Gapp Guenther, Holzknecht Peter
Quality Assurance Microbiology, Sandoz GmbH/Novartis, Kundl, Austria.
PDA J Pharm Sci Technol. 2011 May-Jun;65(3):217-26. doi: 10.5731/pdajpst.2011.00693.
A sterile active ingredient plant and a sterile finished dosage filling plant both comprise very complex production processes and systems. The sterility of the final product cannot be assured solely by sterility testing, in-process controls, environmental monitoring of cleanrooms, and media fill validations. Based on more than 15 years experience, 4 years ago the authors created a new but very simple approach to the risk analysis of sterile plants. This approach is not a failure mode and effects analysis and therefore differs from the PDA Technical Report 44 Quality Risk Management for Aseptic Processes of 2008. The principle involves specific questions, which have been defined in the risk analysis questionnaire in advance, to be answered by an expert team. If the questionnaire item is dealt with appropriately, the answer is assigned a low-risk number (1) and if very weak or deficient it gets a high-risk number (5). In addition to the numbers, colors from green (not problematic) through orange to red (very problematic) are attributed to make the results more striking. Because the individual units of each production plant have a defined and different impact on the overall sterility of the final product, different risk emphasis factors have to be taken into account (impact factor 1, 3, or 5). In a well run cleanroom, the cleanroom operators have a lower impact than other units with regard to the contamination risk. The resulting number of the analyzed production plant and the diagram of the assessment subsequently offers very important and valuable information about a) the risk for microbiological contamination (sterility/endotoxins) of the product, and b) the compliance status of the production plant and the risk of failing lots, as well as probable observations of upcoming regulatory agency audits. Both items above are highly important for the safety of the patient. It is also an ideal tool to identify deficient or weak systems requiring improvement and upgrade, and delivers sound arguments for investments. Practical experience with this risk analysis, which has already been executed in several production sites in various countries, has demonstrated that it is simple, workable, and delivers valuable information.
Many important pharmaceutical products need to be sterile because they are to be injected into the patient's bloodstream or muscle. Sterile means that the product must be free of microorganisms (i.e., bacteria, yeast, and moulds). A non-sterile injection or infusion could lead to very serious or even lethal effects on the patient. Therefore one of the biggest challenges in the pharmaceutical industry nowadays is still the sterile production process itself. Microorganisms are everywhere in the environment, and humans are known to be a significant source of microbial contamination of a sterile product. It is necessary to set up a very effective quality assurance system as well as many quality control analysis tools to assure the sterility of the produced vials/syringes or of the bulk material intended for later filling into vials (bulk material, e.g., 10 kg in bags or cans). Above all, to get an accurate indication of the risk of non-compliance of product quality, regulatory agencies such as the U.S. Food and Drug Administration and the updated E.U. Good Manufacturing Practice (GMP) Guide have made it mandatory to perform a risk analysis of the production process. This provides in advance valuable information about the potential risk of a product's non-compliance with product specifications and GMP requirements, in our case regarding sterility. The authors set up a new approach for a risk analysis 4 years ago; this approach stems from fundamental experience gained over the past 15 years. Several specific questions are asked regarding various topics that correlate to the sterile production line and associated quality assurance/control systems. If the answer for an item is satisfactory and the best system is in place with regard to sterility, it is assessed with the prime rating of 1. If the topic is not satisfactory and very weak, the response is 5. Risk numbers from 2 to 4 are for intermediate situations. Because each unit of the production process could have a different type of impact of varying severity on the total product sterility, the average of the answers regarding the unit (e.g., 1, 2) is multiplied by the risk emphasis factor, which could be 1, 3, or 5. To make the rating even more distinct, colors are assigned from green (very good) through orange to red (very weak). There are currently three different risk analyses available for three different production processes. The results provide the users, that is, production personnel and quality assurance personnel, valuable feedback about the risk for possible non-sterility in their process as well as sound arguments to present to management defending upgrades of their production line and control systems in the case of high numbers and red colors. Three years of implementation have demonstrated that this new risk analysis approach works and is very useful in identifying potentially risky components of a production process, thus preventing in advance the production of non-sterile product batches for the market, and finally protecting the patient from hazardous products.
