the added +2.00 D within the DF lens treatment optics shifted the mean defocus from +0.75 to -1.00 D. The DF lens reduced the percentage of hyperopic defocus (≥+0.75 D) in the retinal image from 52 to 25% over these target distances, leading to an increase in myopic defocus (≤-0.50 D) from 17 to 42%. CONCLUSIONS The DF contact lens did not alter the accommodative behavior of children. The treatment optics introduced myopic defocus and decreased the amount of hyperopically defocused light in the retinal image.
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Affiliation(s)
| | - Nicola S. Logan
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Susie Jones
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Dawn Meyer
- School of Optometry, Indiana University Bloomington, Bloomington, Indiana
| | - Matt Jaskulski
- School of Optometry, Indiana University Bloomington, Bloomington, Indiana
| | - Martin Rickert
- School of Optometry, Indiana University Bloomington, Bloomington, Indiana
| | | | | | | | - Pete S. Kollbaum
- School of Optometry, Indiana University Bloomington, Bloomington, Indiana
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Bullimore MA, Lee SSY, Schmid KL, Rozema JJ, Leveziel N, Mallen EAH, Jacobsen N, Iribarren R, Verkicharla PK, Polling JR, Chamberlain P. IMI-Onset and Progression of Myopia in Young Adults. Invest Ophthalmol Vis Sci 2023; 64:2. [PMID: 37126362 PMCID: PMC10153577 DOI: 10.1167/iovs.64.6.2] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Myopia typically starts and progresses during childhood, but onset and progression can occur during adulthood. The goals of this review are to summarize published data on myopia onset and progression in young adults, aged 18 to 40 years, to characterize myopia in this age group, to assess what is currently known, and to highlight the gaps in the current understanding. Specifically, the peer-reviewed literature was reviewed to: characterize the timeline and age of stabilization of juvenile-onset myopia; estimate the frequency of adult-onset myopia; evaluate the rate of myopia progression in adults, regardless of age of onset, both during the college years and later; describe the rate of axial elongation in myopic adults; identify risk factors for adult onset and progression; report myopia progression and axial elongation in adults who have undergone refractive surgery; and discuss myopia management and research study design. Adult-onset myopia is common, representing a third or more of all myopia in western populations, but less in East Asia, where onset during childhood is high. Clinically meaningful myopia progression continues in early adulthood and may average 1.00 diopters (D) between 20 and 30 years. Higher levels of myopia are associated with greater absolute risk of myopia-related ocular disease and visual impairment, and thus myopia in this age group requires ongoing management. Modalities established for myopia control in children would be options for adults, but it is difficult to predict their efficacy. The feasibility of studies of myopia control in adults is limited by the long duration required.
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Affiliation(s)
- Mark A Bullimore
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Katrina L Schmid
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Jos J Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Nicolas Leveziel
- Department of Ophthalmology, Centre Hospitalier Universitaire de Poitiers, Poitiers, Cedex, France
| | - Edward A H Mallen
- School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
| | | | | | - Pavan K Verkicharla
- Myopia Research Lab and Infor Myopia Centre, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Jan Roelof Polling
- Ophthalmology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands Rotterdam, The Netherlands
- Orthopics & Optometry, University of Applied Science, Utrecht, The Netherlands
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Hammond D, Chamberlain P, Arumugam B, Bradley A. Eye growth of children undergoing myopia control treatment compared with emmetropic eye growth. Ophthalmologie 2022; 119:147-148. [PMID: 35080637 DOI: 10.1007/s00347-021-01571-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 01/25/2023]
Affiliation(s)
- David Hammond
- CooperVision Inc., 5870 Stoneridge Drive, Suite 1, 94588, Pleasanton, CA, USA.
| | - Paul Chamberlain
- CooperVision Inc., 5870 Stoneridge Drive, Suite 1, 94588, Pleasanton, CA, USA
| | - Baskar Arumugam
- CooperVision Inc., 5870 Stoneridge Drive, Suite 1, 94588, Pleasanton, CA, USA
| | - Arthur Bradley
- CooperVision Inc., 5870 Stoneridge Drive, Suite 1, 94588, Pleasanton, CA, USA
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Chamberlain P, Bradley A, Arumugam B, Hammond D, McNally J, Logan NS, Jones D, Ngo C, Peixoto-de-Matos SC, Hunt C, Young G. Long-term Effect of Dual-focus Contact Lenses on Myopia Progression in Children: A 6-year Multicenter Clinical Trial. Optom Vis Sci 2022; 99:204-212. [PMID: 35086120 DOI: 10.1097/opx.0000000000001873] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [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: 11/26/2022] Open
Abstract
SIGNIFICANCE Treatment of myopic children with a dual-focus soft contact lens (DFCL; MiSight 1 day) produced sustained slowing of myopia progression over a 6-year period. Significant slowing was also observed in children switched from a single vision control to treatment lenses (3 years in each lens). PURPOSE This study aimed to evaluate the effectiveness of DFCLs in sustaining slowed progression of juvenile-onset myopia over a 6-year treatment period and assess myopia progression in children who were switched to a DFCL at the end of year 3. METHODS Part 1 was a 3-year clinical trial comparing DFCLs with a control contact lens (Proclear 1 day) at four investigational sites. In part 2, subjects completing part 1 were invited to continue for 3 additional years during which all children were treated with MiSight 1 day DFCLs (52 and 56 from the initially treated [T6] and control [T3] groups, respectively). Eighty-five subjects (45 [T3] and 40 [T6]) completed part 2. Cyclopleged spherical equivalent refractive errors (SEREs) and axial lengths (ALs) were monitored, and a linear mixed model was used to compare their adjusted change annually. RESULTS Average ages at part 2 baseline were 13.2 ± 1.3 and 13.0 ± 1.5 years for the T6 and T3 groups, respectively. Slowed myopia progression in the T6 group observed during part 1 was sustained throughout part 2 (mean ± standard error of the mean: change from baseline SERE [in diopters], -0.52 ± 0.076 vs. -0.51 ± 0.076; change in AL [in millimeters], 0.28 ± 0.033 vs. 0.23 ± 0.033; both P > .05). Comparing progression rates in part 2 for the T6 and T3 groups, respectively, indicates that prior treatment does not influence efficacy (SERE, -0.51 ± 0.076 vs. -0.34 ± 0.077; AL, 0.23 ± 0.03 vs. 0.18 ± 0.03; both P > .05). Within-eye comparisons of AL growth revealed a 71% slowing for the T3 group (3 years older than part 1) and further revealed a small subset of eyes (10%) that did not respond to treatment. CONCLUSIONS Dual-focus soft contact lenses continue to slow the progression of myopia in children over a 6-year period revealing an accumulation of treatment effect. Eye growth of the initial control cohort with DFCL was slowed by 71% over the subsequent 3-year treatment period.
