Welcome to the USP Workshop on Particle Size: Particle Detection and Measurement December 8-10, 2010 USP Headquarters, Rockville, MD USP Workshop on Particle Size: Particle Detection and Measurement December 8-10, 2010; USP Headquarters Welcome and Opening Remarks Anthony DeStefano, Ph.D. USP Vice president, General Chapters USP Workshop on Particle Size: Particle Detection and Measurement December 8-10, 2010; USP Headquarters Workshop Overview Desmond Hunt, Ph.D. USP Senior Scientific Liaison USP Workshop on Particle Size: Particle Detection and Measurement December 8-10, 2010; USP Headquarters Session I: Particle and Product Size Fundamentals Chair: Richard Meury Eli Lilly Particle Size Fundamentals Rich Meury Eli Lilly and Company General Chapters Physical Analysis Expert Committee USP Workshop on Particle Size: Detection and Measurement 08 December 2010 Outline What are particles? What is particle size? Particle size detection and measurement 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 6 Particle size detection and measurement •Diversity of applications •Bulk / contaminents •Parenteral / oral •Commonality •Understanding of particle size •Measurement techniques 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 7 Potential effects of API and excipient particle size •Manufacturability – flow •Content uniformity •Dissolution •Bioavailability •Stability •Appearance 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 8 Parenteral and Ophthalmic solutions Regulatory / GMP / Compendial requirements for visible and subvisible particles 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 9 What is a particle? •a small object that behaves as a whole unit in terms of its transport and properties (Wikipedia) •a relatively small or the smallest discrete portion or amount of something (Merriam-Webster) •a small discrete unit of matter (ASTM) 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 10 A particle may be: •Solid in a gas •Solid in liquid •Liquid in gas •Liquid in liquid •Gas in liquid 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 11 What is a particle? Anything that produces a response in the measurement. 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 12 What is particle size (and why is it so misunderstood)? •Shape •Distributions •Sample •Measurement technique 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 13 Shape For non-spherical particles, size is not sufficiently defined by a single number Leads to measurement variability Leads to dependence on measurement technique Pharmaceutically relevant particles exhibit a wide variety of shapes 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 14 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 15 T h e S i z e o fa P a r t i c l e L in e a rd im e n s io n s M ic r o s c o p e A r e a d im e n s io n s S ie v e V o lu m e d im e n s io n s D if f r a c t io n ,E le c t r o z o n e S e t t lin g r a t e S e d im e n t a t io n 08 Dec 2010 USP Workshop 16 Variability of Size Measurements of a Single Particle Shape Flake Trapezoid Sphere Mean SD Range 427 489 427 76 33 11 66% 26% 8% Powder Technology, 57, 143. 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 17 Equivalent Sphere Same min. length dmin dw dmax Same max. length Sphere of same weight dv Same Volume dsed ds Same sedimentation rate 08 Dec 2010 USP Workshop dsieve Same surface area 18 Equivalent Spherical Diam. 100 µm 2 Volume = p r h = 10000 d = 20 20 µm 39 µm h = 100 Volume = 4/3 • pr = 10000 3 r = 39.1 08 Dec 2010 USP Workshop 19 Distributions Particle populations are distributions of both size and shape. • Not adequately described by a single number Variety of ways to describe and display distribution information Need to define the parameter or statistic used to describe the population 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 20 Distributions Descriptors / Statistics • Basis (y axis) –volume, count, other • Scale (x axis) –linear or logarithmic • Bins –size, resolution 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 21 Size without distribution information or definition of reported parameter 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 22 Actual size distribution: normal or log-normal 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 23 Actual size distribution 180 Volume distribution density 160 140 120 100 80 60 40 20 0 10 100 Diameter (microns) 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 24 Cumulative size distribution plot 100 90 80 Cumulative 70 60 50 40 30 20 10 0 10 100 Diameter (microns) 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 25 Log-probability plot 99.9 Cumulative % 99 90 70 50 30 10 1 0.1 10 100 Diameter (microns) 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 26 Log-probability plot 99 Cumulative % 90 70 50 30 10 1 10 100 Diameter (microns) 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 27 Count and volume distributions Count Volume 10 Diameter 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 28 Relative quantities 1 m 10 m 100 m count 1 1 1 surface 1 100 10,000 volume / mass 1 1,000 1,000,000 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 29 Descriptors Position • means, median, mode Dispersion • GSD, span, width, range Quantiles / Percentiles • X50, D90, Q20 Most relevant parameter depends on purpose of measurement. 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 30 Descriptors Means and variances • • • generally used with counting techniques treat all particles in bin as mid-point for cumulative, treat 1/2 as below mid-point Percentiles and quantiles • • generally used where bins defined by limits interpolated from cumulative distribution 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 31 Definitions Dn or Xn nth percentile size, the size which n % of the distribution is below. Qy yth quantile, the % below size y GVM geometric volume mean diameter GSD geometric standard deviation Width (D84.13/D15.87)1/2, estimate of GSD VMD volume median diameter, X50 Da,b da/ db (D4,3 is arithmetic volume mean diameter) 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 32 Definitions d particle size, diameter of a sphere x particle size, diameter of a sphere subscripts may be used to denote measured quantity, e.g. volume, surface, or Feret diameter qr(x) density distribution (linear) where r indicates the dimension, e.g. r = 0 for number distribution, r = 3 for volume distribution q*r(ln x) density distribution (logarithmic) Qr(x) cumulative distribution (general) 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 33 Analysis and Display of Particle Size Data Bins defined by either mid-point or upper and lower limits. • • depends on technique determines what parameters are used Treat distribution plots as histograms • distribution density – normalize AUC – more correct representation of relative amounts 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 34 Distribution Density Linear scale: q*r,i = Qr,i / xi Logarithmic (geometric) scale: q*r,i = Qr,i / log(xi/xi-1) 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 35 Interpolation 100 90 80 Q20 70 60 50 40 10 D50 08 Dec 2010 USP Workshop D90 Company Confidential Copyright © 2000 Eli Lilly and Company 100 36 Interpolation: Percentile sizes Linear x l Du Dl Dx Dl u l Geometric x l Dx Dl exp lnDu / Dl u l where 08 Dec 2010 USP Workshop l = % below bin, u = % above bin Dn = size at n % Company Confidential Copyright © 2000 Eli Lilly and Company 37 0.18 1 0.15 0.8 0.12 0.6 0.09 0.4 0.06 0.2 0.03 0 Cumulative Fraction Volume Fraction Lognormal Distribution 0 10 100 1000 Diameter GMD (D50) = 100 08 Dec 2010 USP Workshop GSD = (Sqrt[D84/D16]) = 2.0 Company Confidential Copyright © 2000 Eli Lilly and Company 38 Useful equations for dealing with lognormal distributions Dn x g S xi x j e z ( i j ) ln 2 S ( i j ) ln 2 S x i x j e x x e(i j ) ln i j 2 S i.e. GCM = GVM *exp(-3ln2S) 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 39 Sample Effects / limitations of sampling Effects of sample preparation Matrix 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 40 Sampling Actual measured sample is (usually) extremely small fraction of original Multiple sample divisions chances for bias / segregation • Lot, containers, composite sample, lab sample, sample preparation, analytical sample, measured sample For best results, use riffler or sample splitter 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 41 Golden rules of sampling (T. Allen) Sample from material in motion Multiple cuts from whole stream 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 42 Sample size and container mg to kg request appropriate amount for analysis request appropriate packaging • container not more than about 1/2 full • easy to mix and sample 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 43 Sample preparation Matrix / packaging / handling Dispersion Dissolution Reactions, form changes Dependent on sample characteristics 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 44 Key thoughts: Particle size analysis results depend on the sample characteristics and preparation The analysis is only as good as the sample 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 45 Measurement Technique All techniques measure different size related properties • affected by shape and material properties –RI, density, etc. Within a technique, depends on measurement conditions • experimental design • software, algorithms • data handling and reporting 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 46 Summary of Methods •Microscopy •Image analysis - static and dynamic •Sieving •Electrical sensing zone •Light Diffraction •Light Extinction / Scattering (SPOS) •Dynamic Light Scattering •Aerodynamic methods •Sedimentation •Others 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 47 Microscopy 10 08 Dec 2010 USP Workshop 20 Best way for shape Number distribution Slow Subjectivity Representative? Which diameter to use? 48 Image analysis Quantitation of images Allows more objective use of microscopy Other uses as well 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 49 Sieving Wide overall and dynamic ranges • limited at low end, about 50 microns Few sample restrictions • Relatively large sample required Slow Low resolution Direct mass measurement 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 50 Electrical sensing zone (Coulter method) Moderately limited overall and dynamic ranges High resolution Requires electrolyte Direct counting Moderately fast 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 51 Light diffraction Relatively wide overall and dynamic ranges Moderate resolution Few sampling restrictions Indirect measurement Fast 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 52 Light Extinction / Scattering (single particle optical sensing) Moderate dynamic and overall ranges High resolution possible, not always utilized Single particle counting, direct Main uses in contamination monitoring 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 53 Dynamic light scattering Sub-micron range limited resolution 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 54 Aerodynamic Methods Impinger Cascade Impactor Time of Flight 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 55 Sedimentation gravity and centrifugal photo and X-ray detection slow 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 56 Others Scanning methods • time of transition of scanned beam (FBRM) – chord measurement Separation methods • FFF Ultrasonic attenuation Laser Doppler velocimetry 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 57 Summary Not necessarily only one correct answer • Depends on underlying question Particle size measurement depends on: • Sample and preparation • Measurement technique and conditions Accurate communication of results depends on: • Understanding of these effects • Use of appropriate parameter or statistic 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 58 Acknowledgements Some of the slides were provided by Malvern Instruments. 