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Ronk M, Liu J, Gallegos A, Luo Y, Fujimori K, Li K, Lee H, Nashed-Samuel Y. Holistic Extractables and Leachables Program: Evaluations of Prefilled Syringe Systems for Biotechnology Products. PDA J Pharm Sci Technol 2020; 74:627-643. [PMID: 32675308 DOI: 10.5731/pdajpst.2019.011379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Prefilled syringes (PFS) are a container and delivery device of choice for storing and administering therapeutic protein products to patients. Addressing concerns and regulatory expectations related to the risk to biologic drug product quality and patient safety from PFS requires implementation of an extractable and leachable program based on understanding of materials, risk assessment, review of existing literature, and testing supported by a sound scientific foundation. Extractables and leachables data generated as part of a thorough and holistic program are presented for five PFS systems, including glass and plastic syringes filled with 12 biologic drug products encompassing the implementation of traditional and single-use biotechnology manufacturing processes. The comprehensive extractables and leachables data presented demonstrate and substantiate a holistic extractable and leachable program designed to ensure product quality and patient safety.
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Affiliation(s)
- Michael Ronk
- Attribute Sciences, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320;
| | - Jian Liu
- Attribute Sciences, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320
| | - Alejandra Gallegos
- Attribute Sciences, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320
| | - Yanxin Luo
- Attribute Sciences, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320
| | - Kiyoshi Fujimori
- Attribute Sciences, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320
| | - Kim Li
- Environment, Health, Safety and Sustainability, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320; and
| | - Hans Lee
- Los Angeles Trade-Technical College, 400 West Washington Blvd, Los Angeles, CA 90015
| | - Yasser Nashed-Samuel
- Attribute Sciences, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320;
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Katsurada M, Nagano T, Nakajima T, Yasuda Y, Miwa N, Sekiya R, Kobayashi K, Hojo D, Nishimura Y. Retrospective analysis of the effect of inhaler education on improvements in inhaler usage. Respir Investig 2021; 59:312-9. [PMID: 33899742 DOI: 10.1016/j.resinv.2020.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/29/2020] [Accepted: 09/07/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Various types of inhalation devices have been released, and it is necessary to acquire the skills for using each of them. The factors that have been previously associated with poor inhalator usage include gender, duration of disease, age, and the type of device. However, it is unclear whether these factors also apply to the Japanese population. The number of education sessions needed to acquire inhaler usage skills is also not established. PATIENTS AND METHODS We performed a retrospective review of the medical records of selected patients and their subjective assessments of their inhaler usage skills between January 2016 and March 2018. The primary outcome was the effect of inhaler education for each inhaler device. The secondary outcomes were the factors affecting the effectiveness of inhaler education, the effects of inhalation education stratified by age, and the number of inhaler education sessions needed to improve inhaler usage skills. RESULTS Data from 399 patients were analyzed. Age and the type of delivery device affected the mastery of inhaler usage skills. Approximately half of the patients had acquired inhaler usage skills during baseline evaluation. Approximately 90% of patients acquired inhalation usage skills after two education sessions, regardless of the type of inhalation device. Among the older patients, 35.0% had acquired inhaler usage skills during the baseline evaluation, and 86.8% acquired them after two education sessions. CONCLUSIONS Inhaler usage skills significantly improved, regardless of the device, after inhalation education, and this was also observed in elderly patients after two education sessions.
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Abstract
Although insulin delivery devices are widely used by the patients, there is a paucity of published guidelines to help professionals manage their patients in insulin therapies. To provide simple and easily implementable guidelines to health care physicians on the choice of insulin delivery devices in routine clinical practice, experts in diabetes gathered together and discussed the recommendations at the National insulin Summit 2018. An ideal insulin delivery device should accurately deliver the prescribed dose of insulin and be easy to use. Recommendations are: (1) insulin should be initiated by using an insulin device if the patient seems to discontinue insulin therapy. (2) Pen devices offer accurate dosing than a syringe and vial and are associated with cost savings in the long term. (3) Switching over from syringes and vial to disposable pen devices improves adherence. (4) FlexPen® offers better accuracy, and it requires lower dose force and injection force than SoloStar® and KwikPen® (5). Durable delivery pens such as NovoPen® 4 maintain accuracy and low dose force compared with vials and syringes. (6) One pen should be used by only one patient. (7) Regular counseling on the proper use of the pen device is required regularly. This consensus-based recommendation is a useful reference tool for health care practitioners to initiate insulin therapy in patients with diabetes by using the appropriate insulin pen device.