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Affiliation(s)
| | | | | | | | | | - Nicola S Logan
- Ophthalmic Research Group, School of Optometry, Aston University, Aston Triangle, Birmingham, United Kingdom
| | - Deborah Jones
- Centre for Ocular Research and Education, School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Cheryl Ngo
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Sofia C Peixoto-de-Matos
- Clinical and Experimental Optometry Research Lab, Centre of Physics, School of Sciences, University of Minho, Braga, Portugal
| | - Chris Hunt
- Visioncare Research Ltd., Farnham, Surrey, United Kingdom
| | - Graeme Young
- Visioncare Research Ltd., Farnham, Surrey, United Kingdom
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Hammond D, Chamberlain P, Arumugam B, Bradley A. [Eye growth of children undergoing myopia control treatment compared with emmetropic eye growth. German version]. Ophthalmologe 2022; 119:525-527. [PMID: 35217879 DOI: 10.1007/s00347-021-01570-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 10/19/2022]
Affiliation(s)
- David Hammond
- CooperVision Inc., 5870 Stoneridge Drive, Suite 1, 94588, Pleasanton, CA, USA.
| | - Paul Chamberlain
- CooperVision Inc., 5870 Stoneridge Drive, Suite 1, 94588, Pleasanton, CA, USA
| | - Baskar Arumugam
- CooperVision Inc., 5870 Stoneridge Drive, Suite 1, 94588, Pleasanton, CA, USA
| | - Arthur Bradley
- CooperVision Inc., 5870 Stoneridge Drive, Suite 1, 94588, Pleasanton, CA, USA
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Sulley A, Hammond D, Hunt C, Arumugam B, Chamberlain P. Subjective experiences of children switched from single vision to dual focus myopia control daily disposable contact lenses. Cont Lens Anterior Eye 2022. [DOI: 10.1016/j.clae.2022.101674] [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: 11/03/2022]
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Lumb E, Chamberlain P, Arumugam B, Hunt C, Young G. Myopia Progression and Slit-Lamp Findings in Children: MiSight® 1 day clinical trial. Cont Lens Anterior Eye 2022. [DOI: 10.1016/j.clae.2022.101663] [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: 11/03/2022]
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Myler H, Pedras-Vasconcelos J, Phillips K, Hottenstein CS, Chamberlain P, Devanaryan V, Gleason C, Goodman J, Manning MS, Purushothama S, Richards S, Shen H, Zoghbi J, Amaravadi L, Barger T, Bowen S, Bowsher RR, Clements-Egan A, Geng D, Goletz TJ, Gunn GR, Hallett W, Hodsdon ME, Janelsins BM, Jawa V, Kamondi S, Kirshner S, Kramer D, Liang M, Lindley K, Liu S, Liu Z, McNally J, Mikulskis A, Nelson R, Ahbari MR, Qu Q, Ruppel J, Snoeck V, Song A, Yan H, Ware M. Anti-drug Antibody Validation Testing and Reporting Harmonization. AAPS J 2021; 24:4. [PMID: 34853961 PMCID: PMC8816448 DOI: 10.1208/s12248-021-00649-y] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022] Open
Abstract
Evolving immunogenicity assay performance expectations and a lack of harmonized anti-drug antibody validation testing and reporting tools have resulted in significant time spent by health authorities and sponsors on resolving filing queries. Following debate at the American Association of Pharmaceutical Sciences National Biotechnology Conference, a group was formed to address these gaps. Over the last 3 years, 44 members from 29 organizations (including 5 members from Europe and 10 members from FDA) discussed gaps in understanding immunogenicity assay requirements and have developed harmonization tools for use by industry scientists to facilitate filings to health authorities. Herein, this team provides testing and reporting strategies and tools for the following assessments: (1) pre-study validation cut point; (2) in-study cut points, including procedures for applying cut points to mixed populations; (3) system suitability control criteria for in-study plate acceptance; (4) assay sensitivity, including the selection of an appropriate low positive control; (5) specificity, including drug and target tolerance; (6) sample stability that reflects sample storage and handling conditions; (7) assay selectivity to matrix components, including hemolytic, lipemic, and disease state matrices; (8) domain specificity for multi-domain therapeutics; (9) and minimum required dilution and extraction-based sample processing for titer reporting.
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Affiliation(s)
- Heather Myler
- Immunochemistry Department, PPD Laboratories, 2244 Dabney Road, Richmond, Virginia, 23230-3323, USA.
| | - João Pedras-Vasconcelos
- Product Quality and Immunogenicity, Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drugs Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, 20903, USA
| | - Kelli Phillips
- Immunochemistry Department, PPD Laboratories, 2244 Dabney Road, Richmond, Virginia, 23230-3323, USA
| | - Charles Scott Hottenstein
- Immunogenicity, GlaxoSmithKline Pharmaceuticals, 1250 South Collegeville Road, Collegeville, Pennsylvania, 19426, USA
| | - Paul Chamberlain
- NDA Advisory Services, Ltd., Grove House, Guildford Road, Leatherhead, KT22 9DF, Surrey, UK
| | | | - Carol Gleason
- Global Biometric and Data Sciences, Bristol-Myers Squibb, Princeton, New Jersey, 08540, USA
| | - Joanne Goodman
- Integrated Bioanalysis, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | | | - Shobha Purushothama
- Diagnostics Accelerator, Alzheimer's Drug Discovery Foundation, 57W 57th Street, New York, New York, USA
| | - Susan Richards
- Translational Medicine and Early Development, Sanofi, Framingham, Massachusetts, 01701, USA
| | - Honglue Shen
- Specialty Bioanalytics, Teva Pharmaceuticals, West Chester, Pennsylvania, 19380, USA
| | - Jad Zoghbi
- Translational Medicine and Early Development, Sanofi, Framingham, Massachusetts, 01701, USA
| | | | - Troy Barger
- Bioanalytical Sciences, Amgen Research, Thousand Oaks, California, 91320, USA
| | - Steven Bowen
- Product Quality and Immunogenicity, Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drugs Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, 20903, USA
| | - Ronald R Bowsher
- B2S Life Sciences, 97 East Monroe Street, Franklin, Indiana, 46131, USA
| | | | - Dong Geng
- Legend Biotech, 10 Knightsbridge Road, Piscataway, New Jersey, 08554, USA
| | - Theresa J Goletz
- Drug Metabolism & Pharmacokinetics, EMD Serono, Billerica, Massachusetts, 01821, USA
| | - George R Gunn
- Immunogenicity, GlaxoSmithKline Pharmaceuticals, 1250 South Collegeville Road, Collegeville, Pennsylvania, 19426, USA
| | - William Hallett
- Product Quality and Immunogenicity, Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drugs Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, 20903, USA
| | - Michael E Hodsdon
- Laboratory for Experimental Medicine, Eli Lilly and Company, Indianapolis, Indiana, 46285, USA
| | - Brian M Janelsins
- Product Quality and Immunogenicity, Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drugs Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, 20903, USA
| | - Vibha Jawa
- Predictive and Clinical Immunogenicity Pharmacometrics, Pharmacodynamics and Drug Metabolism, Merck and Co., 2000 Galloping Hill Road, Kenilworth, New Jersey, 07033, USA
| | - Szilard Kamondi
- Kamondi Bioanalytical Consultancy, Rheinfelden, Switzerland / Roche Pharma Research & Early Development, Pharmaceutical Sciences, Bioanalytical R&D, Roche Innovation Center, Basel, Switzerland
| | - Susan Kirshner
- Product Quality and Immunogenicity, Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drugs Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, 20903, USA
| | - Daniel Kramer
- Translational Medicine and Early Development, Sanofi, Frankfurt am Main, Germany
| | - Meina Liang