08 Dec 2010 USP Workshop Company Confidential Copyright © 2000 Eli Lilly and Company 59 Desirable Formulations Properties and Delivery Strategies API / Dry Systems Stephen W. Hoag, Ph.D. University of Maryland, Baltimore School of Pharmacy 20 N. Pine St. Baltimore MD 21201 Phone 410-706-6865 Email [email protected] Lecture Objectives and Outline Objective: – To make a successful dosage form there are critical quality attributes (CQA) that the final dosage form must have. To obtain the desirable CQA the API must have desirable physical properties. This talk will examine the how particle properties can affect the CQA of the final dosage from and strategies for developing a formulation. Outline – – – Formulation requirements Particle properties and powder behavior Formulation Strategies Dosage Form Requirements Main dosage form design criteria – – – – – Accuracy/Precision dosing Drug delivery Manufacturability Patient acceptability Stability Raw Material Inputs Manufacturing Process Processing Conditions Final Product Outputs Tablet Press Operation Source: Wikipedia - Tablets Capsule Filling Dosator Method Dosing Disc Principle Capsule Plug Powder Flow Significance Powder must flow from hopper to tablet die 1,000 – 3,000 kg Lot 100 – 300 mg Tablet Low density or fluidized powder bed High density powder bed Highly consolidated powder bed Drug Delivery Bioavailability can depend on particle size E.g. Folic acid – Amount Released 75% of labeled claim in 1 hr Gut Wall Disintegration Dissolution Steps depend on formulation & particle size Formulation Attributes: Minimum running characteristics – – – Compactibility Fluidity Lubricity Minimum delivery characteristic – Release Particle properties and powder behavior Particle Properties PS & PSD Distribution Type Particle Shape Image Source: PharmTech, Dec 2001, p38-45 Forces Between Particles Particle-particle Adhesion H Av x 2 24 a van der Waals 10Q 2 2 Aq x 1 a / x 2 Electrostatic AL x FA Capillary Particle Contact & Size Represents adhesive force at contact point Smaller particles have many more contact points/volume than larger particles Percolation Segregation Smaller particles tend to filter down through larger particles Bed Vibration Net affect larger particles on top of bed Dissolution Noyes Whitney Eq. Surface to Volume Ratio dm SD (C s Cb ) dt h Particle Diameter S = Surface Area m = Mass t = Time D = Diff. coef. h = Bndry. layer C = Conc. Property Constraints Flow Rate Dissolution Rate Minimum Flow Rate Particle Size Formulation Strategies Formulation Strategies The best formulation strategy is? – – It depends on circumstances Need to do risk assessment to decide: Other excipients, i.e. formulation Best process to be used Particle Ranges Formulation Type Nano Particles Size Range Properties 200 – 500 nm Flow: Need specialize formulation techniques to get dispersion of particle in dissolution medium Dissolution: Typically excellent Micronized API 10 – 40 µm Flow: Very cohesive, poor flow, hard to mix, but doesn‘t easily segregate Dissolution: Typically excellent ―Typical‖ API 50 – 150 µm Flow: Less cohesive, average flow, easy to mix, but may easily segregate Dissolution: Depends Granules 250 – 400 µm Flow: Non cohesive, excellent flow, typically don‘t segregate Dissolution: Depends Beads 400 – 750 µm Flow: Need specialized formulating techniques, hard to make into tablet or capsule Dissolution: Often CR formulation Consideration of the Dose of Drug is the Starting Point... LOW DOSE (<25 mg) – – Most of the tablet will be excipients Content Uniformity High DOSE (>250 mg) – – – Most of the tablet will be drug Compactibility Fluidity Low Dose Formulation Strategy Flow, lubricity and compactability less important Poor compactability – Poor fluidity – Overcome by including lubricant Poor dissolution – – – Overcome by including a glidant Poor lubricity – Over come with filler-binders Overcome by adding disintegrant Use water soluble filler-binders Reduce API particle size Risks Content Uniformity – – Need specialized mixing procedures like geometric dilution Controlling Particle size %CV – Coefficient of Variation np (1 p ) s %CV 100 100 np X 100 np X np Assuming p is small thus (1-p) = 1 np (1 p) %CV - Example For example: – – – Tablet 400 mg total 10 mg active Density = 1.5 g/cc ca 6% Max allowed %CV 30 25 % CV • 20 15 10 5 0 0 250 500 750 Particle Size (um) 1000 High Dose Formulation Strategy • Flow, lubricity and compactability very important – • Poor compactability – • Granulation: wet or dry Poor lubricity – • Granulation: wet or dry Poor fluidity – • Limits to how much can bulk up with excipients Overcome by including lubricant Poor dissolution – – – Overcome by adding disintegrant Reduce API particle size Water soluble excipients and granulation binders Summary • • • First principle models relating particle properties to finished product CQA don‘t exist Can be guided by general principles and empirical experience To develop formulation need to understand how particle size affects formulation and how to use this info when developing formulation References Pharmaceutical dosage forms: tablets, Hoag and Augsburger, 3rd Ed, vol. 1-3 Marcel Dekker, Inc. (2008) The theory and practice of industrial pharmacy; Lea & Febiger, Lachman, Lieberman & Kanig (1986) pp 3-21 Principles of powder technology; John Wiley and Sons, New York, Martin Rhodes, (1990) pp 227-298 Carstensen, JT. Solid pharmaceutics: mechanical properties and rate phenomena. Academic press, NY (1980). Muhammad E. Fayed, Lambert Otten, Handbook of powder science and technology, 2nd edition (1997) Chapman & Hall, New York Characteristics and Requirements for an Ideal Parenteral Liquid Dosage Form USP Workshop on Particle Size Rockville, MD December 8-10, 2010 Presenter Gregory A. Sacha, Ph.D. Parenteral Dosage Form Preparations administered by circumventing the body‘s most protective barriers and, therefore, are prepared to meet Pharmacopeial requirements for sterility, pyrogens/endotoxins, and particulate matter. © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 87 Categories of Injections (USP) Solutions ready for injection Dry, soluble products ready to be combined with a solvent just prior to use. Suspensions ready for injection Dry, insoluble products ready to be combined with a vehicle just prior to use. Emulsions Liquid concentrates ready for dilution prior to administration. © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 88 Parenteral Product Packaging Ampoules Vials Pre-filled Syringes Glass and Plastic Bottles Plastic Bags and Bottles Add-Vantage® Dual Chamber Vials/Syringes Cartridges, Delivery Pens, and Autoinjectors © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 89 Parenteral Packaging © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 90 Route of Administration Intravenous – Direct Injection – Infusion Subcutaneous Intramuscular Intradermal Intraspinal Intrathecal Intra-arterial Others © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 91 Characteristics and Requirements 92 Regulatory – Meets SISPQ – Safety, Identity, Strength, Purity, Quality • Includes sterility, free from pyrogens, toxicologically safe, essentially particle free User Requirements – Ease of administration – Pharmaceutical elegance – Comfort Manufacturing Requirements – Ease of manufacturing – No interactions with processing equipment © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. Characteristics and Requirements Toxicologically Safe – Formulations contain the drug and excipients, e.g. • Solubilizing agent(s) / vehicle • Buffers, other stabilizers • Anti-microbial preservatives – Excipients can be a source of impurities – Many potential formulation additives are not sufficiently safe for injectable drug administration – Limited number of preservatives available for multidose vials due to toxicity – Limited concentration ranges for surfactants © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 93 Characteristics and Requirements Isotonic – Typically about 280 mOsm/kg – All routes of injectable administration and topical ophthalmic application should be isotonic • Only possible exception: small volume IV injections – Possible outcomes of administering non-isotonic formulations include: • Hemolysis • Phlebitis • Muscle irritation © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 94 Characteristics and Requirements Stability – Physically, chemically, and microbiologically – No interaction with packaging components • Appropriate container type and formulation components to prevent glass delamination. – Formulation variables conducive to delamination include pH > 8 and chelating agents – Ammonium sulfate treatment may increase potential for flaking • Eprex incident – polysorbate in the formulation leached a curing agent from the rubber stopper that caused pure red cell aplasia (PRCA) © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 95 Characteristics and Requirements Compatible with IV admixtures if needed – For example, adding heparin, insulin, and other components to a daily parenteral nutrition infusion – Combining any small volume injectable product with an infusion solution requires knowledge of product compatibility with infusion plus with any other drug products part of the admixture – Hospital pharmacists rely on the Trissel‘s Handbook on Injectable Drugs © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 96 Requirements Sterility – Free from microbial contamination for entire shelf life of product – Tested on a small number of samples compared to the entire batch size – Methods are Membrane Filtration and Direct Transfer – Tests are limited by: • Sampling and statistical representation • Potential for accidental contamination • Potential for interactions between media, conditions, and drug that may inhibit microbial growth. © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 97 Requirements Pyrogen Free – Fever producing agents plus, depending on amount, can produce a cascade of more serious physiologic problems including death (sepsis) – Endotoxins: lipopolysacharides from gram negative microbial contamination • All endotoxins are pyrogens but not all pyrogens are endotoxins – Limulus Amebocyte Lysate Test (LAL) and rabbit pyrogen test © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 98 Requirements Essentially Free from Visible Particulate Matter – Sources are from throughout the manufacturing process • Material preparation and handling – Tubing used throughout the process especially if using a peristaltic pump after the filtration process – Material used to cover manufacturing equipment during the autoclave process – Fragments of packaging material used to contain stoppers & pre-sterilized syringes – Extractables from Bioshield paper used to cover equipment for autoclaving © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 99 Requirements Essentially Free from Visible Particulate Matter • Manufacturing – Metal fragments from mixing units – Metal fragments from stopper insertion tubes for prefilled syringes – Fragments from magnetic stir bars – Metal fragments from abrasion during cleaning processes – Erosion of gaskets • Packaging Materials – Silicone on syringes and stoppers – Glass from breaking ampoules – Coring from puncturing stopper with needle – Removing plastic covering from containers – Dislodging stoppers © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 10 0 10 1 Requirements Limits for Subvisible Particulate Matter – 1st Test by Light Obscuration Method If the numbers exceed the requirements: – 2nd Test by Microscopic Particle Count Method Test Product ≥10 m ≥25 m L.O. SVI 6000 600 / container LVI 25 3 / mL SVI 3000 300 / container LVI 12 2 / mL Micro © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. User Requirements Pharmaceutical elegance – Clear, colorless solution Flows easily through the needle – Little pressure required for injection Fast rate of administration – Prefer not to stand and slowly administer to patient by hand © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 10 2 User Requirements Easy to prepare and stable for user requirements – Prefilled needles ready to inject – Prefilled IV bags – Over pressure in the vial so that it is easier to remove – Syringes and IV infusions may not always be prepared in laminar flow hoods. This can be a source of microbial and particle contamination. – Dosages my be prepared 24 hours or more in advance. © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 10 3 Manufacturing Requirements Easy to prepare – Requires a limited number of weighing, addition, and pH adjustment steps – Requires few to no calculations – Requires no in-process release testing Does not interact with manufacturing equipment – No sticky residues affecting flow through filling needles – M-cresol is absorbed by silicone tubing and will lead to losses during hold times Easy to filter Easy to clean © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. 10 4 10 5 Summary ―Simple‖ injectable solutions have many rigorous requirements to ensure patient safety. Also have user and manufacturing specific requirements. Manufacturing methods, packaging and formulation components, and administration methods all present challenges to meeting sterility, stability, and particle free specifications. © 2010 Baxter International Inc. Baxter is a registered trademark of Baxter International Inc. Desirable Formulations Properties and Delivery Strategies Injectable Dosage Forms: Large Molecules USP workshop on Particle Size: Particle Detection & Measurement Rockville, Maryland Sandeep Nema, PhD Executive Director, Pfizer What is Biologics? • Biologics = Biopharmaceuticals (in Europe) ~ Biotherapeutics • Biologics comprise a heterogenous group of pharmaceutical products which are derived from living organisms, e.g.: • • • • • • • • Recombinant therapeutic proteins Immunoglobulins (antibodies) Peptides Oligonucleotides Vaccines Blood and blood components Somatic cells Gene therapy • Biologics can be composed of: • • • • • Sugars Proteins Nucleic acids Complex combinations of these substances May be living entities such as cells and tissues • Biologics • Produced by biotechnology methods and other technologies • Isolated from a variety of natural sources (microorganisms, animals, humans, plants) US Regulatory Definition of a Biologics Public Health Service (PHS) Act PHS Act § 351(i); 42 U.S.C. § 262(i) ―Biological product‖ means a virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component or derivative, allergenic product, or analogous product, or arsphenamine or derivative of arsphenamine (or any other trivalent organic arsenic compound) applicable to the prevention, treatment, or cure of a disease or condition of human beings Regulatory review based on 1991 CDER/CBER Inter-center Agreement and 2003 CDER/CBER Reorganization No Single Universal Classification of BioTx BioTx can be grouped or classified based on a broad variety of attributes: • Molecular Weight (MW): • MW < 500 – small molecules • MW >1,000 – medium molecules • MW > 5,000 - 10,000 – large molecules • Small molecules SAR may follow the Lipinski Rule of Five; BioTx – no analogs of the Rule of Five • Chemistries and the level of structural complexity: • BioTx are usually (not always) biopolymers built from amino acids, nucleotides, saccharides • Conjugates of large molecules with medium size (CovX) or small molecules (PEG) • Manufacturing or source of the material: • Small molecules are made by well understood and controlled chemical synthesis • Proteins (including antibodies) are made by less controlled fermentation • Cell components • Cells or tissues • Regulatory cutoff in the US (may be different in other countries): • Peptides and oligonucleotides fall under NDA • Proteins and antibodies – under BLA • Functional class • Enzyme • Antibodies • Hormones • Others • IMS classification Small Molecules vs. Therapeutics Small Molecules Chemical entity Biotherapeutics Small molecule, most NCEs Mostly therapeutic proteins: MAb, Usually prepared by genetic recombinant methods in cells MW < 1 kDa Large molecular weight e.g. MAb MW ~ 150 kDa Half-life Usually short (< 24 h) Generally long, e.g. 21 days in some MAb Route of administration Oral usually IV or sc usually Immunogenicity Usually low - anaphylactic reactions uncommon Can be immunogenic even if fully human: anaphylactic/oid reactions Toxicology data Animal toxicology/efficacy data useful for human Animal models (AEs and tox) not always predictive (Complexity) studies Drug interactions Possible, e.g. via CYP450 enzymes Very uncommon Selectivity Can act on other receptors at higher doses Selective for target regardless of dose (larger functional effects?) Volume of distribution May be much higher than ECF Limited to plasma volume for Ab Active metabolites Possible and can be many None 110 Typical Small Molecule vs Biologic Therapeutics Structure and Size Comparison Small molecule* Structure Compound/ function Coumadin: BMS; Biologic* MW 308.33 MW (Da) Compound/ function 204.22 Tryptophan: Amino acid Structure HC C C HC Anticoagulant NH C HC CH NH2 OH CH C CH2 C O Amoxil: GSK; 419.45 5808 Bacterial infection Singulair: Merck; Insulin (Humulin:Lilly) Diabetes 608.18 22124 GH deficiency Lipitor:Pfizer; Lipid lowering agent 1209.42 ~150000 Representation of insulin hexamer structure from www.biotopics.co.uk/ as/insulinproteinstruc ture.html hGH (Pfizer: Genotropin) Asthma Included only as a molecular size reference (CFK drawing) mAb (Humira: Abbott) RA Representation of human growth hormone structure from Expasy Representation of a general monoclonal antibody structure (Pfizer drawing) DIA *Reference: Molecule information from Physicians Desk Reference, Thomson LARC/ EIRGM Publishing, unless otherwise noted. 