Jacobsen Ann-Christin, Visentin Sonja, Butnarasu Cosmin, Stein Paul C, di Cagno Massimiliano Pio
Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, 5230 Odense, Denmark.
Department of Molecular Biotechnology and Health Sciences, University of Turin, 10124 Turin, Italy.
Pharmaceutics. 2023 Feb 9;15(2):592. doi: 10.3390/pharmaceutics15020592.
Replacing in vivo with in vitro studies can increase sustainability in the development of medicines. This principle has already been applied in the biowaiver approach based on the biopharmaceutical classification system, BCS. A biowaiver is a regulatory process in which a drug is approved based on evidence of in vitro equivalence, i.e., a dissolution test, rather than on in vivo bioequivalence. Currently biowaivers can only be granted for highly water-soluble drugs, i.e., BCS class I/III drugs. When evaluating poorly soluble drugs, i.e., BCS class II/IV drugs, in vitro dissolution testing has proved to be inadequate for predicting in vivo drug performance due to the lack of permeability interpretation. The aim of this review was to provide solid proofs that at least two commercially available cell-free in vitro assays, namely, the parallel artificial membrane permeability assay, PAMPA, and the PermeaPad assay, PermeaPad, in different formats and set-ups, have the potential to reduce and replace in vivo testing to some extent, thus increasing sustainability in drug development. Based on the literature review presented here, we suggest that these assays should be implemented as alternatives to (1) more energy-intense in vitro methods, e.g., refining/replacing cell-based permeability assays, and (2) in vivo studies, e.g., reducing the number of pharmacokinetic studies conducted on animals and humans. For this to happen, a new and modern legislative framework for drug approval is required.
用体外研究取代体内研究可以提高药物开发的可持续性。这一原则已应用于基于生物药剂学分类系统(BCS)的生物豁免方法中。生物豁免是一种监管程序,在该程序中,药物基于体外等效性证据(即溶出度试验)而非体内生物等效性获得批准。目前,生物豁免仅适用于高水溶性药物,即BCS I/III类药物。在评估难溶性药物(即BCS II/IV类药物)时,由于缺乏通透性解释,体外溶出度试验已被证明不足以预测体内药物性能。本综述的目的是提供确凿证据,证明至少两种市售的无细胞体外试验,即平行人工膜通透性试验(PAMPA)和PermeaPad试验,在不同的形式和设置下,有潜力在一定程度上减少和取代体内试验,从而提高药物开发的可持续性。基于本文的文献综述,我们建议应将这些试验作为以下方面的替代方法实施:(1)更耗能的体外方法,例如改进/取代基于细胞的通透性试验;(2)体内研究,例如减少在动物和人体上进行的药代动力学研究数量。要实现这一点,需要一个新的、现代化的药物批准立法框架。