- Integrated Bioanalysis, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, South San Francisco, California, USA
| | | | - Susana Liu
- Pfizer Inc., 17300 Trans Canada Hwy, Kirkland, Quebec, Canada
| | - ZhenZhen Liu
- Product Quality and Immunogenicity, Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drugs Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, 20903, USA
| | - Jim McNally
- BioAgilytix Labs, Durham, North Carolina, 27713, USA
| | - Alvydas Mikulskis
- Clinical Biomarkers, Vertex Pharmaceuticals, Inc., Boston, Massachusetts, 02210, USA
| | - Robert Nelson
- Immunochemistry Department, Covance Laboratories Ltd., Harrogate, HG3 1PY, UK
| | - Mohsen Rajabi Ahbari
- Office of Study Integrity and Surveillance, Office of Translational Sciences, Center for Drug Evaluation and Research (CDER), Food and Drug Administration, Silver Spring, Maryland, 20993, USA
| | - Qiang Qu
- Global Product Development, Pfizer Inc., Andover, Massachusetts, 01810, USA
| | - Jane Ruppel
- BioAnalytical Sciences, Genentech, South San Francisco, California, USA
| | - Veerle Snoeck
- Translational Biomarkers and Bioanalysis, UCB Biopharma SRL, B-1420, Braine-l'Alleud, Belgium
| | - An Song
- Development Sciences, Immune-Onc Therapeutics, Palo Alto, California, 94303, USA
| | - Haoheng Yan
- Product Quality and Immunogenicity, Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drugs Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, 20903, USA
| | - Mark Ware
- Janssen BioTherapeutics, Janssen R&D LLC, Spring House, Pennsylvania, 19477, USA
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Chamberlain P, Bullimore MA. Author's reply. Ophthalmic Physiol Opt 2021; 41:1384. [PMID: 34402540 DOI: 10.1111/opo.12872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Mark A Bullimore
- College of Optometry, University of Houston, Houston, Texas, USA
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Reker D, Rybakova Y, Kirtane AR, Cao R, Yang JW, Navamajiti N, Gardner A, Zhang RM, Esfandiary T, L'Heureux J, von Erlach T, Smekalova EM, Leboeuf D, Hess K, Lopes A, Rogner J, Collins J, Tamang SM, Ishida K, Chamberlain P, Yun D, Lytton-Jean A, Soule CK, Cheah JH, Hayward AM, Langer R, Traverso G. Computationally guided high-throughput design of self-assembling drug nanoparticles. Nat Nanotechnol 2021; 16:725-733. [PMID: 33767382 PMCID: PMC8197729 DOI: 10.1038/s41565-021-00870-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 01/28/2021] [Indexed: 05/22/2023]
Abstract
Nanoformulations of therapeutic drugs are transforming our ability to effectively deliver and treat a myriad of conditions. Often, however, they are complex to produce and exhibit low drug loading, except for nanoparticles formed via co-assembly of drugs and small molecular dyes, which display drug-loading capacities of up to 95%. There is currently no understanding of which of the millions of small-molecule combinations can result in the formation of these nanoparticles. Here we report the integration of machine learning with high-throughput experimentation to enable the rapid and large-scale identification of such nanoformulations. We identified 100 self-assembling drug nanoparticles from 2.1 million pairings, each including one of 788 candidate drugs and one of 2,686 approved excipients. We further characterized two nanoparticles, sorafenib-glycyrrhizin and terbinafine-taurocholic acid both ex vivo and in vivo. We anticipate that our platform can accelerate the development of safer and more efficacious nanoformulations with high drug-loading capacities for a wide range of therapeutics.
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Affiliation(s)
- Daniel Reker
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Yulia Rybakova
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Ameya R Kirtane
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ruonan Cao
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Engineering Science, University of Toronto, Toronto, Ontario, Canada
| | - Jee Won Yang
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Robert Frederick Smith School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, NY, USA
| | - Natsuda Navamajiti
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Biomedical Engineering Program, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Apolonia Gardner
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Rosanna M Zhang
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Tina Esfandiary
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Johanna L'Heureux
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Thomas von Erlach
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Elena M Smekalova
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Kaitlyn Hess
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Aaron Lopes
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Jaimie Rogner
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Joy Collins
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Siddartha M Tamang
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Keiko Ishida
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Paul Chamberlain
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - DongSoo Yun
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Abigail Lytton-Jean
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Christian K Soule
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Jaime H Cheah
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Alison M Hayward
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert Langer
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Giovanni Traverso
- Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
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Abstract
PURPOSE Both emmetropic and myopic eyes elongate throughout childhood. The goals of this study were to compare axial elongation among untreated progressing myopes, progressing myopes treated with a myopia control contact lens and emmetropes, in order to place axial elongation in the context of normal eye growth in emmetropic children, and to consider whether normal physiological eye growth places limits on what might be achieved with myopia control. METHODS Axial elongation data were taken from the 3-year randomised clinical trial of a myopia control dual-focus (MiSight® 1 day) contact lens. These were compared with data for myopic and emmetropic children in two large cohort studies: the Orinda Longitudinal Study of Myopia (OLSM) and the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). Each study's published equations were used to calculate annual axial elongation. Four virtual cohorts-myopic and emmetropic for each model-were created, each with the same age distribution as the MiSight clinical trial subjects and the predicted cumulative elongation calculated at years 1, 2 and 3 for myopes and emmetropes using both the OLSM and SCORM models. RESULTS The untreated control myopes in the MiSight clinical trial showed mean axial elongation over 3 years (0.62 mm) similar to the virtual cohorts based on the OLSM (0.70 mm) and SCORM (0.65 mm) models. The predicted 3-year axial elongation for the virtual cohorts of emmetropes was 0.24 mm for both the OLSM and SCORM models-similar to the mean 3-year elongation in MiSight-treated myopes (0.30 mm). CONCLUSIONS The 3-year elongation in MiSight-treated myopes approached that of virtual cohorts of emmetropes with the same age distribution. It is hypothesised that myopic axial elongation is superimposed on an underlying physiological axial elongation observed in emmetropic eyes, which reflects increases in body stature. We speculate that optically based myopia control treatments may minimise the myopic axial elongation but retain the underlying physiological elongation observed in emmetropic eyes.