2008 What is considered a Large Molecule? • Biologics • What about complex synthetic molecules, with or w/o modifications, where there is heterogeneity? • Oligonuceotides • RNAi • Product-related substances Molecular variants of the desired product formed during manufacture and/or storage which are active and have no deleterious effect on the safety and efficacy of the drug product. These variants possess properties comparable to the desired product and are not considered impurities. Example in many mAbs 20-40% deamidated species; various glycosylated forms Molecular variants Heterogeneity Glycoforms 113 IgG Heterogeneity – Simplified Example The # of variation sites in each half-antibody × the number of possible variations at each site= 2 × 6 × 4 × 4 × 5 × 5 × 2 = 9600 possible states. (9600)2 ≈ 108 possible states (assume each half independent) Ref: Kozlowski and Swann, Advanced Drug Delivery Review, 58(5-6), 707-722, 2006 114 Generic Formulation Ingredients • Limited excipients are used in the formulation of injectables and only a subset for biologics • Approximately 50:50 Liquid vs lyophilized dosage forms Ingredient Purpose Examples Surfactant Reduce aggregate and particle formation Tween 80, Tween 20, Pluronic Cryo/lyo-protectants Protect damage during freezing or drying Sucrose, trehalose Buffers Maintain pH Histidine, succinate, citrate, phosphate Others as needed Salts, Antioxidant, chelators, preservatives NaCl, Methionine, EDTA, phenol/cresol Manufacturing Processes – Drug Product High level overview www.germes-online.com Excipient addition Small molecule API Mixing/blending Biologic Sterile filtration Compression Fill/Lyophilize /Finish Fill/Finish Oral Tablet Clip art: www.aperfectworld.org Sterile Liquid DIA LARC/ EIRGM 2008 Sterile Lyophile Typical Protein Sterile Biologic Drug Product Manufacturing Process API stored at low temp Bulk thawing Prepare diluent Clarifying filtration (0.45µm) Sterile filter (0.2µm) Mix Sterile holding vessel IPC: protein concentration Add diluent Mix IPC: protein conc, bioburden & pH Sample: endotoxin, bioburden Bioburden reduction IPC: prefiltrarion bioburden, conc Sterile filter (0.2µm) Holding vessel IPC: Bulk Sterility Fill & finish DIA LARC/ EIRGM 2008 Example: Release & Stability Testing, Sterile Solution Injectable DP Attribute Biotherapeutics Method Small Molecule Method Color Clarity or Degree of Opalescence Visual appearance Visual Appearance Visual appearance Visual Appearance Visual Inspection pH Osmolality Volume in container Label Claim Identity Purity Visible Particles pH Osmometry Volume Absorbance at 280 nm or HPLC Peptide Mapping(Primary ID method) CGE (Reducing) / SDS-PAGE (Reducing) - fragments CGE (non-Reducing) / SDS-PAGE (non-Reducing) - aggregate SEC - aggregate Binding ELISA Cell Based Bioassay Purity Purity Potency/Activity pH Osmometry Volume HPLC* or spectroscopy (typically a single method) Safety Endotoxin Endotoxin Safety Safety Sterility Sub-visible Particulate Matter Sterility Particulate Matter Acidic species Isoelectric Focusing, cIEF (deamidation) Oxidation Lys-C map followed by RP-HPLC Coloration Spectrophotometer or using a 96 well plate method at fixed wave-lengths Comparing to standards - Munsell color standard - Gardner solution color standard - Tristimulus - Ph. Eur. 2.2.2 Can be an indication of potential interactions What Opalescence can or can’t tell? • Opalescence monitored and quantiated – Comparison to reference (Ph. Eur. 2.2.1 Clarity and degree of opalescence of liquids). No analogous USP test – Nephelometry – Turbidimetry – Light Scattering using 96 well plate – High through put adaptations • Colored solutions present a challenge for measurement of opalescence since even moderately colored solutions provide a negative interference. should be evaluated with ratio turbidimeters or nephelometers with ratio selection. • Opalescence can be an early sign of problems • Benign Opalescence especially at high concentration protein formulations IgG1 24 mg/mLin a buffer, 150 mM NaCl, and PS-80, pH 6.0 in glass vials Reference III standard [18–30 nephelometric turbidity units (NTU)] Following filtration through a 0.22 μm sterilizing filter, the opalescence remained unchanged Characterization of Opalescent Solution -No change in dimer conc - Zav hydrodynamic radius slightly higher with increase in protein conc - Viscosity increases f(conc.) - Non-ideal behavior negative B22 values net attractive forces between Protein molecules - No changes in biophysical characteristics - Ionic strength dependent Increase in opalescence correlates to molecular self-association of mAb Attributed opalescence of an IgG1 formulation to Rayleigh scatter and indicated that opalescence is not caused by noncovalent association N. Wang et. al., ―Opalescence of an IgG1 Monoclonal Antibody Formulation is Mediated by Ionic Strength and Excipients‖, BioPharm International, April 2009 121 Opalescence and Turbidity Mahler et al, EJPB, 59, 407 (2005) Opalescent Solution and Particles Ph.Eur. IV Stir shake USP Stir shake IV Mahler et al, EJPB, 59, 407 (2005) Utilization of Orthogonal Techniques like FFF, AUC, DLS No PS80 0.45um filter +PS80 Visible Particles Intrinsic Reversible or irreversible aggregation Precipitation (solubility, degradants, interactions) Extrinsic Environmental particles Shedding from plastic, stoppers or flakes from glass Pharmacopoeial Requirements: Extrinsic Particles USP <1> Injection: ―essentially free from visible particulates‖ or ―essentially free from particles of foreign matter that can be observed on visual inspection‖ Ph Eur. Injections: ―Solutions for injection should be clear and practically free from particles‖ JP: Injections should meet the requirements of the Foreign Insoluble Matter Test <6.06> and Insoluble Particulate Matter Test <6.07>. ―clear and free from readily detectable foreign insoluble matter‖ Focus has been on extraneous particles. USP and EP define ‗particulate matter as extraneous mobile undissolved particles, other than gas bubbles, unintentionally present in the solutions‘. Ph. Eur. Monograph on Monoclonal Antibody ―Monoclonal Antibodies for Human Use‖ monograph requires such products to be ―without particles‖. Inconsistent No threshold size or number provided What is Essentially or Practically Free of Particles? - DAC-5 - PF Proposal Characterization - Visibility Clear & essentially particulate-free Possible presence of non-visible aggregates Presence of particulates Size distribution (light obscuration) Morphological evaluation Composition analysis after separation Hazy/turbid UV Turbidimeter May use standard solutions NTU ~0 <2 <20 <200 <4k <10k 127 Wei Wang Ophthalmic Particles The USP and JP describe topical ophthalmic product requirements while the Ph. Eur. does not. USP 32 <789>: ―Particulate matter consists of mobile, randomly sourced, extraneous substances, other than gas bubbles, that cannot be quantitated by chemical analysis because of the small amount of material they represent and because of their heterogeneous composition. Ophthalmic solutions should be essentially free from particles that can be observed on visual inspection.‖ Light obscuration or microscopic particle count test as per USP <788> are required with more stringent limits applied. Drops (per mL basis vs per contianer) Ointments Injections JP XV General Test 18 <6.08>: ―Ophthalmic solutions prepared as aqueous solution and aqueous vehicles attached to Ophthalmic Solutions to be prepared before use should be clear and free from foreign insoluble matter when inspected with the unaided eye‖. A limit for Insoluble Particulate Matter is described in JP <6.08>. Sub-visible particles Major parts are harmonized across USP, EP and JP though some key differences remain 1. USP defines large volume injection as those containing >100mL of DP while Ph. Eur. and JP consider 100 mL product as large volume injection and requiring a more stringent sub-visible PM limit. 2. Currently, USP exempts injection products intended for subcutaneous (sc) and intramuscular (im) injection from the requirements of <788>. No such exemptions are allowed in Ph. Eur and JP, but Ph. Eur. recognizes that a higher limit may be appropriate for these products. 3. Radiopharmaceutical preparations are exempt from these requirements and so are the preparations for which the label states that the product is to be used with a final filter provided that the filter delivers a solution that complies with the Ph. Eur. sub-visible particles test (2.9.19) Pharmacopeial Forum article suggesting that the current PM limit should be more restrictive (not based on extensive biologics product analysis) Should one monitor other Sub-visible sizes? For protein drug products, particles in the size range of 1 to 10 microns (in addition to 10 and 25 micron size range) should also be quantitated as they have the potential to cause immunogenicity. Immunogenecity depends on Route of administration ID >SC / IM > IV Little evidence between particles and immunogenecity / nAb or safety FDA is asking this information for IND and BLA Good practice during development (e.g. 2, 5, 8 micron sizes) 130 Scientific Data to Address Following Questions regarding 2-10 micron particles? • What are the various aggregation pathways under different stress conditions of heat, light, freeze-thaw, agitation, etc? Are different aggregates generated and what is the influence when various stresses are combined? • What is the definition of aggregate? Is 5-mer an aggregate? • Is there a connection between the type of aggregate and immunogenicity or other adverse events (AE)?. • Understanding the relationship between the amount of aggregate and AE. In most cases the expected amount of aggregate of size 0.1 to 10 micron is expected to be in the range of 0.0002 to 0.01% (ref) • Improving the analytical methodology to measure and quantitate particles below 10 micron. Current instruments like HIAC, Coulter Counter, Micro Flow Imaging (MFI), Particle Insight, Flow Particle Imaging Analyzer, etc give variable and different results likely due to differences in the operational principles. • Identifying and distinguishing extraneous particles like silicone oil, and foreign matter from the protein particles so that relative proportions of each type of particles can be determined. Instruments like Raman microscopy (RapID), FTIR microscopy, electron microscopy with elemental analysis, etc are available but they have significant limitations in terms of throughput. 