Pharmacy Department, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.
Pharmacy Department, Henri Mondor University Hospital, Créteil, France.
Pharm Res. 2020 Aug 2;37(8):159. doi: 10.1007/s11095-020-02859-z.
Monoclonal antibody (Mabs) containing medicinal products are widely used in clinical practice. Prior to parenteral administration, licensed Mab containing medicinal products are transferred to the ready-to-administer (RTA) forms. Reconstitution and/or preparation should follow the guidelines for Good Reconstitution/Good Preparation Practice. Preparation in the pharmacy must take place within the framework of a suitable quality management system. The responsible pharmacist must apply a risk assessment on the process to ensure the appropriate quality of the RTA preparation, especially because the extent of quality testing is limited by batch size (often one single unit) and time restraints. In these cases, appropriate quality is to be assured by means of qualification activities, environmental monitoring, process validation with growth medium and in-process controls. Correct labelling of the Mab containing RTA preparations includes a suitable storage advice and a defined shelf life. Physicochemical stability of a given Mab preparation can be assessed based on a specific stability study (supplied by the manufacturer in the SmPC or scientific journals, study published by an expert in a peer-reviewed scientific journal). Physicochemical stability studies require the use of various orthogonal physicochemical methods to detect accurately the degradation changes that may result from the deamidation, oxidation, disulfide formation, aggregation or fragmentation during storage. Complementary, biological activity can be measured. Compatibility studies of Mabs and devices used for preparation and administration are still scarce. Microbiological stability of Mab preparations is related to the complexity of the preparation process, the growth supporting nature of the preparation and the integrity of the container or container/closure combination. In use viability tests revealed that the potential of Mab preparations to support microbial growth was similar to that of the pure vehicle solutions used as control solutions. The enumerated microbial counts varied according to the species utilized and the type of Mab preparation. If sterility testing of the individual preparation is impossible, maximum permitted shelf life can be assessed empirically with regard to the maximum shelf lives defined in the USP <797> monograph. Finally, microbiological and physicochemical stability are to be considered concurrently when determining the shelf life of an individual Mab preparation. In each case, shelf life should be limited according to the shorter period of proven stability, either derived from the microbiological or physicochemical stability data.
单克隆抗体(Mabs)药物广泛应用于临床实践。在进行肠外给药之前,许可的含 Mab 药物被转移到即用型(RTA)形式。再配制和/或准备应遵循良好再配制/良好准备实践的指南。在药房中的制备必须在适当的质量管理体系框架内进行。负责药剂师必须对该过程进行风险评估,以确保 RTA 制剂的适当质量,特别是因为质量测试的程度受到批量(通常为一个单一单位)和时间限制的限制。在这些情况下,适当的质量应通过资格活动、环境监测、用生长培养基进行的工艺验证和过程控制来保证。含 Mab 的 RTA 制剂的正确标签包括适当的储存建议和规定的保质期。特定 Mab 制剂的物理化学稳定性可以基于特定的稳定性研究进行评估(由制造商在 SmPC 或科学期刊中提供,或由同行评审的科学期刊中的专家发表的研究)。物理化学稳定性研究需要使用各种正交物理化学方法来准确检测储存过程中可能由于脱酰胺、氧化、二硫键形成、聚集或片段化而导致的降解变化。此外,可以测量生物活性。Mab 和用于制备和给药的设备之间的相容性研究仍然很少。 Mab 制剂的微生物稳定性与制剂过程的复杂性、制剂的生长支持性质以及容器或容器/密封件组合的完整性有关。在使用中,活力测试表明, Mab 制剂支持微生物生长的潜力与用作对照溶液的纯载体溶液相似。计数的微生物数量根据所用的物种和 Mab 制剂的类型而变化。如果无法对单个制剂进行无菌测试,则可以根据 USP <797>专论中定义的最大允许保质期经验性地评估最大允许保质期。最后,在确定单个 Mab 制剂的保质期时,应同时考虑微生物和物理化学稳定性。在每种情况下,保质期应根据微生物或物理化学稳定性数据中证明的较短稳定性期限来限制。