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Woods J, Jones D, Jones L, Jones S, Hunt C, Chamberlain P, McNally J. Ocular health of children wearing daily disposable contact lenses over a 6-year period. Cont Lens Anterior Eye 2021; 44:101391. [DOI: 10.1016/j.clae.2020.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/29/2020] [Accepted: 11/22/2020] [Indexed: 12/26/2022]
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Woods J, Jones D, Jones L, Young G, Hunt C, Chamberlain P, McNally J. 5 years of daily disposable contact lens wear in children. Cont Lens Anterior Eye 2021. [DOI: 10.1016/j.clae.2020.12.007] [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: 10/21/2022]
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Chalmers RL, McNally JJ, Chamberlain P, Keay L. Adverse event rates in the retrospective cohort study of safety of paediatric soft contact lens wear: the ReCSS study. Ophthalmic Physiol Opt 2020; 41:84-92. [PMID: 33179359 PMCID: PMC7839756 DOI: 10.1111/opo.12753] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/10/2020] [Accepted: 09/30/2020] [Indexed: 01/08/2023]
Abstract
Purpose To ascertain the safety of soft contact lens (SCL) wear in children through a retrospective chart review including real‐world clinical practice settings. Methods The study reviewed clinical charts from 963 children: 782 patients in 7 US eye care clinics and 181 subjects from 2 international randomised clinical trials (RCTs). Subjects were first fitted while 8–12 years old with various SCL designs, prescriptions and replacement schedules, and observed through to age 16. Clinical records from visits with potential adverse events (AEs) were electronically scanned and reviewed to consensus by an Adjudication Panel. Results The study encompassed 2713 years‐of‐wear and 4611 contact lens visits. The cohort was 46% male, 60% were first fitted with daily disposable SCLs, the average age at first fitting was 10.5 years old, with a mean of 2.8 ± 1.5 years‐of‐wear of follow‐up observed. There were 122 potential ocular AEs observed from 118/963 (12.2%) subjects; the annualised rate of non‐infectious inflammatory AEs was 0.66%/year (95% CI 0.39–1.05) and 0.48%/year (0.25–0.82) for contact lens papillary conjunctivitis. After adjudication, two presumed or probable microbial keratitis (MK) cases were identified, a rate of 7.4/10 000 years‐of‐wear (95% CI 1.8–29.6). Both were in teenage boys and one resulted in a small scar without loss of visual acuity. Conclusion This study estimated the MK rate and the rate of other inflammatory AEs in a cohort of SCL wearers from 8 through to 16 years of age. Both rates are comparable to established rates among adults wearing SCLs.
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Affiliation(s)
| | | | | | - Lisa Keay
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia.,The George Institute for Global Health, UNSW Sydney, Sydney, NSW, Australia
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Chamberlain P, Gilmore A, Silver K, Zatoński M, Laurence L, Alebshehy R. Changes in industry interference in policy in the United Kingdom 2017-2020. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.217] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The Tobacco Industry Interference (TII) Index evaluates the implementation of FCTC Article 5.3. The first edition of the Global TII Index was published in 2019, included 33 countries, and covered the years 2017-2018. A second edition, covering 2018-2019, is scheduled to be published in October 2020. This paper reports on findings of the Index for the UK, the changes observed between 2017 and 2020, and the resulting policy recommendations.
Methods
The UK Index was based on a questionnaire covering different forms of tobacco industry interference. Lower scores indicate better compliance with Article 5.3. In order to complete the questionnaire, an expert consultation was conducted with UK's leading tobacco control specialists. This was supplemented by a scoping review of academic literature, media websites, government websites, and the Tobacco Tactics resource.
Results
In the 2019 Index the UK has achieved the lowest score among 33 countries surveyed. Strengths of the UK system included the exclusion of TI from government bodies that set public health policy and from FCTC COP delegations; the obligation of the government to publish information on all meetings with TI; and guidelines stipulating that its diplomats must not engage on behalf of TI. Nevertheless, weaknesses were also identified; including only partial implementation of the above obligations, the absence of an effective lobbying register, and the ongoing involvement of parliamentary consultative bodies, individual politicians and political parties with TI and affiliated organisations.
Discussion
The change of government in the UK in 2019, the shifting policy framework resulting from Brexit, and the increasing use by the tobacco industry of third parties to access policymakers, bring new challenges to the maintenance of robust Article 5.3 compliance. The presentation will analyse how this has affected the change in the UK's performance between the 2019 and the 2020 Tobacco Industry Interference Index.
Key messages
The need to strengthen transparency regulations for policymakers. A need for continued monitoring against an agreed framework in the light of very fluid political developments.
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Affiliation(s)
- P Chamberlain
- Tobacco Control Research Group, Department of Health, University of Bath, Bath, UK
| | - A Gilmore
- Tobacco Control Research Group, Department of Health, University of Bath, Bath, UK
| | - K Silver
- Tobacco Control Research Group, Department of Health, University of Bath, Bath, UK
| | - M Zatoński
- Tobacco Control Research Group, Department of Health, University of Bath, Bath, UK
| | - L Laurence
- Tobacco Control Research Group, Department of Health, University of Bath, Bath, UK
| | - R Alebshehy
- Tobacco Control Research Group, Department of Health, University of Bath, Bath, UK
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Chamberlain P, Rup B. Immunogenicity Risk Assessment for an Engineered Human Cytokine Analogue Expressed in Different Cell Substrates. AAPS J 2020; 22:65. [PMID: 32291556 DOI: 10.1208/s12248-020-00443-2] [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] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/02/2020] [Indexed: 11/30/2022]
Abstract
The purpose of this article is to illustrate how performance of an immunogenicity risk assessment at the earliest stage of product development can be instructive for critical early decision-making such as choice of host system for expression of a recombinant therapeutic protein and determining the extent of analytical characterization and control of heterogeneity in co- and post-translational modifications. Application of a risk-based approach for a hypothetical recombinant DNA analogue of a human endogenous cytokine with immunomodulatory functions is described. The manner in which both intrinsic and extrinsic factors could interact to influence the relative scale of risk associated with expression in alternative hosts, namely Chinese hamster ovary (CHO) cells, Pichia pastoris, Escherichia coli, or Nicotinia tabacum is considered in relation to the development of the investigational product to treat an autoimmune condition. The article discusses how particular product-related variants (primary amino acid sequence modifications and post-translational glycosylation or other modifications) and process-derived impurities (host cell proteins, endotoxins, beta-glucans) associated with the different expression systems might influence the impact of immunogenicity on overall clinical benefit versus risk for a therapeutic protein candidate that has intrinsic MHC Class II binding potential. The implications of the choice of expression system for relative risk are discussed in relation to specific actions for evaluation and measures for risk mitigation, including use of in silico and in vitro methods to understand intrinsic immunogenic potential relative to incremental risk associated with non-human glycan and protein impurities. Finally, practical guidance on presentation of this information in regulatory submissions to support clinical development is provided.
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Affiliation(s)
- Paul Chamberlain
- NDA Advisory Board, NDA Regulatory Science Ltd, Grove House, Guildford Road, Leatherhead, Surrey, KT22 9DF, UK.