131 Identification of Particles is Important Important to understand the cause of particle formation October 2010, Procrit (Epoetin Alfa) Injection Presence of Particulate Matter: Extremely thin glass flakes (lamellae) have the potential to be present in Procrit (epoetin alfa) vials. Flakes result from interaction of the formulation and the glass over the shelf life of the products 132 Protein and Other Particles - ID MFITM uses morphology Nanoparticle Tracking Analysis RAP ID (Berlin) uses Raman Spectroscopy Isolation at smaller sizes difficult - FTIR or Raman can be used on isolates Other techniques for isolated particle ID (or on filter) - EDX - NMR - XPS - TEM, SEM, AFM - CD, DSC - Protein specific dyes Protein Particles Pictures using MFI D. K. Sharma et al, ―Micro-Flow Imaging: Flow Microscopy Applied to Sub-visible Particulate Analysis in Protein Formulations‖, The AAPS Journal, online published 2June 2010 Impact of Container/Closure HIAC Counting of particles Significant difference (due to silicone oil droplets ?) What is a relevant count / limit for particulates ? S.K. Singh et. al., ―An industry perspective on the monitoring of subvisible particles as a quality attribute for protein therapeutics‖, J Pharm Sci., 99 (8), 3302, 2010 Processing and Particles Potential Particle Formation During Biologics DP Manufacturing • • • • • • • Freezing and thawing Stirring during formulation Transfer of solution via pump Filtration Filling through Needle Transport and shipping Contact with various material of construction (SS, plastic, teflon, filter membrane) • Residual disinfectant or sterilant like peroxide • Container closure interactions – Glass flaking; silcone oil protein interactions; metal protein interactions Air-water or ice interface Cavitation Shear? Compatibility of formulation with material Intrinsic Particles At least 12 products have been approved in US and EU where visible protein particles are generated over time but their amount in relation to the total drug (protein) is negligible. Arzerra (ofatumumab) : Colorless solution and may contain a small amount of visible translucent-to-white, amorphous, ofatumumab particles. However, the solution should not be used if discolored or cloudy, or if foreign particulate matter is present. Vectibix (panitumumab): solution may contain a small amount of visible translucentto-white, amorphous, proteinaceous, panitumumab particulates Erbitux (cetuximab): solution may contain a small amount of easily visible, white, amorphous, cetuximab particulates Stelara (ustekinumab):colorless to light yellow product that may contain a few small translucent or white particles. We can expect more! Dosage and Administration • Qualify filters - Demonstrating that filtration of the solution (via in-line IV filters) results in removal of these protein particles when product ages - Included in Dosage and Administration Instruction - Shipping and other stresses during handling taken into account • All approved products validated that dose of drug can still be administered • How does one perform visual inspection of these products? - visual inspection standards have to be created so that the inspectors can qualitatively compare the number and size of these particles. Concerns associated with the presence of particles that develop over time, while the product is in distribution or storage, must be addressed during development via formulation selection and stability testing. In some cases, precautions and specific instructions-for-use may be included product labeling, for example use of in-line filters at time of administration. What happens to product In-vivo? • Upon administration to the patient, the protein is – In a different environment (pH, buffer, ionic strength) – Protein binding – Higher temp (37C) for minutes to days to months depending on the half-life • What changes can occur? – Aggregation, particle formation, ppt – Oxidation, acidic species formation Data from Genentech (Ref. J. Liu) Time in Serum at 37ºC SEC Results Weeks % HMWS % Main % LMWS 0 2.0 97.4 0.6 1 4.4 92.9 2.7 4 7.8 86.0 6.2 What do we know? This is just beginning to be studied. There is lot to learn Hard to study in-vivo Need complex analytical (separation, detection) techniques Can monitor gross changes only How do these changes link to safety and efficacy? Challenges and Unanswered questions? • Is there a relationship between intrinsic protein particles and safety? Is there a particle size influence – No to maybe to potentially to yes – Safety of the marketed products (in terms of nAb) • If the intrinsic particles are present in a product , is validating in-line filter or a syringe filter OK? • How do you determine and quantitate intrinsic protein particles in suspension / dispersed products? • Many studies formulation, processing done at lab scale – not in an aseptic environment, where it is hard to avoid extrinsic particles. • Not covered are challenges with the visual inspection, what is considered ‗essentially free‘, validation of automated inspection systems where there product is foams / has bubbles? • Material limitations, hence a Stage appropriate controls Acknowledgements Satish Singh Carol Kirchhoff Typical mAb Analytical Methods: Release and Characterization DRUG SUBSTANCE Appearance pH UV IEF Peptide Map SDS-PAGE, reducing SDS-PAGE, nonreducing HPLC- SEC Carbohydrate Size Profiling DNA rProtein A ELISA HCP ELISA (commercial kit) SDS-PAGE, silver stain Binding ELISA Bioburden Endotoxin Mycoplasma Virus Testing Functional Bioassay HCP ELISA (cell line specific) CHARACTERIZATION DRUG PRODUCT Appearance Strength (UV) IEF Peptide Map SDS-PAGE, reducing SDS-PAGE, nonreducing HPLC- SEC Endotoxin Particulate Matter Sterility Binding ELISA Functional Bioassay Additional Impurity Assays as needed: •Oxidation •Deamidation (iCE) •Fragment MALDI-TOF Mass Spec Electrospray Mass Spec LC/MS, MS/MS AUC CD Biacore Fluorescence Impurity Isolation/Enrichment Impurity Bioactivity N-Terminal Sequence C-Terminal Sequence Free Thiol Western Blotting Alternative HPLC Assays Additional CE Assays Amino Acid Analysis 2D Electrophoresis Carbohydrate Charge Profiling DSC Phase appropriate methods – not all methods available at early stages Biologics – PHS Act Definition • Monoclonal antibodies for in-vivo use in the prevention or treatment of disease. • Proteins intended for therapeutic use, including cytokines (e.g. interferons), enzymes (e.g., thrombolytics), and other novel proteins. • Immunomodulators (non-vaccine and non-allergenic products) intended to treat disease by inhibiting or modifying a pre-existing immune response • Growth factors, cytokines, and monoclonal antibodies intended to mobilize, stimulate, decrease or otherwise alter the production of hematopoietic cells in vivo • Combination products comprise of a biological product component with a device and/or drug component. • Cellular products, including products composed of human, bacterial or animal cells (such as pancreatic islet cells for transplantation), or from physical parts of those cells (such as whole cells, cell fragments, or other components intended for use as preventative or therapeutic vaccines) • Vaccines • Allergenic extracts used for the diagnosis and treatment of allergic diseases and allergen patch tests • Antitoxins, antivenins, and venoms • Blood, blood components, plasma derived products (for example, albumin, immunoglobulins, clotting factors, fibrin sealants, proteinase inhibitors), including recombinant and transgenic versions of plasma derivatives, (for example clotting factors), blood substitutes, plasma volume expanders, human or animal polyclonal antibody preparations including radiolabeled or conjugated forms, and certain fibrinolytics such as plasma-derived plasmin, and red cell reagents 143 Identification of Particles Important to understand the cause E.g. generation of particles during freeze-thaw Photo-degradation of the product and generation of particles Particles •Excipient / drug interactions •When the B2-coated stopper was first used, the xxx drug product formulation contained polysorbate 80. After the formulation change that removed this surfactant, fiber-like particles were seen in some final container lots. An investigation into the phenomenon revealed that a silicon oil coating applied to the stoppers at Mfg site caused the particles to form in the absence of polysorbate 80. Two development runs were filled on to establish whether unsiliconized stoppers could be used for manufacture of drug product that did not contain polysorbate 80. No particles were observed for these two lots, and the product passed the critical release specifications. Based on this evidence, the use of unsiliconized stoppers for product xxx final container production was implemented for all subsequent lots. Aggregates – Classification based on Size 146 USP Workshop on Particle Characterization, 8-10 December 2010 Analytical Techniques for the Forensic Analysis of Particulate Matter Ronald G. Iacocca PhD Senior Research Advisor Analytical Sciences R&D Product Research and Development Outline of Presentation New technologies for measuring foreign particulate matter Advantages and challenges of imaging technologies Advanced spectroscopic techniques for looking at isolated particles Case study 3/25/2011 File name/location 148 Copyright © 2010 Eli Lilly and Company Disclaimer This information is not intended to suggest regulatory policy or QC procedures for the release of clinical trial or market product 3/25/2011 File name/location 149 Copyright © 2010 Eli Lilly and Company Current Regulatory Policy USP <788> • 6000 particles 10-25 µm • 600 particles >25 µm • No visible particles, ―essentially particle free‖ Technology used • HIAC or light obscuration techniques • Membrane microscopy particle counting • Manufacturing – automated vision systems combined with human inspection 3/25/2011 File name/location 150 Copyright © 2010 Eli Lilly and Company Current Techniques Advantages • Very robust for the defined size ranges • Well established and understood Disadvantages • No shape information with light obscuration • Particles may be a gel or semi-solid, and will not be visible on a membrane filter • Particles may be transparent • Difficult to determine root cause 3/25/2011 File name/location 151 Copyright © 2010 Eli Lilly and Company Scenario: Subvisible Count is Exceeded, or Visible Particulates are Observed New technology that can provide insight into the root cause of particle generation Dynamic Image Analysis 3/25/2011 File name/location 152 Copyright © 2010 Eli Lilly and Company Dynamic Image Analysis Key 1 dispersed particles 2 device for control of particle motion 3 measurement volume 4 light source 5 optical system 6 depth of field 7 image capture device 8 image analyser 9 display Detection Zone 3/25/2011 File name/location 153 Copyright © 2010 Eli Lilly and Company Typical Images Obtained 3/25/2011 File name/location 154 Copyright © 2010 Eli Lilly and Company Foreign Particulate Matter 3/25/2011 File name/location 155 Copyright © 2010 Eli Lilly and Company Protein Aggregates Equivalent Circular Diamter Measurement Range: 1µm to 1827µm Cell Depth: 100µm 3/25/2011 File name/location 156 Copyright © 2010 Eli Lilly and Company Foreign Particle 3/25/2011 File name/location 157 Copyright © 2010 Eli Lilly and Company Prior to Compositional Identification Particulates Observed Are images available Particle Density Many particles or one singular occurrence Multiple Lots 3/25/2011 File name/location Persistent? Formulation Instability? Glass incompatibility Materials shedding particles (MOC) Filters? Particle Shape Sharp corners: no solubility Fluffy Corrosion product or ppt. Particle Size Expect: Small more numerous Large one or two Structural Rigidity Structural Material (glass, metal, polymer, API)? Residue? Color Helpful, but may be misleading. Color = f(size) 158 Copyright © 2010 Eli Lilly and Company Investigation Portion of Particulate Investigation: Identification of Composition Characterization portion of particle investigation Use more advanced tools Working with single particles rather than ensemble techniques 3/25/2011 File name/location 159 Copyright © 2010 Eli Lilly and Company Solid State Characterization of Materials 3/25/2011 File name/location 160 Copyright © 2010 Eli Lilly and Company Problem Statement Development formulation tank was swabbed. Particulates were found • Analyze the swab to determine composition • Find source of slight residue 3/25/2011 File name/location 161 Copyright © 2010 Eli Lilly and Company FTIR Analysis Preliminary FTIR analysis of the particles showed that the unknown material was PTFE Swabs were submitted for additional analysis 3/25/2011 File name/location 162 Copyright © 2010 Eli Lilly and Company Scanning Electron Analysis – Morphology and Elemental Composition 3/25/2011 File name/location Element Wt % At % CK OK FK MgK AlK SiK PK MoL SK ClK KK TiK CrK FeK NiK 44.32 14.24 06.85 00.53 01.57 05.47 00.67 01.05 00.32 01.94 00.16 01.83 04.96 12.60 03.48 64.34 15.52 06.29 00.38 01.02 03.39 00.38 00.19 00.17 00.96 00.07 00.67 01.66 03.93 01.03 163 Copyright © 2010 Eli Lilly and Company So, In the Midst of the Unknown, Analyze More! L01336p49B001.spe: blank swab 2005 Apr 5 Al mono 49.8 W 194.0 µ45.0° 224.00 eV 3.1569e+004 max Company Name L01336p49I001.spe: swab from Alimta tank 9.34 min 2005 Apr 5 Al mono 49.8 W 194.0 µ Su1s/Point3: blank swab/1 (SG3) 4 L01336p49B001.spe x 10 -F1s Atomic % C1s 58.0 F1s 25.2 O1s 13.9 Si2p 2.7 Cl2p 0.2 5 -C1s Atomic % C1s 71.5 O1s 28.5 L01336p49I001.spe x 10 -O1s 6 3 2.5 3 2 1 -Cl2s 1200 1000 800 600 Binding Energy (eV) 400 200 0 0 1400 1200 1000 800 600 Binding Energy (eV) 400 -Cl2p -Si2s -Si2p -F2s 1 0.5 0 1400 -C1s c/s -O KLL -C KLL c/s 2 -O1s -O KLL -O KLL -F KLL2 -F KLL1 -F KLL 4 1.5 9.34 min Su1s/Point4: swab from Alimta tank/1 (SG3) 4 3.5 Company Name 5.1673e+004 max 200 0 Elemental analysis shows C, Cl, O, Si, F but no metallic elements 3/25/2011 File name/location 164 Copyright © 2010 Eli Lilly and Company Final Analysis – Time of Flight Secondary Ion Mass Spectroscopy Summary of analytical data: • Only showed elements of PTFE 3/25/2011 File name/location 165 Copyright © 2010 Eli Lilly and Company Conclusion of Case Study Multiple particle present, which is always found. Whenever stainless steel is swabbed, stainless steel particles are detected Stainless steel particles were coated with an approved lubricant that had a structure similar to PTFE, hence different answers were obtained with instruments that had different sampling depths. All of the data were ―correct,‖ one had to realize that this was a multivariate problem. 