School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.
J Aerosol Med Pulm Drug Deliv. 2012 Dec;25 Suppl 1:S6-9. doi: 10.1089/jamp.2012.1Su3.
Radiolabeling of inhaler formulations for imaging studies is an indirect method of determining lung deposition and regional distribution of drug in human subjects. Hence, ensuring that the radiotracer and drug exhibit similar aerodynamic characteristics when aerosolized, and that addition of the radiotracer has not significantly altered the characteristics of the formulation, are critical steps in the development of a radiolabeling method. The validation phase should occur during development of the radiolabeling method, prior to commencement of in vivo studies. The validation process involves characterization of the aerodynamic particle size distribution (APSD) of drug in the reference formulation, and of both drug and radiotracer in the radiolabeled formulation, using multistage cascade impaction. We propose the adoption of acceptance criteria similar to those recommended by the EMA and ISAM/IPAC-RS for determination of therapeutic equivalence of orally inhaled products: (a) if only total lung deposition is being quantified, the fine particle fraction ratio of both radiolabeled drug and radiotracer to that of the reference drug should fall between 0.85 and 1.18, and (b) if regional lung deposition (e.g., outer and inner lung regions) is to be quantified, the ratio of both radiolabeled drug and radiotracer to reference drug on each impactor stage or group of stages should fall between 0.85 and 1.18. If impactor stages are grouped together, at least four separate groups should be provided. In addition, while conducting in vivo studies, measurement of the APSD of the inhaler used on each study day is recommended to check its suitability for use in man.
对吸入制剂进行放射性标记是一种间接方法,可用于确定人体肺部药物沉积和药物的区域分布。因此,确保放射性示踪剂和药物在气溶胶化时表现出相似的空气动力学特征,并且添加放射性示踪剂不会显著改变制剂的特征,是开发放射性标记方法的关键步骤。验证阶段应在体内研究开始之前,在放射性标记方法的开发过程中进行。验证过程涉及使用多级级联冲击器对参考制剂中的药物的空气动力学粒径分布(APSD)以及放射性标记制剂中的药物和放射性示踪剂进行特征描述。我们建议采用类似于 EMA 和 ISAM/IPAC-RS 为确定吸入性治疗产品的治疗等效性而推荐的接受标准:(a) 如果仅定量测定总肺沉积,则放射性标记药物和放射性示踪剂的细颗粒分数与参考药物的细颗粒分数之比应在 0.85 和 1.18 之间;(b) 如果要定量测定区域性肺沉积(例如,外肺区和内肺区),则每个撞击器阶段或阶段组中放射性标记药物和放射性示踪剂与参考药物的比率应在 0.85 和 1.18 之间。如果将撞击器阶段分组,则应至少提供四个单独的组。此外,在进行体内研究时,建议测量每个研究日使用的吸入器的 APSD,以检查其在人体中的适用性。