| | - Bonita Rup
- Bonnie Rup Consulting, LLC, Reading, Massachusetts, USA
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20
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Wessels H, Lehnick D, Höfler J, Jankowsky R, Chamberlain P, Roth K. Pharmacodynamics, safety, and immunogenicity of Pelmeg ®, a pegfilgrastim biosimilar in healthy subjects. Pharmacol Res Perspect 2019; 7:e00507. [PMID: 31417681 PMCID: PMC6691755 DOI: 10.1002/prp2.507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/26/2019] [Accepted: 06/28/2019] [Indexed: 11/11/2022] Open
Abstract
A pharmacodynamics (PD) and immunogenicity study was conducted to investigate biosimilarity of Pelmeg®, a pegfilgrastim biosimilar to EU-authorized Neulasta®. The multiple-dose, randomized, double-blind, two-sequence, and three-period cross-over study comprised 96 healthy male subjects, receiving Pelmeg (Test [T]) and Neulasta (Reference [R]) in a sequential manner (T-T-R vs R-R-T). Subjects were dosed with 3 mg pegfilgrastim, as this dose was previously shown to be in the ascending part of the dose-response curve for PD. The primary PD endpoint was the area under the effect curve (AUEC0-last) for absolute neutrophil count (ANC). The primary immunogenicity endpoint was proportion of anti-drug antibody (ADA)-positive subjects at the end of Period 2 (ie, after administration of two doses of the same study drug). Comparability was demonstrated for the PD endpoint, with the geometric mean ratio (T/R) of AUEC0-last being 101.59%, with a corresponding 95% CI of [99.58; 103.63]. Of note, when using tighter acceptance limits (90.00%-111.00%), comparability between test and reference was shown as well. Only two confirmed ADA positive samples were detected, one after treatment with Pelmeg and one after Neulasta. These had a low ADA titer, no filgrastim reactivity, and no neutralizing capacity. No clinically meaningful differences in safety between Pelmeg and Neulasta were observed. Overall, the results from this study confirmed the biosimilarity of Pelmeg and Neulasta for PD and immunogenicity, as shown already at the bioanalytical level and in the pivotal PK/PD study with Pelmeg.
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Affiliation(s)
- Hendrik Wessels
- Cinfa Biotech GmbH (now part of the Mundipharma network of independent associated companies)MunichGermany
| | | | | | - Ruediger Jankowsky
- Cinfa Biotech GmbH (now part of the Mundipharma network of independent associated companies)MunichGermany
| | | | - Karsten Roth
- Cinfa Biotech GmbH (now part of the Mundipharma network of independent associated companies)MunichGermany
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21
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Kurnick SA, Mannion AJ, Feng Y, Madden CM, Chamberlain P, Fox JG. Genotoxic Escherichia coli Strains Encoding Colibactin, Cytolethal Distending Toxin, and Cytotoxic Necrotizing Factor in Laboratory Rats. Comp Med 2019; 69:103-113. [PMID: 30902120 PMCID: PMC6464076 DOI: 10.30802/aalas-cm-18-000099] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 08/31/2018] [Revised: 10/13/2018] [Accepted: 11/29/2018] [Indexed: 02/06/2023]
Abstract
Although many Escherichia coli strains are considered commensals in mammals, strains encoding the cyclomodulin genotoxins are associated with clinical and subclinical disease in the urogenital and gastrointestinal tracts, meningitis, and inflammatory disorders. These genotoxins include the polyketide synthase (pks) pathogenicity island, cytolethal distending toxin (cdt), and hemolysin-associated cytotoxic necrotizing factor (cnf). E. coli strains are not excluded from rodents housed under SPF conditions in academic or vendor facilities. This study isolated and characterized genotoxin-encoding E. coli from laboratory rats obtained from 4 academic institutions and 3 vendors. A total of 69 distinct E. coli isolates were cultured from feces, rectal swab, nares, or vaginal swab of 52 rats and characterized biochemically. PCR analysis for cyclomodulin genes and phylogroup was performed on all 69 isolates. Of the 69 isolates, 45 (65%) were positive for pks, 20/69 (29%) were positive for cdt, and 4 (6%) were positive for cnf. Colibactin was the sole genotoxin identified in 21 of 45 pks+ isolates (47%), whereas cdt or cnf was also present in the remaining 24 isolates (53%); cdt and cnf were never present together or without pks. All genotoxin-associated strains were members of pathogen-associated phylogroup B2. Fisher exact and χ² tests demonstrated significant differences in genotoxin prevalence and API code distribution with regard to vendor. Select E. coli isolates were characterized by HeLa cell in vitro cytotoxicity assays, serotyped, and whole-genome sequenced. All isolates encoding cyclomodulins induced megalocytosis. Serotypes corresponded with vendor origin and cyclomodulin composition, with the cnf+ serotype representing a known human uropathogen. Whole-genome sequencing confirmed the presence of complete pks, cdt, and hemolysin-cnf pathogenicity islands. These findings indicate that genotoxin-encoding E. coli colonize laboratory rats from multiple commercial vendors and academic institutions and suggest the potential to contribute to clinical disease and introduce confounding variables into experimental rat models.
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Affiliation(s)
- Susanna A Kurnick
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Anthony J Mannion
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Yan Feng
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Carolyn M Madden
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Paul Chamberlain
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - James G Fox
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts;,
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22
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Campagna G, Chamberlain P, Orengo-Nania S, Biggerstaff K, Khandelwal S. Ophthalmic Conditions Associated with Inpatient Falls among Veterans. Optom Vis Sci 2018; 95:1114-1119. [DOI: 10.1097/opx.0000000000001312] [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: 11/25/2022] Open
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23
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Wilson S, Chamberlain P, Dodd I, Esmail A, Robinson JH. Interaction of a Plasmin A-Chain/t-PA B-Chain Hybrid Enzyme with Plasma Inhibitors In Vivo and In Vitro. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1645066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryA hybrid plasminogen activator consisting of the “A” chain of plasmin linked to the “B” chain of rt-PA was inhibited in vitro in human and guinea pig plasmas 4 to 5-fold more rapidly than its parent activator, two-chain t-PA. Using zymographic and autoradiographic techniques together with the use of immunodepleted plasma the major inhibitor was identified as aIpha-2-antiplasmin. The pharmacokinetic profile of the hybrid in guinea pigs was determined by two different methods: disappearance of fibrinolytic activity and removal of radiolabelled hybrid from the circulation. Fibrinolytic activity was cleared rapidly via inhibitory mechanisms, whilst radiolabelled material was cleared considerably more slowly due to the formation of hybrid-inhibitor complexes. When the active site of the hybrid was reversibly acylated inhibitory mechanisms were evaded and a prolonged pharmacokinetic profile of activity was observed.
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Affiliation(s)
- S Wilson
- The Department of Biotechnology, SmithKline Beecham, Great Burgh, Epsom, Surrey, UK
| | - P Chamberlain
- The Department of Biotechnology, SmithKline Beecham, Great Burgh, Epsom, Surrey, UK
| | - I Dodd
- The Department of Biotechnology, SmithKline Beecham, Great Burgh, Epsom, Surrey, UK
| | - A Esmail
- The Department of Biotechnology, SmithKline Beecham, Great Burgh, Epsom, Surrey, UK
| | - J H Robinson
- The Department of Biotechnology, SmithKline Beecham, Great Burgh, Epsom, Surrey, UK
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Lewis CM, Ajmani GS, Kyrillos A, Chamberlain P, Wang CH, Nocon CC, Peek M, Bhayani MK. Racial disparities in the choice of definitive treatment for squamous cell carcinoma of the oral cavity. Head Neck 2018; 40:2372-2382. [PMID: 29947066 DOI: 10.1002/hed.25341] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 06/20/2017] [Revised: 01/22/2018] [Accepted: 05/07/2018] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Definitive surgery is recommended for oral cavity squamous cell carcinoma (SCC). The purpose of this study was to present our assessment of the disparities in treatment selection for oral cavity SCC. METHODS Non-Hispanic white and non-Hispanic black patients with oral cavity SCC were identified in the National Cancer Database (NCDB). Regression models were used to estimate relative risk (RR) of receiving surgery and absolute difference between non-Hispanic white and non-Hispanic black patients. RESULTS There were 82.3% of non-Hispanic white patients who received surgery, compared to 64.2% of non-Hispanic black patients (P < .001). The non-Hispanic black patients were less likely to receive surgery than non-Hispanic white patients (RR 0.87) with an absolute difference of 10.9%. The non-Hispanic black patients were significantly more likely to not be offered surgery (RR 1.42) and to refuse recommended surgery (RR 1.38) but not have a contraindication to surgery (RR 1.17). CONCLUSION The non-Hispanic black patients are less likely to receive or be recommended surgery for oral cavity SCC and are more likely to refuse surgery. Further study is needed to identify strategies to close this disparity.