3/25/2011 File name/location 166 Copyright © 2010 Eli Lilly and Company Summary New technologies will enable more detailed particle analysis Numbers of particles in size ―bins‖ is insufficient for today‘s drug development/drug manufacturing arena • Must look at aspects such as: • – – – – Frequency of occurrence Shape Color Kinetics – where to they appear in the process For chemical analysis of particles • Spectroscopic techniques can provide a wealth of information on composition and root cause if the operating principles are understood 3/25/2011 File name/location 167 Copyright © 2010 Eli Lilly and Company The Development of Particle Size Reference Standards G Rideal and J Storey Whitehouse Scientific Ltd, Waverton, Chester, CH3 7PB, UK Summary 1. The evolution of particle size standards 2. The importance of producing representative standards Spatula sampling versus spin riffling 3. The certification of BCR ‘Mirror’ standards 4. Early laser diffraction results – manufacturers and end users 5. A new 19 – 190 micron opaque microsphere standard (a) Primary particle size results (b) Laser results (manufacturers and end users) 6. Multimodal standards – image analysis and sub-micron 7. Sieve calibration microspheres 8. Conclusion Obtaining a representative sub sample Sampling a 15 – 150 micron bottle by spatula First sample from 10g bottle Second sample Producing ‘single shot’ reference standards The spinning riffler Masterbatch in Sub samples out Subdivisions from 8 - 100 A continuous 100 stage spinning riffler Contra-rotating powder disperser Rotating feeder Collecting pots Size distribution in the sub-samples is independent of the position on the riffler (100 stage batch riffler) Subdivision strategy for a 1000Kg Clear glass standard (15 – 150 microns) 1000 Kg 320 x 2.5g samples for analysis Up to 4 million bottles @ 0.25g 25 Kg 1/100 = 250g 1/100 = 2.5g Series 1 Series 2 Series 3 Series 4 Series 5 Validation of the spinning riffler 2.5g bottle-to-bottle variation (15 – 150m clear glass standard) Series Number 1 2 3 4 5 6 Averages Uncertainty* (+/-) d (0.1) 37.33 37.63 37.58 37.70 37.54 37.52 37.55 0.26 d (0.5) 63.17 63.36 63.17 63.16 63.08 62.93 63.14 0.28 d (0.9) 92.23 92.25 92.02 92.00 91.87 91.79 92.03 0.36 * Confidence level not less than 95% Courtesy of Malvern Instruments Tests 57 54 57 55 57 53 Certification of the BCR ‘Mirror’ standards 3 – 30 micron standard 10 - 100 micron standard For clear glass microspheres, laser diffraction results depend of diffraction theory used 1994 laser diffraction data for the 3 - 30 micron standard Fraunhofer theory Mie theory Errors increase with decreasing size Comparison of Mie and Fraunhofer scattering theory for 3 – 30m clear glass microspheres Results for Mie theory Results for Fraunhofer theory Note. Both theories give identical results for opaque standards (Courtesy of Malvern Instruments) Laser diffraction data for a 3 – 30 micron clear glass reference standard - round robin test (a) Benchmark results (2006) (b) Results from 60 labs (PACQS) NB. Participating laboratories used Mie scattering theory The large scatter of results suggests that insufficient attention to dispersion was paid by many of the laboratories Laser diffraction data for a 10 – 100 micron clear glass reference standard - PACQS round robin test (2006) Much closer results than for the 3 – 30 micron standard - indicates good sampling and dispersion New 19 – 190 micron opaque microsphere standard spin riffling results from 550kg master batch Table 1. Subdivision accuracy: 19 – 190 micron opaque standard (Sympatec Helos) Percentile 10 25 50 75 90 Size (microns) 37.4 46.9 61.0 74.7 87.8 1.0 0.9 0.8 0.7 0.8 Uncertainty (+/-%) 54 tests (Courtesy of LGC) Results for 1g bottles – analysed dry Fine structural detail introduced in the 19 – 190m opaque standard High resolution image analysis Reducing resolution replicates laser Evidence of fine structure from laser analysis 19 – 190 micron standard – primary analysis results Image analysis - ShapeSizer Coulter Counter – 100 tests Image analysis - Malvern Mean and uncertainty values for 19 – 190mm silver coated microsphere standard Percentile 5 10 25 50 75 90 95 ShapeSizer Size (m)1 Uncertainty (+/-%) 36.02 10.55 40.51 8.49 49.31 5.64 65.80 6.47 72.91 3.20 85.75 4.66 92.65 8.27 Coulter2 (av. 50 tests) Uncertainty (+/-%) 34.3 4.52 39.3 4.78 49.1 7.66 64.5 6.98 74.7 6.93 85.6 9.14 92.4 9.59 Malvern Morphologi3 Uncertainty (+/%)) 33.9 1.3 38.1 0.84 47.3 1.10 64.6 0.67 73.2 1.69 87.4 1.40 100.4 2.28 1. 5 x 10,000 particles, 2. 5 x 60,000 counts, 3. 5 x 95,000 particles Notes. 1. The uncertainty levels can be reduced by increasing the particle count 2. Sub-sampling such low corresponding weights may also lead to errors 19 – 190 micron standard - laser diffraction results Laser diffraction analysis of a 19 – 190 micron opaque standard Percentile 5 10 25 50 75 90 95 Sympatec (Dry) Beckman (wet) 32.2 37.4 46.9 61.0 74.7 87.8 97.0 34.5 38.8 49.3 63.0 75.7 88.3 97.6 Horiba (wet) 38.1 42.2 50.5 61.3 74.7 88.6 100.1 Horiba (dry) 40.8 44.8 51.9 61.6 73.8 87.2 97.7 Fritsch (wet) 34.1 38.8 48.1 61.1 76.3 91.4 100.6 Malvern (wet) 33.3 38.2 48.6 61.7 75.6 88.2 95.7 PACQS1 (15 labs) 37.9 1. A quality audit scheme run by LGC 62.2 89.2 19 – 190 micron opaque standard – repeatability and reproducibility (laser diffraction analysis) (a) Repeatability 5 repeats - Sympatec (b) Reproducibility 15 labs - PACQS Remarkably consistent results whether analysed on the same instrument or in 15 labs using a range of instruments 19 – 190m Opaque Standard comparison of methods Excellent agreement with the primary methods A 500 – 2000m Multimodal Image Analysis Standard Comparison of Retsch CAMSIZER® and Haver CPA cumulative data with the certificated values from a 500 – 2000mm Image Analysis Standard (Multistandard) Percentile Certificate data (microns) Haver CPA (microns) Retsch CAMSIZER (microns) 5 715 730 721 10 780 790 781 25 897 905 897 50 1101 1125 1123 75 1334 1335 1346 90 1652 1660 1670 95 1816 1827 1846 Performance in analysing the individual peaks in a 500 – 2000mm Image Analysis Standard (Multistandard) Peak # 1 2 3 4 5 6 7 8 592 758 858 1098 1301 1449 1640 1884 Certificate (m) 610 750 860 1100 1300 1400 1650 1860 Haver CPA (m) 600 760 865 1110 1310 1430 1660 1865 Retsch CAMSIZER m 500 – 2000m Multimodal Image Analysis Standard Effect of sample weight/number on results (Haver CPA) (a) Reducing weight (b) Repeatability for 20g samples Reducing count from 150,000 to 15,000 does not significantly affect the results Sub-micron multimodal standard CPS Disc Centrifuge The ‘line start’ principle: 3 latex blend 900nm 380nm 190nm Inject sample Sub-micron multimodal standard (continued) CPS Disc Centrifuge Separation and analysis of the 3 latex blend 190nm 380nm 900nm Sub micron challenge test standard 10 peak multimodal standard - from 1.5 microns to 0.1 microns Single peak analysis aligns with ‘Multistandard’ Ensures NIST traceability of the results Sieve calibration microspheres Microspheres certified Calibration graph produced For NIST traceable certification of sieves from 20 – 3350 microns Conclusions 1. Particle size standards have to evolve to meet the demands of the latest technology 2. Monosized latex standards for calibrating single channels in a Coulter Counter are not so suitable for laser sizers or sieves . 3. Irregular shaped standards, eg BCR quartz, give different results depending on the method of analysis 4. Spherical reference standards should give the same results irrespective of the method of analysis 5. However in lasers, the diffraction theory used can influence the size, especially for clear glass microspheres at small sizes 6. Opaque spherical standards do not depend on diffraction theory 7. High resolution methods eg. image analysis or centrifugation require multimodal standards to challenge the resolution 8. To guarantee long term supplies and minimise subsampling, large master batches and single shot bottles are to be preferred NIST Perspective on Standards for Subvisible Particles (with an Emphasis on Protein Therapeutics) Dean Ripple Process Sensing Group NIST, Gaithersburg USP Workshop on Particle Size: Particle Detection & Measurement December 8, 2010 Outline • Overview of reference materials & their properties • Candidate reference materials • Instrumental effects & relationship to reference material choice • Pathways to accurate measurements • Planned activities Acknowledgments • • • • • • Josh Wayment Germarie Sanchez-Pomales Michael Carrier Dick Cavicchi Rebecca Zangmeister Michael Tarlov Vision Goal 1. Establish repeatability for each instrument type for lowcontrast protein aggregates or surrogates • • • • • Test surrogate systems Round robin comparisons Identify need for reference materials or other instrument standardization Develop protein-based standards Promote consensus through appropriate standards Goal 2. Understand differences among instruments • • • • NIST-built light obscuration/light scattering apparatus Compare light obscuration and flow imaging in the 1 to 50 µm range. Extend comparison to Coulter counters, particle diffusion Document biases to enable informed changes to USP <788> <789>, etc. Goal 3. Support efforts in particle identification, correlation with immunogenicity Desirable Properties of Reference Standards 1. Irregular structure 2. Variable aspect ratio (width to length ratio) ranging from fiber to near-spherical 3. Small refractive index difference between particles & matrix fluid 4. Properties stable over long periods (years) 5. Properties stable with expected variations in use: mixing prior to use exposure to flow field shear variations in matrix liquid leaching from storage container 6. Viscosity of matrix liquid is in range of water to typical protein formulations (or variable) 7. Proper use is simple Existing NIST Reference Materials Particle Size Distribution Number Particle Type 1021 Glass bead 1003c Glass bead 1004b Glass bead 659 SiN 1978 ZrO grains 1982 ZrO spheroids 1984 WC/Co grains 1985 WC/Co spheroids 8632 Road dust Size Range (µm) 2 to 12 20 to 45 40 to 150 0.2 to 10 0.3 to 2 10 to 150 9 to 30 18 to 55 1 to 20 Limitations of existing standards: • No particles with low aspect ratios • No particles with low optical contrast • Existing standards have high density Diameter Number 1690 1961 Particle Type Polystyrene sphere Polystyrene sphere Size (µm) 1 30 Multiple diameter standards from other sources as well. Optical Properties Space Validate instruments over a range of optical particle properties that bracket optical properties of protein particulates Refractive Index Polystyrene Spheres Precip. CaF2 in CaCl2 solution Artificial Particles Aerogel fragments Length / Width Ratio Abraded ETFE Roughness Interaction of Diameter & Concentration Particle counts may be in error due to either: • direct errors in counting particles (e.g., particle too transparent to trigger count) • errors in particle size gives wrong distribution of concentration vs. size A single calibration with a ‗concentration vs. size‘ curve will only work provided the variation of concentration with size for the reference material is similar to that of the tested material OR the size uncertainty is much smaller than that of concentration Interaction Proportional to Slope of Concentration vs. Size Curve Particle concentration 1.10 Apparent error in concentration, c 1.05 1.00 0.95 0.90 0.90 Error in size, l 0.95 1.00 1.05 1.10 1.15 Particle size Typical protein particulates: 10% error in size propagates to 25% error in concentration Candidates for Particulate Standards Particle type Characteristic shape Typical size (µm) Precipicated calcium fluoride Irregular crystals 1 to 40 Aerogel Irregular crystals 1 to 20 Irregular, aggregated polymers Routinely <1, larger? Aggregate of nanoparticles Routinely <1, some larger Self-assembled polyions Sintered fumed silica Natural fibers Long cylinders, straight Diameters of 1 µm or or serpentine larger Engineered particles Any 2D shape <1 to >500 Abraded polymer Irregular forms <1 to 100 T or pH induced protein aggregates Irregular aggregates; irregular filaments <1 to >100 Artificially fixed protein aggregates as above as above Engineered Fibers Borrow from semiconductor manufacturing technology: • • Fabricated polymer films A single 150 mm wafer can produce 2x108 particles of area 40 µm2 Candidate system: SU-8 • Highly biocompatible • Submicron to mm length scales • Index of refraction 1.6 (Cavalli et al,J. of Comb. Chem., 2007, Vol. 9, No. 3) Advantages Disadvantages Any 2D shape Variable optical density Variable particle flexibility Particles are well defined Possibly expensive No irregular 3D shapes? Requires index matching liquid? An interesting possibility for standards for visible particles, as well NIST Approach for Engineered Fibers Recipe: • Spin coat and bake release layer on silicon wafer • Spin on 2 µm of SU-8 photoresist • Expose SU-8 layer through optical mask • Develop & bake SU-8 • Release Initial work: large, 2D particles Goal: small, textured particles NIST Center for Nanoscale Science and Technology (CNST) NanoFab Facility Optical Images of Particles Optical microscopy of SU-8 particle on Si wafer 340 m Particles in solution via microscopic flow imaging Abraded Polymer Particles: NIST Recipe ETFE polymer (alternating tetrafluoroethlyene & ethylene copolymer) has desirable properties: 1. Refractive index of 1.40 (very similar to protein adsorbed on wall from solution) 2. Very durable & tough 3. Can we make it look like a protein? ETFE roofing panels Recipe for preparation: (Eden Project, wikicommons picture) • Mechanically abrade to make wet slurry • Dilute with water + 0.1 % (w/v) surfactant • Filter & size selection by gravimetric sedimentation ETFE in water + 24 % sucrose (n = 0.03) ETFE in water (n = 0.07) Agitated IgG Protein Particulates 1. Induce particulate formulation in protein solution by varying temperature, pH, agitation, etc. 2. Stablize particulates by protein fixative, surfactants, buffer choice Are they stable? Does the particle geometry mimic natural particulates? Which morphology do we mimic? (variable scale) NIST Approach 1. Form aggregates by overnight agitation 2. Cross link with gluteraldehyde 3. Quench cross-linker 4. Remove excess cross-linker & initial buffer by dialysis 5. If necessary, filter or sediment out large aggregates 6. Formulate to stabilize aggregates: Choice 2: Freeze dry with added sugar. Optimal surfactant to add? What happens to hydrated aggregates? Choice 1: Very high sucrose concentration: 60% sucrose by weight is soluble at room temperature; yet will form a glass of the solution (not the lyophilized product) at -80 °C Optical Method 1: Flow Microscopy • Commonalities of instruments: digital capture and analysis of particulates flat flow cells typical range of 1 to 100 µm • Proprietary features: particle identification algorithm optical light source, camera, objectives, apertures Contrast & spatial resolution depend on proprietary choices Brightfield Images: Phase Contrast of Out-of-Focus Images • An out of focus image will be shaded either light or dark due to diffraction of light by a particle—similar to phase contrast microscope. • Image contrast due to out-of-focus condition may be greater than inherent image contrast for in-focus image! • Apparent size of object will depend definition of particle edge as ‗dark‘ or ‗light‘ contour. • Detection will depend on choice of threshold value and whether phasecontrast effect favors detection or not. • Particles imaged in flow cells will have this effect to some extent Same particle, different focus (20x, 7.2 µm shift in focus): 20 µm Optical Method 2: Light Obscuration Particle passing through light beam reduces optical transmission • Diffraction effects for small particles must be accounted for • Scattering cross section depends on particle morphology Existing instruments: • well validated & key part of USP <788> • question of sensitivity to particles of low refractive index mismatch Improvements in sensitivity possible? NASA Kepler Mission—find extrasolar planets by obscuration of star light Sensitivity: 10-5 change in transmission Price: $600 Million Light Obscuration: Refractive Index of Particle 4 Aspect ratio = 4 (prolate spheroids), Wavelength 633 nm n = 0.1 0.05 0.02 0.01 Extinction efficiency 3 2 1 0 1 10 Equivalent diameter, µm 100 Light Obscuration: Effect of Wavelength 4 Aspect ratio = 4 (prolate spheroids) n = 0.02 Wavelength = 450 nm Extinction efficiency 3 633 nm 2 800 nm 1 Factor of 2.3 difference in efficiency for 10 µm particles 0 1 10 Equivalent diameter, µm 100 Light Obscuration: Effect of Roughness 1.0000 Sphere 4th deg. Chebyshev, 0.05 roughness Extinction efficiency 4th deg. Chebyshev, 0.1 roughness 6th deg. Chebyshev, 0.05 roughness 0.1000 Mildly rough particles give very little change in extinction efficiency 0.0100 0.0010 0.1 1 Equiv. spherical diameter, µm 10 Light Obscuration Summary • Refractive index matters: factor of 2 drop in sensitivity if n= 0.02 for 10 µm particles • Wavelength matters: factor of 2 drop in sensitivity for long wavelengths + small n for 10 µm particles • Very elongated particles—drop in sensitivity • Roughness—no indication of significant effect • Not at all clear why light obscuration undercounts for >20 µm 1. We need direct measures of particulate refractive index or density 2. NIST spectral light scattering/obscuration apparatus will attempt to exploit wavelength dependence of scattering in 1 to 20 µm region to distinguish proteins from non-proteins. Can we also find effective extinction efficiency? Particle Refractive Index Refractive Index of Particle Best measure of protein mass bound in aggregates Possible Methods: • Immersion in index matching fluids—difficult because the particles are quite fragile and sensitive to the matrix liquid • Quantitative Phase Microscopy—(Nugent and Paganin) good choice, but the method is patented and software presently hard to obtain. Variants may be outside of patent. • Digital holography—promising method • Spectral light scattering—NIST is assembling a system to do this. • Through-focus Scanning Optical Microscopy (TSOM)—Extended version of QPM; needs lots of modeling • Gravimetric Sedimentation—Measure of average density of particles; works for aspect ratio near 1 Gravimetric Measurement of Particulate Density Sedimentation velocity vs proportional to /d2 • Measure diameter d and velocity vs with flow imaging microscope in ―no flow‖ condition • • Special care needed to suppress convection (vs 1 µm/s for d = 10 µm) Only works for particles that are close to spherical 300 Distance, µm • 200 100 0 0 20 40 Time, s Track of a polystyrene bead Initial results for IgG particulates: 10 kg/m3 60 Electrical Sensing Zone Method: ‗Coulter Counter‘ Flow of ions V/I = R Perturbing the electrical resistance R of the channel ... perturbs measured voltage to current ratio, V/I • Nominal measurement of particle volume—what methods would we use to certify volume of highly non-spherical reference materials? • Volume may be difficult to interpret or relate to optical measurements for extended, fibrous, or porous particles • Do proteins aggregate in optically invisible, extended structures (gel-like) with reduced ionic conductivity? Conclusions • Instrumental effects could introduce sizable errors in particle concentration count for protein particulates • Several promising surrogates: Next steps—usability studies, comparison with industrially developed particles, stability studies • Measurement of protein-particulate refractive index/density a high priority to guide reference standards & to understand light obscuration/scattering • Coulter counter promising, but what are we measuring? • Calibration/validation of light obscuration & flow imaging: Monodisperse bead size standards + polydisperse surrogate USP Workshop on Particle Size: Particle Detection and Measurement December 8-10, 2010; USP Headquarters Reference Standards: USP Perspective Barb Jones, Ph.D. USP Vice President, Reference Standards Evaluation Current Standard Particle Used Count Reference Standard (Lot K0H089) in the Following General Chapters: <788> Particulate Matter in Injections (Light Obscuration) <789> Particulate Matter in Ophthalmic Solutions (Light Obscuration) Each set contains 2 units of a dilute suspension of monosized polystyrene Spheres (15 µm) and 2 units of suspending fluid to be used as blanks. Collaborative Testing 12 collaborating Laboratories Each laboratory analyzed 4 containers of the suspended particles and 4 blanks. Samples were mixed, degassed, and three portions from each container were analyzed. The particle counts were measured at both 10 µm and 15 µm. Only the data from the 2nd and 3rd portions were used. Data Analysis and Value Assignment A statistical 12 analysis was performed and limits were assigned. laboratories contributed data Counts were corrected (using the data from the preceding blanks) using the method specified in <788> On collaborator failed the particle County Accuracy Test and that data was excluded. Corrected Counts at 10 and 15 m Figure 1. Corrected Counts at 10 and 15 m 4500 4000 3500 Corrected count per ml 3000 2500 10 um 15 um 2000 1500 1000 Collaborator 6 500 0 0 10 20 30 40 50 60 Code 70 80 90 100 110 120 Ratio of Counts at 10 m to Those at 15 m Figure 2. Ratio of Counts at 10 m to Those at 15 m 4 3.5 Collaborator 6 3 10:15 ratio 2.5 2 1.5 1 0.5 0 0 10 20 30 40 50 60 Code 70 80 90 100 110 120 Differences between 2nd and 3rd Portions Figure 3. Differences between 2nd and Comparing 3rd Portions –2nd Sample Vialsnumbers for Standard and 3rd Code 0 10 20 30 40 50 60 70 80 90 100 110 120 1000 Difference of Counts (3rd - 2nd) 500 0 10 um 15 um -500 -1000 Collaborator 6 -1500 Differences between 2nd and 3rd Portions Comparing 2nd and 3rd numbers for Blank Blank Vials Code 0 10 20 30 40 50 60 70 80 90 100 110 120 60 Difference of Counts (3rd - 2nd) 40 20 Collaborator 6 0 -20 -40 -60 10 um 15 um Lower limit Upper limit Particle Size Standard The USP Particle Count Reference Standard is not suitable for Particle Size determination… USP would like your opinions on what is needed for a Particle Size Reference Standard(s) USP Workshop on Particle Size: Particle Detection and Measurement December 8-10, 2010; USP Headquarters Session II: Industry Perspectives Track 1: Solutions Spalding Auditorium Track 2: Aerosols Briggs/Parker/ Marshall/Wiley USP Workshop on Particle Size: Particle Detection and Measurement December 8-10, 2010; USP Headquarters Session II, Track 1: Industry Perspectives for Solutions Chair: Dr. Michael Mulkerrin Oncomed USP Workshop on Particle Size: Particle Detection and Measurement December 8-10, 2010; USP Headquarters Industry Perspectives for Solutions – Historical Perspective Russell E. Madsen, M.S. President, The Williamsburg Group, LLC Chairman, USP Visual Inspection of Parenterals Expert Panel Introduction This presentation provides a history of visual inspection practices and requirements for parenteral products in the United States Discusses a proposal to demonstrate a batch of the product is ―essentially free‖ as currently specified in USP <1> The Need to Inspect Visual inspection of parenteral products is driven by the need to minimize the introduction of unintended particulate matter Inspection also offers the opportunity to reject non-integral units (e.g., those with cracks or incomplete seals) Current expectation for inspection of each finished unit (100% inspection) Human Visual Performance Threshold for human vision is generally accepted to be about 50 µm Detection is probabilistic Probability of detection increases with increasing particle size – probability of detection for a single 50 µm particle in clear solution in a 10 mL vial with diffuse illumination between 2000-3000 lux is slightly greater than 0% – probability increases to approximately 40% for a 100 µm particle and becomes greater than 95% for particles 200 µm and larger Particle Effects on Patients Most studies have focused on sub-visible particles, with a diameter of less than 50 µm – Smallest particles (approximately 1 µm in diameter) are often trapped in the liver, lungs and spleen – IV infusion of particles larger than the internal diameter of capillaries may be clinically significant, increasing the risk of an embolic syndrome No reports of adverse events associated with the injection of individual visible particles have been found ―Essentially Free‖ Zero defects is the desired goal ZD is not a workable specification for visible particulate matter – current packaging components – processing capability Thus the terminology ―essentially free‖ - but what does it mean? More precise definition is desirable to prevent misunderstanding and to aid in communication History of Inspection Standards In 1915, USP IX described the need for injectable compounds to be true solutions In 1916, NF IV included six monographs for parenteral products detailing the method of preparation Neither provided guidance with respect to solution clarity History of Inspection Standards The first appearance of ―solution clarity‖ and freedom from contaminants for parenterals occurred in 1936 in NF VI – A requirement for clarity in injectable solutions specified, ―Aqueous ampule solutions are to be clear; i.e., when observed over a bright light, they shall be substantially free from precipitate, cloudiness or turbidity, specks or flecks, fibers or cotton hairs, or any undissolved material.‖ History of Inspection Standards The requirement for visual clarity of parenteral products was coordinated November 1, 1942, appearance of NF VII and USP XII – These compendia used the term ―substantially free‖ to describe the need for control of particle contamination and the perceived lack of ideal quality in the injectable material inspected History of Inspection Standards NF VII (1942) – ―Aqueous solutions are to be clear; i.e., when observed over a bright light, they shall be substantially free from precipitate, cloudiness, or turbidity, specks or flecks, fibers or cotton hairs, or any un-dissolved material. Substantially free shall be construed to mean a preparation which is free from foreign bodies that would be readily discernable by the unaided eye when viewed through a light reflected from a 100 watt Mazda lamp using as a median a ground glass and a background of black and white‖ History of Inspection Standards USP XII (1942) – ―Appearance of Solutions or Suspensions— Injections which are solutions of soluble medicaments must be clear, and free of any turbidity or un-dissolved material which can be detected readily without magnification when the solution is examined against black and white backgrounds with a bright light reflected from a 100 watt Mazda lamp or its equivalent‖ History of Inspection Standards Both the USP and the NF used the same test procedure; however the USP procedure was more rigorous in that it omitted the qualifying adjective, ―substantially.‖ These compendial requirements were used by the FDA in its role as the Quality Control Office for all pharmaceuticals purchased by the Armed Forces during World War II History of Inspection Standards USP XIII (1947) – ―Clarity of Solutions—Water for Injection, pharmacopeial Injections or pharmacopeial Solutions of medicament, intended for parenteral administration, unless exempted by individual monographs, must be substantially free of any turbidity or undissolved material which can be detected readily without accessory magnification (except for such optical correction as may be required to establish normal vision), when the solution is examined against a black background and against a light which at a point ten inches below the source provides an intensity of illumination not less than 100 and not more than 350 foot candles. This intensity of illumination may be obtained from a 100 watt, inside frosted incandescent lamp operating at rated voltage, or from fluorescent lamps, or from any equivalent source of light.‖ – Additional information on page 628 provided details of the light sources described and equated the light from three 15 watt fluorescent lamps to that from the 100 watt bulb History of Inspection Standards United States vs. Bristol Labs, Inc. (1949) – FDA inspector found particle-contaminated ampules in the accepted stock of six Bristol Laboratories injectable products – The company was served on September 25, 1948, with FDA Injunction #198 – Bristol Laboratories challenged the results of the test by preparing a blinded test group of 150 ampules containing 1½ mL sterile saline (the test group included 38 ampules that the FDA inspector had rejected as contaminated with particles) – At the conclusion of the testimony for the government, on January 25, 1949, the court granted the defendant‘s motion for dismissal— the FDA expert witness passed 36 out of 38 previously rejected containers on the witness stand – The case was dismissed on the grounds ―1) that the standards involved were indefinite and 2) that the evidence was insufficient to show such violation of the Act as would warrant the granting of the relief prayed for (destruction of the ampules)‖ History of Inspection Standards USP XV through XVIII (1955-1970) – USP XV: ―Every care should be exercised in the preparation of injections to prevent contamination with micro-organisms and foreign material. Good pharmaceutical practice also requires that each Injection, in its final container, be subjected individually to visible inspection.