Rossi F, Legras J F
Agence Française de Sécurité Sanitaire des Produits de Santé, Département de l'Evaluation des Produits Biologiques, Saint-Denis Cedex.
Ann Med Interne (Paris). 2000 May;151 Suppl 1:1S55-61.
The viral safety of IVIg is defined by transposition of European Directives. Directive 89/381/CEE defines plasma-derived medicinal products (pd-MP) which should be registred through a Marketing Authorization (75/318/CEE) and requires specific criteria for donation acceptability and fractionation processing. Recommendations and Notes for Guidance are prepared by the "Biotechnology Working Party" (BWP), Committee for Proprietary Medicinal Products (CPMP) ad hoc group. "Note for Guidance on Virus Validation Studies: CPMP/BWP/268/95" defines, for conventional viruses, the validation study as regards viral elimination /inactivation steps (relevant virus, scale reduction system and statistical interpretation of the results). "Note for Guidance on 'blood products'- CPMP/BWP/269/95" defines the key issues of viral safety: starting material, viral elimination /inactivation steps within the fractionation processing and in process controls. Pd-MP used as excipients are also covered. BWP/CPMP recommends that exclusion criteria only be considered for sporadic, familial or iatrogenic Creutzfeldt-Jakob disease (CJD), while withdrawal should be undertaken, according to the precaution principle, when a donor is suffering from nv-CJD (February 1998). Also, screening tests currently under development for transmissible spongiform encephalopathies are encouraged to be introduced for fractionation products (January 1999). Some donor exclusion criteria for conventional viruses and prions are specific to France. In conclusion, measures taken to ensure pd-MP viral safety are constantly changing. Its evaluation can only be done when considering numerous parameters within a global context.
静脉注射免疫球蛋白(IVIg)的病毒安全性由欧洲指令的转换来界定。89/381/CEE号指令定义了血浆衍生药品(pd-MP),这类药品应通过上市许可(75/318/CEE)进行注册,并要求有捐赠可接受性和分馏处理的特定标准。“生物技术工作组”(BWP)、专利药品委员会(CPMP)特设小组编写了建议和指导说明。“病毒验证研究指导说明:CPMP/BWP/268/95”针对常规病毒定义了关于病毒清除/灭活步骤(相关病毒、规模缩减系统和结果的统计解释)的验证研究。“‘血液制品’指导说明:CPMP/BWP/269/95”定义了病毒安全性的关键问题:起始原料、分馏处理过程中的病毒清除/灭活步骤以及过程控制。用作辅料的pd-MP也涵盖在内。BWP/CPMP建议,仅针对散发性、家族性或医源性克雅氏病(CJD)考虑排除标准,而当供体患有新型克雅氏病(nv-CJD,1998年2月)时,应根据预防原则进行撤回。此外,鼓励对分馏产品引入目前正在开发的可传播性海绵状脑病筛查检测(1999年1月)。法国针对常规病毒和朊病毒有一些特定的供体排除标准。总之,为确保pd-MP病毒安全性所采取的措施在不断变化。只有在全球背景下考虑众多参数时才能对其进行评估。