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Affiliation(s)
- Carol M Lewis
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gaurav S Ajmani
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Alexandra Kyrillos
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois
| | | | - Chi-Hsiung Wang
- Center for Biomedical Research Informatics, NorthShore University HealthSystem, Evanston, Illinois
| | - Cheryl C Nocon
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Monica Peek
- Secton of General Internal Medicine, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Mihir K Bhayani
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
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Chamberlain P, Back A, Lazon P, Jones D, Jones S, Ngo C, Peixoto-de-Matos S, Young G. Adaptation of children to daily disposable soft contact lenses. Cont Lens Anterior Eye 2018. [DOI: 10.1016/j.clae.2018.03.018] [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: 10/28/2022]
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Chamberlain P, Back A, Lazon P, Jones D, Logan N, González-Méijome J, Saw SM, Young G. 3 year effectiveness of a dual-focus 1 day soft contact lens for myopia control. Cont Lens Anterior Eye 2018. [DOI: 10.1016/j.clae.2018.03.097] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Salmikangas P, Kinsella N, Chamberlain P. Chimeric Antigen Receptor T-Cells (CAR T-Cells) for Cancer Immunotherapy - Moving Target for Industry? Pharm Res 2018; 35:152. [PMID: 29855723 PMCID: PMC5982434 DOI: 10.1007/s11095-018-2436-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/23/2018] [Indexed: 12/19/2022]
Abstract
The first CD19 CAR T-cell products, Kymriah and Yescarta, are entering the US market and also being evaluated for marketing authorization in the EU. This breakthrough has expanded the interest and also investments towards novel chimeric antigen receptor (CAR) designs, both for hematological malignancies and solid tumors. At the same time, there is active development in moving from autologous products to allogeneic, off-the-shelf -products. New manufacturing technologies are also emerging for production of these complex genetically-modified cells and even decentralized manufacturing in hospitals is under consideration. However, the high potency of CAR T-cells is associated with toxicity and not all patients respond to the treatment. In addition, the number of patient and product variables impacting the clinical outcome is high. The race towards novel CAR T treatment options for cancer patients has begun, but without careful design of the constructs and overall understanding of the factors that impact the ultimate outcome in each case, the road towards commercial success may be long and winding. This review discusses the product- and patient-related variables that may pose challenges for the industry and developers both from the scientific and regulatory perspective.
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Chandrasekar T, Sharma A, Tennent L, Wong C, Chamberlain P, Abraham KA. A whole system approach to improving mortality associated with acute kidney injury. QJM 2017; 110:657-666. [PMID: 28521019 DOI: 10.1093/qjmed/hcx101] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is in the main managed by non-nephrologists, many who feel challenged by or lack awareness of the complexity that the renal element adds to their patients' care. National reports have raised major concerns about the quality of care and have predicted that mortality reductions of 30% are achievable with good medical practice. AIM This quality improvement project evaluated whether a whole system approach could improve outcomes for patients with AKI. DESIGN AND METHODS Quality improvement methodology was used to understand hospital patterns, processes and professional knowledge. Change concepts were developed which included management of patients at risk, staff education and awareness program, development of a patient specific electronic alert to prompt diagnosis, easy to remember care bundle (ABCDE-IT), dedicated outreach team and patient and family empowerment leaflet. RESULTS Statistical process control analysis was used to verify outcomes over time. A shift in the in-hospital mortality rate corresponded to a relative 23.2% reduction in mortality and was sustained over the next 33 months (P < 0.0001). The favourable shift in mortality was temporally distinct from the improved AKI detection rate. This timeframe corresponded to lying below the 99.8% lower confidence limit in comparison with all English acute trusts for comparative AKI specific SHMI/HSMR mortality rates. Length of stay also reduced shortly after onset of the project by 14.1% or 2.6 day reduction (P < 0.0001). CONCLUSION This project demonstrated that an integrated, whole-system approach is necessary to ensure sustained improvements in AKI mortality and length of stay.
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Affiliation(s)
- T Chandrasekar
- Nephrology Directorate, Aintree University Hospital, Liverpool L9 7AL, UK
| | - A Sharma
- Nephrology Directorate, Royal Liverpool University Hospital, Liverpool L7 8XP, UK
| | - L Tennent
- Administrative Services, Liverpool Heart and Chest Hospital, Liverpool L14 3PE, UK
| | - C Wong
- Nephrology Directorate, Aintree University Hospital, Liverpool L9 7AL, UK
| | - P Chamberlain
- Innovation and Strategy, South Sefton CCG, Liverpool L20 3DL, UK
| | - K A Abraham
- Nephrology Directorate, Aintree University Hospital, Liverpool L9 7AL, UK
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Chamberlain P. Multidisciplinary approach to evaluating immunogenicity of biosimilars: lessons learnt and open questions based on 10 years' experience of the European Union regulatory pathway. ACTA ACUST UNITED AC 2014. [DOI: 10.2147/bs.s50012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kollbaum P, McGiffen R, Rickert M, Tarrant J, Chamberlain P. Binocular summation of presbyopic contact lens corrections. Cont Lens Anterior Eye 2013. [DOI: 10.1016/j.clae.2013.08.111] [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: 11/24/2022]
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Ferguson DJP, Bowker C, Jeffery KJM, Chamberlain P, Squier W. Congenital toxoplasmosis: continued parasite proliferation in the fetal brain despite maternal immunological control in other tissues. Clin Infect Dis 2012; 56:204-8. [PMID: 23074307 DOI: 10.1093/cid/cis882] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Congenital toxoplasmosis is a serious condition but little is known of the natural history of parasite development and associated fetal tissue destruction. METHODS Two cases identified by ultrasound underwent induced abortion at 21 and 30 weeks' gestation. At autopsy, the placenta and fetal organs were examined by histology and immunocytochemistry employing anti-Toxoplasma stage-specific antibodies to confirm diagnosis and also provide information on the stage of parasite development. RESULTS In both cases, maternal serology prior to termination showed both specific immunoglobulin M (IgM) and immunoglobulin G (IgG), whereas retrospective analysis of an earlier sample (12-14 weeks' gestation) showed only IgM reactivity consistent with infection occurring in the first trimester. The finding of a number of tissue cysts but few or no tachyzoites within the placenta and fetal adrenal and heart is characteristic of a chronic infection. However, in contrast, there were still areas of the fetal brain with large numbers of actively dividing, tissue-destructive tachyzoites. CONCLUSIONS These observations show that continued parasite proliferation and tissue destruction can occur within the fetal brain even when there is a marked maternal immune response including maternal IgG. This finding strongly suggests that there may be benefits from treating cases of recently acquired congenital infection to destroy any remaining proliferating parasites located in immunologically protected sites such as the fetal brain.