无菌活性成分生产车间和无菌成品灌装车间都包含非常复杂的生产流程和系统。最终产品的无菌性不能仅通过无菌检测、过程控制、洁净室环境监测和培养基灌装验证来确保。基于15年以上的经验,作者在4年前创建了一种全新但非常简单的无菌车间风险分析方法。这种方法不是失效模式与效应分析,因此不同于2008年PDA技术报告44《无菌工艺的质量风险管理》。该原理涉及预先在风险分析问卷中定义的特定问题,由一个专家团队来回答。如果问卷项目得到妥善处理,答案被赋予低风险数字(1),如果非常薄弱或存在缺陷,则得到高风险数字(5)。除了数字之外,还赋予从绿色(无问题)到橙色再到红色(问题非常严重)的颜色,以使结果更醒目。由于每个生产车间的各个单元对最终产品的整体无菌性有明确且不同的影响,因此必须考虑不同风险强调因素(影响因素1、3或5)。在运行良好的洁净室中,洁净室操作人员对污染风险的影响低于其他单元。分析得出的生产车间数字和评估图表随后提供了非常重要且有价值的信息,这些信息涉及:a)产品微生物污染(无菌性/内毒素)风险,以及b)生产车间的合规状态和批次不合格风险,以及监管机构即将进行审核时可能出现的情况。上述两项对于患者安全都极为重要。它也是识别需要改进和升级的有缺陷或薄弱系统的理想工具,并为投资提供有力依据。在多个国家的几个生产基地已经实施了这种风险分析的实践经验表明,它简单可行,并能提供有价值的信息。
许多重要的药品需要无菌,因为它们要注入患者的血液或肌肉中。无菌意味着产品必须不含微生物(即细菌、酵母和霉菌)。非无菌注射或输注可能会对患者造成非常严重甚至致命的影响。因此,当今制药行业最大的挑战之一仍然是无菌生产过程本身。微生物在环境中无处不在,而且众所周知,人类是无菌产品微生物污染的重要来源。必须建立非常有效的质量保证体系以及许多质量控制分析工具,以确保生产的小瓶/注射器或用于后续灌装到小瓶中的散装物料(散装物料,例如袋装或罐装的10千克)的无菌性。最重要的是,为了准确了解产品质量不符合规定的风险,美国食品药品监督管理局等监管机构以及更新后的欧盟《良好生产规范》(GMP)指南已强制要求对生产过程进行风险分析。这提前提供了有关产品不符合产品规格和GMP要求的潜在风险的有价值信息,在我们的案例中是关于无菌性的风险。作者在4年前建立了一种新的风险分析方法;这种方法源于过去15年积累的基本经验。针对与无菌生产线及相关质量保证/控制系统相关的各个主题提出了几个特定问题。如果某个项目的答案令人满意且在无菌方面有最佳系统到位,则给予1的最高评级。如果该主题不令人满意且非常薄弱,则答案为5。2到4的风险数字用于中间情况。由于生产过程的每个单元对产品总无菌性可能有不同类型且严重程度各异的影响,因此关于该单元的答案平均值(例如1、2)乘以风险强调因素,该因素可以是1、3或5。为了使评级更加明显,从绿色(非常好)到橙色再到红色(非常薄弱)分配颜色。目前针对三种不同的生产过程有三种不同的风险分析。结果为用户,即生产人员和质量保证人员,提供了有关其过程中可能出现的非无菌风险的有价值反馈,以及在数字高且为红色的情况下向管理层提出升级生产线和控制系统的有力依据。三年的实施表明这种新的风险分析方法有效,并且在识别生产过程中潜在的风险组件方面非常有用,从而提前防止向市场生产非无菌产品批次,最终保护患者免受有害产品的侵害。