Nedergaard Hanne, Vestergaard Susanne, Jensen Pernille Theil, Kristiansen Morten Wagner, Jensen Michael Bech, Ostergaard Per B, Norsell Tina, Bjerre Jens
Pharmaceutics, Biopharm, Novo Nordisk A/S, Novo Alle, Bagsvaerd, Denmark.
Clin Ther. 2008 Jul;30(7):1309-15. doi: 10.1016/s0149-2918(08)80055-0.
Recombinant activated factor VII (rFVIIa) is indicated to treat bleeding episodes or prevent bleeding related to surgery in patients with hemophilia A or B who have antibodies to coagulation factors VIII or IX. The first-generation rFVIIa formulation is stable when stored under refrigeration. A new formulation has been developed for storage at room temperature, which may improve patients' access to treatment during bleeding episodes.
These in vitro experiments were conducted to evaluate the stability of the new formulation of rFVIIa, both lyophilized and reconstituted, under the expected storage conditions, as well as at higher temperatures.
The stability of the new rFVIIa formulation when stored under various conditions before and after reconstitution was evaluated in terms of retained activity (clotting assay), rFVIIa content (high-performance liquid chromatography [HPLC]), and rFVIIa degradation products (HPLC), including aggregates (dimer/oligomer). Activity was analyzed within specific limits representing the allowable minimum/maximum for each test parameter at the end of the product's shelf-life, as adopted by the European Medicines Agency and the US Food and Drug Administration. Before reconstitution, vials from 9 lots of the new rFVIIa formulation, 3 of each size (1, 2, and 5 mg/vial), were stored at refrigerated temperature (5 degrees C) and at room temperature (25 degrees C) for 24 months, and at 30 degrees C for 12 months. To simulate short-term exposure to temperatures higher than recommended, samples were stored at 40 degrees C for 6 months, followed by storage at 25 degrees C for 12 months. To simulate the home setting, in which the product may be alternately stored in and out of the refrigerator, samples were stored at 30 degrees C for 8 hours and then at 5 degrees C for 16 hours, repeated daily for 5 days. To analyze the effect of storage at extremely elevated temperatures, samples were exposed to temperatures of 50 degrees C, 60 degrees C, and 70 degrees C for 12 hours. After reconstitution, samples were maintained at 25 degrees C for up to 6 hours or at 5 degrees C for up to 24 hours.
The specific activity and rFVIIa content of the new lyophilized formulation remained stable after storage for 24 months at 5 degrees C and 25 degrees C, and for 12 months at 30 degrees C; after 5 days of daily alternation between storage at 5 degrees C and 30 degrees C; and after storage for 6 months at 40 degrees C followed by 12 months at 25 degrees C. When stored at 50 degrees C and 60 degrees C for 12 hours, activity remained constant, whereas rFVIIa aggregates increased within the specified limits; after storage at 70 degrees C for 12 hours, rFVIIa activity decreased in parallel with the formation of aggregates, which exceeded the specified limit for the 5-mg product. After reconstitution, samples of all vial sizes of the new rFVIIa formulation retained their activity when stored at 25 degrees C for 6 hours and at 5 degrees C for 24 hours.
In these in vitro experiments, the new lyophilized formulation of rFVIIa was stable when stored for 24 months at 25 degrees C, 12 months at 30 degrees C, 6 months at 40 degrees C, and 12 hours at 50 degrees C and 60 degrees C without compromise to its activity or rFVIIa content. The reconstituted product retained activity when stored at 25 degrees C for 6 hours and at 5 degrees C for 24 hours.
重组活化因子 VII(rFVIIa)适用于治疗患有血友病 A 或 B 且体内存在针对凝血因子 VIII 或 IX 的抗体的患者的出血发作或预防与手术相关的出血。第一代 rFVIIa 制剂在冷藏条件下储存时是稳定的。现已开发出一种可在室温下储存的新制剂,这可能会改善患者在出血发作期间获得治疗的机会。
进行这些体外实验以评估冻干和复溶后的 rFVIIa 新制剂在预期储存条件下以及在更高温度下的稳定性。
根据保留活性(凝血测定)、rFVIIa 含量(高效液相色谱 [HPLC])和 rFVIIa 降解产物(HPLC),包括聚集体(二聚体/寡聚体),评估新 rFVIIa 制剂在复溶前后在各种条件下储存时的稳定性。活性分析在特定限度内进行,这些限度代表了欧洲药品管理局和美国食品药品监督管理局所采用的产品保质期结束时每个测试参数的允许最小值/最大值。在复溶前,从 9 批新 rFVIIa 制剂中取出小瓶,每种规格(1、2 和 5mg/瓶)各 3 瓶,分别在冷藏温度(5℃)和室温(25℃)下储存 24 个月,在 30℃下储存 12 个月。为模拟短期暴露于高于推荐温度的情况,将样品在 40℃下储存 6 个月,然后在 25℃下储存 12 个月。为模拟家庭环境,即产品可能交替在冰箱内外储存的情况,将样品在 30℃下储存 8 小时,然后在 5℃下储存 16 小时,每天重复 5 天。为分析在极高温度下储存的影响,将样品暴露于 50℃、60℃和 70℃温度下 12 小时。复溶后,新 rFVIIa 制剂所有规格小瓶的样品在 25℃下储存 6 小时或在 5℃下储存 24 小时时均保持其活性。
新冻干制剂的比活性和 rFVIIa 含量在 5℃和 25℃下储存 24 个月、在 30℃下储存 12 个月、在 5℃和 30℃之间每日交替储存 5 天后以及在 40℃下储存 6 个月然后在 25℃下储存 12 个月后均保持稳定。在 50℃和 60℃下储存 12 小时时,活性保持不变,而 rFVIIa 聚集体在规定限度内增加;在 70℃下储存 12 小时后,rFVIIa 活性与聚集体的形成平行下降,对于 5mg 产品,聚集体超过了规定限度。复溶后,新 rFVIIa 制剂所有规格小瓶的样品在 25℃下储存 6 小时和在 5℃下储存 24 小时时均保持其活性。
在这些体外实验中,rFVIIa 新冻干制剂在 25℃下储存 24 个月、在 30℃下储存 12 个月、在 40℃下储存 6 个月以及在 50℃和 60℃下储存 12 小时时保持稳定,其活性和 rFVIIa 含量不受影响。复溶后的产品在 25℃下储存 6 小时和在 5℃下储存 24 小时时保持活性。