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Affiliation(s)
- David J P Ferguson
- Nuffield Department of Clinical Laboratory Science, Oxford University Hospital, UK.
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Kennedy S, Altman D, Purwar M, Noble J, Chamberlain P, Knight H, Ruyan P, Ismail LC, Barros F, Lambert A, Papageorghiou A, Carvalho M, Jaffer Y, Bertino E, Gravett M, Bhutta Z, Villar J. I179 THE INTERGROWTH-21ST PROJECT: DESIGN, STANDARDISATION AND QUALITY CONTROL STRATEGIES. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60209-4] [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: 10/27/2022]
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Boyd PA, Rounding C, Chamberlain P, Wellesley D, Kurinczuk JJ. The evolution of prenatal screening and diagnosis and its impact on an unselected population over an 18-year period. BJOG 2012; 119:1131-40. [PMID: 22676508 DOI: 10.1111/j.1471-0528.2012.03373.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To review changes in and impact of prenatal screening and diagnosis. DESIGN Population-based congenital anomaly register study. SETTING Oxfordshire. POPULATION Congenital anomalies confirmed and those suspected prenatally, delivered 1991-2008. METHODS Analysis of proportions of congenital anomalies confirmed and those suspected prenatally. MAIN OUTCOME MEASURES Birth prevalence, prenatal detection rates, pregnancy outcomes. RESULTS A total of 2651 (2.3%) infants/fetuses had a congenital anomaly diagnosed. There were 3839 suspected or confirmed cases, 2847 due to a prenatal suspicion, of which 1659 had an anomaly confirmed at delivery, and 1188 false-positive diagnoses, 91% due to reporting ultrasound normal variants. The percentage of prenatal notifications rose from 48% in 1991-93 to 83-88% from 1996 to 2003 and dropped to 61% in 2006-08, partly reflecting changes in the reporting of normal variants. Reporting these increased the prenatal diagnosis rate from 53 to 63% with an increase in false-positive rate from 0.09 to 1.04%. A total of 722 (44% of prenatally detected affected fetuses) resulted in termination; 48% of these had chromosome anomalies, 34% had isolated structural anomalies, 7% had multiple anomalies, 10% had familial disorders; 42% had lethal anomalies and 58% would probably have survived the neonatal period giving an estimated 20% reduction in birth prevalence of congenital anomalies compatible with survival because of terminations. CONCLUSION There has been an improvement in prenatal detection of congenital anomalies over the two decades studied. The recognition that reporting normal variants, although increasing prenatal detection rates, leads to an increase in false-positive diagnoses has had an impact on practice that has redressed the balance between these two effects.
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Affiliation(s)
- P A Boyd
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
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Sarris I, Ioannou C, Chamberlain P, Ohuma E, Roseman F, Hoch L, Altman DG, Papageorghiou AT. Intra- and interobserver variability in fetal ultrasound measurements. Ultrasound Obstet Gynecol 2012; 39:266-273. [PMID: 22535628 DOI: 10.1002/uog.10082] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To assess intra- and interobserver variability of fetal biometry measurements throughout pregnancy. METHODS A total of 175 scans (of 140 fetuses) were prospectively performed at 14-41 weeks of gestation ensuring an even distribution throughout gestation. From among three experienced sonographers, a pair of observers independently acquired a duplicate set of seven standard measurements for each fetus. Differences between and within observers were expressed in measurement units (mm), as a percentage of fetal dimensions and as gestational age-specific Z-scores. For all comparisons, Bland-Altman plots were used to quantify limits of agreement. RESULTS When using measurement units (mm) to express differences, both intra- and interobserver variability increased with gestational age. However, when measurement of variability took into account the increasing fetal size and was expressed as a percentage or Z-score, it remained constant throughout gestation. When expressed as a percentage or Z-score, the 95% limits of agreement for intraobserver difference for head circumference (HC) were ± 3.0% or 0.67; they were ± 5.3% or 0.90 and ± 6.6% or 0.94 for abdominal circumference (AC) and femur length (FL), respectively. The corresponding values for interobserver differences were ± 4.9% or 0.99 for HC, ± 8.8% or 1.35 for AC and ± 11.1% or 1.43 for FL. CONCLUSIONS Although intra- and interobserver variability increases with advancing gestation when expressed in millimeters, both are constant as a percentage of the fetal dimensions or when reported as a Z-score. Thus, measurement variability should be considered when interpreting fetal growth rates.
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Affiliation(s)
- I Sarris
- Oxford Maternal and Perinatal Health Institute, Green Templeton College and Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Oxford, UK
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Chamberlain P, Bahmanyar S, Pagarigan B, Patel P, Muir J, Abbasian M, Mahmoudi A, Zhu D, Riggs JR. Potent triazolopyridine and pyrazolopyrimidine inhibitors of PLK1 and the structural basis for divergent SAR between the series. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311079323] [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: 11/10/2022] Open
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Abstract
Although mAbs present a different set of challenges from other product classes, and the pre-clinical safety evaluation may need to be more extensive than for other medicinal products to overcome the limited predictive value of conventional pre-clinical test systems, the level of risk associated with first administration to human subjects can be effectively mitigated. This article seeks to provide a systematic approach to identifying and addressing the pertinent risks relative to the characteristics of the particular mAb product before the first administration to human subjects.
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Lawton R, Gardner P, Green B, Davey C, Chamberlain P, Phillips P, Hughes G. An engineered solution to the maladministration of spinal injections. Qual Saf Health Care 2011; 18:492-5. [PMID: 19955463 DOI: 10.1136/qshc.2007.025767] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND An overview is provided of the progress made in a Department of Health (DH) initiative to implement an engineered solution to the maladministration of spinal injections. In an effort to eliminate the possibility of misconnection errors at the spinal route, the DH is investigating the potential for dedicated spinal equipment that will be incompatible with standard Luer syringes, needles and associated devices. METHOD Background information on the problem of misconnection errors is provided and a systematic approach to their eradication is detailed. Research to date has entailed extensive bench-testing of prototype non-Luer connectors, a prospective hazard analysis of spinal procedures in haematology and anaesthesia and usability evaluation of prototype non-Luer devices in simulated environments. RESULTS The prospective hazard analysis identified two potential risks which will need to be managed as part of a successful implementation programme. CONCLUSION Usability testing of two prototype connection systems concluded that one design was inadequate, as the non-Luer element was provided as a separable adapter. The second connection system was modified following the first round of testing, and achieved improved satisfaction ratings from clinicians in round two. This system was selected to proceed to a pre-implementation evaluation and the research team are currently evaluating its acceptability in clinical use.
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Affiliation(s)
- R Lawton
- Institute of Psychological Sciences, University of Leeds, Leeds LS2 9JT UK.