‖ – USP XVI and XVII: ―Every care should be exercised in the preparation of injections to prevent contamination with microorganisms and foreign material. Good pharmaceutical practice also requires that each Injection, in its final container, be subjected individually to visible inspection whenever the nature of the container permits.‖ History of Inspection Standards Fed. Std. 142 (1959-1970) – Int. Fed. Std. No. 00142, Parenteral Preparations, was issued by the United States Navy-BuMed (August 1, 1959) – Mandatory on all Federal agencies, issued pursuant to the Federal Property and Administrative Services Act of 1949 – Applicable to sterile parenteral preparations in final containers, intended for human consumption – The standard was superseded on October 31, 1966, by Fed. Std. No. 142a – Provided requirements for clarity of solutions as well as limits for visible particulate matter (the standard was applicable as a final test to a sample of finished product, not to 100% on-line inspection, and the sampling was in accordance with MIL-STD105) History of Inspection Standards Fed. Std. 142a – Section ―S6.2.1 Clarity of solutions”. Applicable to type I, class 1; type II, class 1; type II, class 3; and solutions of dry solids (type IV, class 1). – ―Solutions of parenteral preparations shall be clear and free from undissolved or particulate matter within the limits permitted in the classification of defects and the applicable acceptable quality level (AQL), when examined without accessory magnification (except for such optical correction as may be required to establish normal vision) against a black background and against a white background and illumination from a light which at a point 25.4 centimeters (10 inches) from its source, provides an intensity of illumination of not less than 100 and not more than 350 foot-candles. Some biological products need not be clear and entirely free from turbidity, provided this is characteristic of the product. The clarity standards for such products shall be judged on an item for item basis with the characteristic properties of the product considered in each case.‖ History of Inspection Standards Fed. Std. 142a – For aqueous solutions (type I, class 1), the ―solution not clear‖ defect was classified as Major A, Inspection Level II and the AQL (percent defective) as 1.0 – For example, if there were 30,000 units in the batch, the clarity of solution test would pass if upon inspection a sample of 315 units, 7 or fewer contained visible particulate matter – Thus, under Fed. Std. 142a, agencies of the Federal government, including FDA, would deem this level to be acceptable and to comply with the meaning of the USP term ―essentially free.‖ – The significance of Fed. Std. 142a is that it provided government-endorsed acceptance limits for the presence of ―visible‖ particles History of Inspection Standards USP XIX, Supplement 1 (1975) – ―Solutions of medicament, intended for parenteral administration, unless exempted by individual monographs, must be ―substantially free‖ of any turbidity or un-dissolved material which can be detected readily without accessory magnification (except for such optical correction as may be required to establish normal vision).‖ – ―Every care should be exercised in the preparation of injections to prevent contamination. Good pharmaceutical practice also requires that each Injection, in its final container, be subjected individually to a physical inspection, whenever the nature of the container permits, and that every container whose contents show evidence of contamination with visible foreign material be rejected.‖ History of Inspection Standards USP XX (1980) – ―Every care should be exercised in the preparation of injections to prevent contamination. Good pharmaceutical practice also requires that each injection, in its final container, be subjected individually to a physical inspection, whenever the nature of the container permits, and that every container whose contents show evidence of contamination with visible foreign material be rejected.‖ [Same as XIX Supplement 1] History of Inspection Standards USP XXIII (1995) – Use of the term substantially free was replaced by the term essentially free – ―Every care should be exercised in the preparation of all products intended for injection, to prevent contamination with microorganisms and foreign material.‖ – <788> Particulate Matter In Injections • ―Particulate matter consists of mobile, randomly sourced, extraneous substances . . . that cannot be quantitated by chemical analysis due to the small amount of material that it represents and to its heterogeneous composition. Injectable solutions, including solutions constituted from sterile solids intended for parenteral use, should be essentially free from particles that can be observed on visual inspection.‖ History of Inspection Standards Current USP, General Chapter <1> Injections – ―Each final container of all parenteral preparations shall be inspected to the extent possible for the presence of observable foreign and particulate matter (hereafter termed ―visible particulates‖) in its contents. The inspection process shall be designed and qualified to ensure that every lot of all parenteral preparations is essentially free from visible particulates.‖ No inspection method is specified. History of Inspection Standards Japanese Pharmacopoeia, Fifteenth Edition, General Rules for Preparations, 11. Injections (2006) – ―Unless otherwise specified, Injections meet the requirements of the Foreign Insoluble Matter Test for Injections <6.06>.‖ – Two inspection methods are described History of Inspection Standards JP Method 1 (applied to injections either in solutions, or in solution constituted from sterile drug solids) – ―Clean the exterior of containers, and inspect with the unaided eyes at a position of light intensity of approximately 1000 lx under an incandescent lamp: Injections must be clear and free from readily detectable foreign insoluble matters. As to Injections in plastic containers for aqueous injections, the inspection should be performed with the unaided eyes at a position of light intensity at approximately 8000 to 10,000 lx, with an incandescent lamp at appropriate distances above and below the container.‖ History of Inspection Standards JP Method 2 (applied to injections with constituted solution) – ―Clean the exterior of the containers, and dissolve the contents with constituted solution or with water for injection carefully, avoiding any contamination with extraneous foreign substances. The solution thus constituted must be clear and free from foreign insoluble matters that is clearly detectable when inspected with the unaided eyes at a position of light intensity of approximately 1000 lx, right under an incandescent lamp.‖ History of Inspection Standards European Pharmacopoeia 6.0, Parenteral Preparations, Injections (2008) – ―Solutions for injection, examined under suitable conditions of visibility, are clear and practically free from particles.‖ The inspection is described as follows. ―Gently swirl or invert the container . . . and observe for about 5 s[econds] in front of the white panel. Repeat the procedure in front of the black panel. Record the presence of any particles.‖ History of Inspection Standards Stimuli to the Revision Process, Pharmacopeial Forum Vol. 35(5) [Sept.–Oct. 2009] – ESSENTIALLY FREE [Insert at the end of the Definitions section of <1> Injections]: Where used in this Chapter, the term essentially free means that when the batch of Injection is inspected as described herein, no more than the specified number of units may be observed to contain visible particulates. History of Inspection Standards Stimuli to the Revision Process, Pharmacopeial Forum Vol. 35(5) [Sept.–Oct. 2009] – Visible Particulates in Injections [Insert as a subheading under Foreign and Particulate Matter]: This test is intended to be applied to product that has been 100% inspected as part of the manufacturing process; it is not sufficient for batch release testing alone, and a complete program for the control and monitoring of particulate matter remains an essential prerequisite. This includes dry sterile solids for injection when reconstituted as directed in the labeling. Other methods that have been demonstrated to achieve the same or better sensitivity for visible particulates may be used as an alternative to the one described below. History of Inspection Standards Stimuli to the Revision Process, Pharmacopeial Forum Vol. 35(5) [Sept.–Oct. 2009] – Visible Particulates in Injections (cont.) Injections shall be clear and free from visible particulates when examined without magnification (except for optical correction as may be required to establish normal vision) against a black background and against a white background with illumination that at the inspection point has an intensity between 2000 and 3750 lux. This may be achieved through the use of two 15-W fluorescent lamps (e.g., F15/T8). The use of a high-frequency ballast to reduce flicker from the fluorescent lamps is recommended. Higher illumination intensity is recommended for examination of product in containers other than those made from clear glass. History of Inspection Standards Stimuli to the Revision Process, Pharmacopeial Forum Vol. 35(5) [Sept.–Oct. 2009] – Visible Particulates in Injections (cont.) Before performing the inspection, remove any adherent labels from the container and wash and dry the outside. The unit to be inspected shall be gently swirled, ensuring that no air bubbles are produced, and inspected for approximately 5 s against each of the backgrounds. The presence of any particles should be recorded. For batch-release purposes, sample and inspect the batch using ANSI/ASQ Z1.4 General Inspection Level II, single sampling plans for normal inspection, AQL 0.65. Not more than the specified number of units contains visible particulates. For product in distribution, sample and inspect 60 units. Not more than one unit contains visible particulates. History of Inspection Standards PF Stimuli Proposal – Based on Fed. Std. 142a, updated AQL from date captured by PDA Survey of Visual Inspection Practices 2008 – Attempts to harmonize USP, JP and Ph. Eur. – Stakeholders‘ comments captured at May 13, 2010, meeting of USP Visual Inspection of Parenterals Advisory Panel – Comments are being addressed and will likely result in several changes, including the proposed AQL and sampling levels USP Workshop on Particle Size: DETECTION AND MEASUREMENT December 8 – 10, 2010 Medical Impact on Particle Size David F. Driscoll, Ph.D. Stable Solutions LLC, Easton, MA, USA [email protected] Parenteral ―Particles‖ (Physical Characteristics) • ―Soft‖ Particles – refers to droplets, as, e.g., emulsions, such as injectable oil-in-water dispersions – flexible, malleable, deformable – LOW embolic risk • ―Hard‖ Particles – refers to solids, particulates, precipitates in injectable liquids – inflexible, rigid, obstructing – HIGH embolic risk Medical Risk: Mechanisms • ―Embolic‖ Risk (USP788 + USP729) Blood flow from the right side of the heart into the pulm. artery pulm. capillaries – For truly embolic (“hard”) particles (> 5 m), the embolic dose is relatively low – For similarly sized, but deformable (“soft”) globules, the embolic dose is much greater • ―Metabolic‖ Risk Blood flow from the left side of the heart into the aorta main arteries to vital organs – Can be small-diameter (< 5 m) rigid (“hard”) particulates or deformable, large-diameter, (“soft”) fat globules (> 5 m), involving the RES – The liver comprises 90 to 95% of RES function and is a “target organ” for injury from intravascular particles Medical Risk: Mechanisms continued • ―Immunological‖ Risk Intravenous route for “allergen” increases the risk for systemic anaphylactoid response, irrespective of particle ”hardness” or “softness” • ―Pharmacological‖ Risk Alteration of homogeneity of dosage form can result in “therapeutic failures” from either a subtherapeutic (“under-delivery”) or toxic (“over-delivery”) response. MEDICAL RISKS: Particulates and Embolic Phenomena 1996;20:81-87 (CaHPO4) Report Summary Paroxysmal respiratory failure and death occurred in two young adult females … autopsy revealed an amorphous material containing containing calcium [and phosphorus] obstructing the pulmonary microvasculature of each patient … both received an identical [intravenous] admixture. DFD-SSLLC-2010 Autopsy Specimen from Case-1 “Chemical analysis of the precipitate isolated from [amorphous debris extracted from the pulmonary microvasculature of the autopsy specimens] revealed the presence of calcium and phosphorus” MEDICAL RISKS: Lipids and Embolic Phenomena Report Summary The pathophysiological effects of infusing large amounts of stable lipid emulsions have been shown to cause RES dysfunction in animals and humans. This study investigated the effects on vital RES organs, i.e., liver and lungs, from the infusion of a stable (PFAT5 < 0.05%) vs. highly unstable (PFAT5 ~ 50x higher) fat infusion over 24 hours. Oil-Red-O Staining of Lung Specimens in Fat Infusion Groups Receiving Stable A vs. Unstable B Admixtures Characterization FAT DEPOSITS: Normal (absent); Abnormal (limited, moderate or diffuse) TISSUE STRUCTURE: Normal (intact); Abnormal ( cellularity, infiltration, and/or necrosis) Human Evidence of Pulmonary Fat Emboli (15/30 infants receiving i.v. fat; median duration 2 weeks) “The location of fat, predominantly in small pulmonary capillaries, and the absence of lipid emboli in other organs, suggests that lipid coalescence takes place before death and is not a postmortem artifact.” Puntis JWL, Rushton DI. Pulmonary intravascular lipid in neonatal necropsy specimens. Archives of Disease in Childhood 1991;66:26-28. MEDICAL RISKS: Lipids and Injury to Vital Organs Report Summary The pathophysiological effects of infusing large amounts of stable lipid emulsions have been shown to cause RES dysfunction in animals and humans. This study investigated the effects on vital RES organs from the infusion of a stable (PFAT5 < 0.05%) vs. modestly unstable (PFAT5 ~ 10x higher) fat infusion over 24 hours. Biochemical Analyses of Liver and Metabolic Effects of Infusion of Stable (s-TNA) vs. Unstable (u-TNA) Lipid Infusions Human Evidence of Liver Injury Associated with I.V. Fat for 2 Weeks “The association between liver dysfunction and hypertriglyceridemia (TG > 150 mg/dL) demonstrated by the present study is consistent with the important role played by the liver in the triglyceride clearance in neonates.” Toce SS, Keenan WJ. Lipid intolerance in newborns is associated with hepatic dysfuntion but not infection. Archives of Pediatric and Adolescent Medicine 1995;149:1249-53. MEDICAL RISKS: Lipids and Impaired Metabolic Clearance J Pediatrics 2008;152:232-36 (Lipid infusions for 1st week of life.) Plots of Serum Triglycerides (TG) in Critically Ill Premature Infants Coarse, PFAT > 0.05% --- Fine, PFAT < 0.05% 5 5 TG Level, Upper Limit of Normal: 150 mg/dL (All serum TG levels obtained on DOL- 4) (All TG levels, n = 122) (TG levels > 150 mg/dL, n = 22) MEDICAL RISKS: Proteins and Particulates and Immunogenic Phenomena Human Evidence of the Immunogenicity of Biologicals Safety-Related Regulatory Actions: 41/174 = 23.6% Most Common Issue: ―Immunomodulatory” JAMA 2008;300:1887-96 Medical Impact of Parenteral ―Particles‖ 1. Compliance with USP Chapters <729> and <788> reduce medical risks (except immunogenic). 