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Affiliation(s)
- Arvind Gupta
- Director and Consultant Physician at Jaipur Diabetes Research Centre, Jaipur, Rajasthan
| | - Sanjeev Phatak
- Founder, Consultant Diabetologist, Vijayratna Diabetes Diagnostic Treatment Centre, Ahmedabad, India
| | - Y Sadashiv Rao
- Consultant Physician and Managing Director, Yalamanchi Hospital and Research Centre Private Limited, Vijayawada
| | - Jayanthy Ramesh
- Department of Endocrinology, Andhra Medical College, Visakhapatnam, India
| | - Debmalya Sanyal
- Consultant Endocrinologist, Department of Endocrinology, G.D. Diabetic Institute, R.N. Tagore Hospital, Kolkata, India
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Kobayashi T, Oshima Y, Tsubokura Y, Hashizume N, Ajimi S, Kayashima T, Nakai M, Sasaki T, Kawaguchi K, Imatanaka N. Effects of dose volume and delivery device on bronchoalveolar lavage parameters of intratracheally administered nano-sized TiO 2 in rats. Regul Toxicol Pharmacol 2016; 81:233-241. [PMID: 27586790 DOI: 10.1016/j.yrtph.2016.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 08/26/2016] [Accepted: 08/28/2016] [Indexed: 12/11/2022]
Abstract
The intratracheal (IT) test is useful for screening the pulmonary toxicity of inhaled materials, including nanomaterials. However, a standard procedure has not yet been authorized internationally, and the effects of different test parameters are unknown. To determine appropriate experimental conditions for the IT test, we intratracheally administered nano-sized TiO2 to male F344 rats at 3.0 mg/kg body weight by using two delivery devices (gavage needle or microaerosolizer) and dose volumes of 0.5-3.0 mL/kg (gavage needle) or 0.5-2.0 mL/kg (microaerosolizer). We evaluated the pulmonary deposition and interlobar distribution of TiO2 at both 30 min and 3 days after administration. In addition, the inflammatory components in bronchoalveolar lavage (BAL) fluid were measured 3 days after administration of TiO2. At dose volumes of 0.5-2.0 mL/kg, the BAL values were comparable regardless of the device used. In addition, pulmonary TiO2 burden and lobar concentration patterns were equivalent at all combinations of dose volume and delivery device. In conclusion, the acute pulmonary toxicity of nanomaterials can be assessed effectively by using an IT test in which the test agent is provided to rats at a dose volume of 0.5-2.0 mL/kg with either a gavage needle or microaerosolizer.
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Affiliation(s)
- Toshio Kobayashi
- CERI Hita, Chemicals Evaluation and Research Institute, Japan, 3-822, Ishii-machi, Hita-shi, Oita, 877-0061, Japan.
| | - Yutaka Oshima
- CERI Hita, Chemicals Evaluation and Research Institute, Japan, 3-822, Ishii-machi, Hita-shi, Oita, 877-0061, Japan
| | - Yasuhiro Tsubokura
- CERI Hita, Chemicals Evaluation and Research Institute, Japan, 3-822, Ishii-machi, Hita-shi, Oita, 877-0061, Japan
| | - Naoki Hashizume
- CERI Kurume, Chemicals Evaluation and Research Institute, Japan, 3-2-7, Miyanojin, Kurume-shi, Fukuoka, 839-0801, Japan
| | - Shozo Ajimi
- CERI Hita, Chemicals Evaluation and Research Institute, Japan, 3-822, Ishii-machi, Hita-shi, Oita, 877-0061, Japan
| | - Takakazu Kayashima
- Chemical Biotesting Center, Chemicals Evaluation and Research Institute, Japan, 1-4-25, Kouraku, Bunkyo-ku, Tokyo, 112-0004, Japan
| | - Makoto Nakai
- Chemicals Assessment and Research Center, Chemicals Evaluation and Research Institute, Japan, 1-4-25, Kouraku, Bunkyo-ku, Tokyo, 112-0004, Japan
| | - Takeshi Sasaki
- National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Kenji Kawaguchi
- National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Nobuya Imatanaka
- Chemicals Assessment and Research Center, Chemicals Evaluation and Research Institute, Japan, 1-4-25, Kouraku, Bunkyo-ku, Tokyo, 112-0004, Japan
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Lal M, Jarrahian C, Zhu C, Hosken NA, McClurkan CL, Koelle DM, Saxon E, Roehrig A, Zehrung D, Chen D. Stability of live attenuated rotavirus vaccine with selected preservatives and primary containers. Vaccine 2016; 34:2483-9. [PMID: 27085171 DOI: 10.1016/j.vaccine.2016.03.093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 12/21/2015] [Revised: 03/22/2016] [Accepted: 03/29/2016] [Indexed: 10/22/2022]
Abstract
Rotavirus infection, which can be prevented by vaccination, is responsible for a high burden of acute gastroenteritis disease in children, especially in low-income countries. An appropriate formulation, packaging, and delivery device for oral rotavirus vaccine has the potential to reduce the manufacturing cost of the vaccine and the logistical impact associated with introduction of a new vaccine, simplify the vaccination procedure, and ensure that the vaccine is safely and accurately delivered to children. Single-dose prefilled presentations can be easy to use; however, they are typically more expensive, can be a bottleneck during production, and occupy a greater volume per dose vis-à-vis supply chain storage and medical waste disposal, which is a challenge in low-resource settings. Multi-dose presentations used thus far have other issues, including increased wastage of vaccine and the need for separate delivery devices. In this study, the goals were to evaluate both the technical feasibility of using preservatives to develop a liquid multi-dose formulation and the primary packaging alternatives for orally delivered, liquid rotavirus vaccines. The feasibility evaluation included evaluation of commonly used preservatives for compatibility with rotavirus vaccines and stability testing of rotavirus vaccine in various primary containers, including Lameplast's plastic tubes, BD's oral dispenser version of Uniject™ (Uniject DP), rommelag's blow-fill-seal containers, and MEDInstill's multi-dose vial and pouch. These presentations were compared to a standard glass vial. The results showed that none of the preservatives tested were compatible with a live attenuated rotavirus vaccine because they had a detrimental effect on the viability of the virus. In the presence of preservatives, vaccine virus titers declined to undetectable levels within 1 month. The vaccine formulation without preservatives maintained a stability profile over 12 months in all primary containers that was similar to its profile in standard glass vials. This study demonstrates that there are multiple options for the primary container for rotavirus vaccines intended for oral delivery. Selection of an optimal primary container should take into consideration additional factors, including stability as well as cold chain volume, usability, cost, and manufacturing feasibility.
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Affiliation(s)
| | | | | | - Nancy A Hosken
- PATH, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - David M Koelle
- Department of Medicine, University of Washington, Seattle, WA, USA; Department of Laboratory Medicine, University of Washington, Seattle, WA, USA; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Benaroya Research Institute, Seattle, WA, USA
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