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Gooding MJ, Rajpoot K, Mitchell S, Chamberlain P, Kennedy SH, Noble JA. Investigation into the fusion of multiple 4-D fetal echocardiography images to improve image quality. Ultrasound Med Biol 2010; 36:957-966. [PMID: 20447758 DOI: 10.1016/j.ultrasmedbio.2010.03.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 03/15/2010] [Accepted: 03/24/2010] [Indexed: 05/29/2023]
Abstract
Recent advances in four-dimensional (4-D) ultrasound enable the acquisition and visualisation of the entire fetal heart. However, getting consistent, shadow free, data remains problematic due to the uncontrollable nature of fetal orientation. This article presents the first investigation into the utility of image fusion to improve the quality of volumetric fetal cardiac imaging. Multiple volume scans are registered using a semiautomatic approach and five fusion methods are assessed for their ability to remove artefacts and improve image quality. Image quality is assessed in terms of signal-to-noise ratio, contrast and contrast-to-noise ratio. Qualitative results are presented for the ability to remove artefacts. The fusion methods assessed were found to be divided into those that reduce noise and those that increase contrast. The effect of fusion on left ventricle segmentation using commercial state-of-the-art software is also considered. The use of image fusion is shown to reduce the variability of volume estimates by about 50% relative to measurement on a single scan.
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Affiliation(s)
- Mark J Gooding
- Nuffield Department of Obstetrics and Gyneacology, University of Oxford, John Radcliffe Hospital, Oxford, UK.
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Chamberlain P. Independence of nutritional information? West J Med 2010. [DOI: 10.1136/bmj.c1438] [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: 11/04/2022]
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Zaki M, Boyd PA, Impey L, Roberts A, Chamberlain P. Congenital myotonic dystrophy: prenatal ultrasound findings and pregnancy outcome. Ultrasound Obstet Gynecol 2007; 29:284-8. [PMID: 17238150 DOI: 10.1002/uog.3859] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE The objective of this study was to assess the maternal and prenatal ultrasound findings and outcome in pregnancies complicated by congenital myotonic dystrophy Type 1 (DM1). METHODS A retrospective chart review of all patients with a diagnosis of DM1 and pregnancy presenting to the Oxford Radcliffe Hospital between 1990 and 2004 was undertaken. Obstetric case notes were reviewed and details of all pregnancies obtained. This included data on prenatal diagnostic tests and obstetric ultrasound scans performed as well as pregnancy complications and pregnancy outcome. Maternal and fetal CTG expansion size was also recorded where available. Maternal genetic case notes were reviewed for details of maternal grip myotonia. RESULTS Sixty pregnancies among 26 couples in which one of the parents was a carrier of DM1 were identified during the study period. These resulted in 36 (60%) pregnancies affected by congenital DM1 and 19 (31.7%) unaffected pregnancies. There were four miscarriages and one termination of pregnancy for non-medical reasons. Nineteen of the 36 affected pregnancies ended in termination following the antenatal diagnosis of congenital DM1 by either chorionic villus sampling (CVS) or amniocentesis. In the remaining 17 affected pregnancies (16 singleton and one twin) there was one miscarriage of an affected fetus with co-existing Down syndrome and eight perinatal deaths. The principal cause of perinatal death was respiratory failure in the early neonatal period. Antenatally noted clinical/sonographic abnormalities in these pregnancies included polyhydramnios (100%), talipes (26.6%) and borderline ventriculomegaly (13.3%). Uni- or bilateral talipes was noted at delivery in 10 of 16 (62.5%) neonates. Maternal grip myotonia was present in all but one of these cases. CONCLUSION The antenatal findings of polyhydramnios and talipes should prompt a search for maternal grip myotonia. If present, definitive testing for congenital DM1 should be considered.
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Affiliation(s)
- M Zaki
- Prenatal Diagnosis Unit, Women's Centre, Oxford Radcliffe Hospital, Headington, Oxford, UK
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Affiliation(s)
- Paul Chamberlain
- Biopharmaceutical Consulting, Development & Regulatory Services, MDS Pharma Services, Sevres, France
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Gomord V, Chamberlain P, Jefferis R, Faye L. Biopharmaceutical production in plants: problems, solutions and opportunities. Trends Biotechnol 2005; 23:559-65. [PMID: 16168504 DOI: 10.1016/j.tibtech.2005.09.003] [Citation(s) in RCA: 139] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2005] [Revised: 05/24/2005] [Accepted: 09/08/2005] [Indexed: 11/24/2022]
Abstract
There are major structural differences between plant and mammalian N-linked glycans, with those from plants being immunogenic in most laboratory mammals and eliciting glycan-specific IgE and IgG antibodies in humans, when delivered parenterally. However, because humans are constantly exposed to plant glycoproteins in the diet, glycosylated plant-made pharmaceuticals (PMPs) should be acceptable for topical and oral administration. To exploit fully the potential that plants offer for the production of therapeutic proteins for parenteral administration, it might be necessary to inhibit plant-specific post-translational modifications to obtain "humanized" non-immunogenic N-glycans on PMPs. The benefits that could accrue are lower manufacturing costs, relative to mammalian cell culture, and a reduced risk of transmission of mammalian pathogens.
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Affiliation(s)
- Véronique Gomord
- CNRS UMR6037, University of Rouen, IFRMP23, GDR2590, UFR des Sciences, 76 821 Mont Saint Aignan, France
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Jones C, Chamberlain P, McVeigh E. Personalized Embryo Transfer Policies in IVF: A Population-Based Analysis. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.207] [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: 11/30/2022]
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Stammers D, Stamp A, Chamberlain P, Ren J. HIV reverse transcriptases: structural basis for inhibition and drug resistance. Acta Crystallogr A 2005. [DOI: 10.1107/s0108767305097886] [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: 11/10/2022] Open
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Affiliation(s)
- Paul Chamberlain
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK.
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Patel Y, Boyd PA, Chamberlain P, Lakhoo K. Follow-up of children with isolated fetal echogenic bowel with particular reference to bowel-related symptoms. Prenat Diagn 2003; 24:35-7. [PMID: 14755407 DOI: 10.1002/pd.787] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [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: 12/19/2022]
Abstract
OBJECTIVES To determine whether there was any evidence of long-term bowel pathology in children, apparently healthy at birth, who had a prenatal second-trimester diagnosis of isolated grade 2 fetal echogenic bowel. METHODS This was a retrospective study using data from the Oxford Congenital Anomaly Register. Fetuses with isolated grade 2 fetal echogenic bowel and date of delivery from 1994 to 2000 inclusive were identified. Information about the health of the children, particularly relating to bowel symptoms, was obtained from hospital records and from a questionnaire sent to the general practitioner. RESULTS A total of 109 cases were identified, with delivery details available for 108. There was one unexplained intrauterine death, and additional problems were subsequently diagnosed in four cases (cystic fibrosis (2), Down syndrome (1), and VACTERL (1)). Questionnaires were sent to the GPs of the 103 who had no problems identified at the time of discharge from the maternity hospital. Age at follow-up ranged from one to four years. Responses to the questionnaires were received from 83 (81%). Of these, 74 (89%) had not reported bowel symptoms to the GP, 9 (11%) reported symptoms relating to constipation (6), chronic abdominal pain (1), infantile colic with milk intolerance (1) and gastro-oesophageal reflux (1). CONCLUSION This small study provides some reassurance that there was no evidence of any serious long-term bowel pathology associated with isolated fetal echogenic bowel.
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Affiliation(s)
- Y Patel
- Department of Paediatric Surgery, The John Radcliffe Hospital, Oxford, UK
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