2. All particles (―soft‖ or ―hard‖) should be controlled in injectable formulations. 3. Increasing particle populations are associated with the following medical risks: Embolic Metabolic Immunogenic Pharmacologic Foreign Particulate Matter in OINDP General Considerations James R. Coleman John A. Robson Foreign Particulate Matter in OINDP USP <788> PARTICULATE MATTER IN INJECTIONS Containers > 100 mL Particles ≥ 10 µm ≤ 12 particles /mL Particles ≤ 25 µm ≤ 2 particles/mL Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 295 Foreign Particulate Matter in OINDP USP <788> PARTICULATE MATTER IN INJECTIONS Containers ≤ 100 mL Particles ≥ 10 µm ≤ 3000 particles/container Particles ≥ 25 µm ≤ 300 particles/container Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 296 Foreign Particulate Matter in OINDP USP<789> PARTICULATE MATTER IN OPHTHALMIC SOLUTIONS Containers > 100 mL Particles ≥ 10 µm ≤ 50 particles /mL Particles ≥ 25 µm ≤ 5 particles/mL Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 297 Foreign Particulate Matter in OINDP USP<789> PARTICULATE MATTER IN OPHTHALMIC SOLUTIONS Containers ≤ 100 mL Particles ≥ 10 µm ≤ 50 particles/mL Particles ≥ 25 µm ≤ 5 particles/mL Particles ≥ 50 µm 2 ≤ particles/mL Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 298 Foreign Particulate Matter in OINDP ―….limits for foreign particulate matter less than 10 micrometers (µm), greater than 10 µm, and greater than 25 µm.‖ Composition of particles Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 299 Foreign Particulate Matter in OINDP Composition: Health: Safety assessment Specific compositions Particle number Source: identification for control Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 300 Foreign Particulate Matter in OINDP 1.Foreign Particles Testing in Orally Inhaled and Nasal Drug Products. Blanchard, J. et al. Pharmaceutical Research Vol.31, No.12 December 2004. 2.Considerations for Foreign Particulates in a Quality by Design Environment. Sundahl, M. IPAC RS 2006 Conference. 3.Best Practices for Managing Quality and Safety of Foreign Particles in Orally Inhaled and Nasal Drug Products, and an Evaluation of Clinical Relevance. Blanchard, J. et al. Pharmaceutical Research Vol. 24, No. 3 January 2007. Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 301 Foreign Particulate Matter in OINDP USP <788> defines: ―Particulate matter in injections and parenteral infusions consists of mobile undissolved particles, other than gas bubbles, unintentionally present in the solutions.‖ Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 302 Foreign Particulate Matter in OINDP Three types of FPM: Component: Occurs prior to filling Environmental: Originating during filling, closure, packaging Functional: Originating from operation of the device Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 303 Foreign Particulate Matter in OINDP These distinctions are critical because control of each type requires very different actions: Component: supply chain control, cleanliness. Environmental: process control. Functional: control of materials. Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 304 Foreign Particulate Matter in OINDP Component: Wash the components and analyze the particulate content Environmental: Open the unused device and analyze particulate content. Functional: Use the device, analyze the particulate content. Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 305 Foreign Particulate Matter in OINDP Consistent with Quality by Design principles, during development: Compile an analytical reference library of all components And all materials encountered as FPM Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 306 Foreign Particulate Matter in OINDP Consistent with Quality by Design principles, during development, preliminary or interim specifications for action or acceptance can be established. These should be based on: Safety assessment of the FPM Stability batches Process batches Scale-up batches Statistical analysis for Control limits Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 307 Foreign Particulate Matter in OINDP Capability of analytical methods Establish a practical lower size limit: As particle size decreases, analytical capability diminishes Isolation of smaller particles becomes more challenging Below 2 µm, uncertainty increases due to higher background noise. Sampling problems Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 308 Foreign Particulate Matter in OINDP Agencies have expressed interest in three ranges of particle size: ≥ 25 µm < 25 and > 10 µm ≤ 10 Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 309 Foreign Particulate Matter in OINDP Blanchard et al. suggest General: 25 µm - 100 µm 10 µm – 25µm 2 µm – 10 µm For nasal products: 2 µm – 20 µm > 20 µm Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 310 Foreign Particulate Matter in OINDP Sampling: For Parenterals: sample the container For DPI: What is in the device prior to use What comes out of the device Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 311 Foreign Particulate Matter in OINDP Sampling: For MDI: What is in the device prior to use What comes out of the device Through the mouthpiece Through the valve Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 312 Foreign Particulate Matter in OINDP For OINDP: Through the mouthpiece Uncertainty about effect of mouthpiece in patients Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 313 Foreign Particulate Matter in OINDP For OINDP: Through the valve Largest dose that a patient might receive One type of worst case Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 314 Foreign Particulate Matter in OINDP USP <788> defines: ―Particulate matter in injections and parenteral infusions consists of mobile undissolved particles, other than gas bubbles, unintentionally present in the solutions.‖ Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 315 Foreign Particulate Matter in OINDP Challenges: Separation / Isolation / Capture Measuring/analyzing only foreign particulates Measuring/analyzing ―all‖ foreign particulates Preparation for sizing and composition determination Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 316 Foreign Particulate Matter in OINDP Challenges: Validation when no FPM standards or reference materials Analyze particles individually Analyze a sufficient number to be statistically significant Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 317 Foreign Particulate Matter in OINDP Challenges: Analyze a sufficient number to be statistically significant Number of particles analyzed = N √N ~ Std. Dev. % RSD 10 3.16 31.62% 100 10.00 10 % 1,000 31.62 3.16 Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 318 Foreign Particulate Matter in OINDP ICH, USP, Pharm. Eur. and other regulatory bodies require validation of analytical methods. Precision Specificity Detection Limit Quantitation Limit Linearity Range Accuracy Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 319 Foreign Particulate Matter in OINDP (Eur) Pharmaceutical Analytical Sciences Group (1999) Position Paper on Particle Sizing: Sample Preparation, Method Validation and Data Presentation Accuracy: Calibration or verification with reference materials for size and for composition Precision: Repeatability equivalent results for repeated analysis, including sample preparation Intermediate Precision equivalent results with different personnel and instrumentation Reproducibility equivalent results when carried out at different sites, with different personnel and different instrumentation Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 320 Foreign Particulate Matter in OINDP Pharmaceutical Analytical Sciences Group (1999) Position Paper on Particle Sizing: Sample Preparation, Method Validation and Data Presentation Specificity: Demonstrated capability to distinguish identity or composition Detection Limit: Demonstrated range of the instrument Robustness: Demonstrated sensitivity to changes in procedure Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 321 Foreign Particulate Matter in OINDP Whatever method for sizing is chosen, Light Obscuration, Light Scattering, Image Analysis, . Microscopy Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 322 Foreign Particulate Matter in OINDP Aerodynamic Diameter: Diameter of a sphere with a density of 1gm/cm³ that has the same inertial properties as the measured particle. Stokes Diameter: Diameter of a spherical particle with the same density and inertial properties as the measured particle. Stokes Diameter = Aerodynamic Diameter / √Density Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 323 Foreign Particulate Matter in OINDP Stokes diameter microns Aerodynamic diameter vs. Stokes diameter 12.00 Polypropylene density 0.92 10.00 8.00 Aluminum density 2.7 6.00 Titanium dioxide density 4.20 4.00 2.00 0.00 0.00 Ferric oxide density 5.3 10.00 20.00 30.00 Stainless steel density 7.8 Aerodynamic Diameter microns Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 324 Foreign Particulate Matter in OINDP Reported as foreign particulates Acrylonitrile butadiene styrene Polybutylene Terephthalate Aluminum Polycarbonate Bacterial fragments Polychlorotrifluoroethylene Bromobutyl rubber Polyester Clay Polyethylene Copper Polyimide Elastomer Polyoxymethylene Ethylene Propylene Diene Polymer Polypropylene Glass Stainless steel Iron Talc Kaolin Transparent synthetic fibers Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 325 Foreign Particulate Matter in OINDP For counting and sizing, many suitable technologies For speciation of individual particles: Organics: Infrared Raman Inorganic: SEM/EDS Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 326 Foreign Particulate Matter in OINDP For counting and sizing, many suitable technologies For composition: Organics: Infrared Raman Standard and collected spectra Inorganic: SEM/EDS Elemental standards and collected spectra Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 327 Foreign Particulate Matter in OINDP IPAC-RS Working Groups ―Best Practices‖: 1. Enumeration of particles in size classes for manufacturing Quality control 1. Rapid 2. Portable 2. When trending toward limits , or when exceeding limits then investigate using composition to identify and control source. 1. Slow 2. Requires personnel and equipment Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 328 Foreign Particulate Matter in OINDP The End Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 329 Foreign Particulate Matter in OINDP The Beginning of an interesting journey Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 330 Foreign Particulate Matter in OINDP Regulatory Agencies are interested in knowing: Number of particles especially in PM10, respirable size range Composition of particles Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 331 Foreign Particulate Matter in OINDP “For both solution and suspension nasal sprays, there should be validated tests and associated acceptance criteria for particulate matter.” “The acceptance criteria should include limits for foreign particulate matter less than 10 micrometers (µm), greater than 10 µm, and greater than 25 µm.” Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 332 Foreign Particulate Matter in OINDP EPA: Airborne particulate matter Two major size classes (EPA): PM 10 “particles generally less than or equal to 10 micrometers” PM 2.5 “generally referring to particles less than or equal to 2.5 micrometers in diameter” “respirable range” Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 333 Foreign Particulate Matter in OINDP For OINDP: After use: Nasal: through the valve Oral: Through the mouthpiece Most like what the patient will receive Uncertainty about effect of the mouthpiece Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 334 Foreign Particulate Matter in OINDP For OINDP: Prior to use Open the device (carefully) To distinguish functional source Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 335 Foreign Particulate Matter in OINDP These distinction are critical because control of each type requires very different actions: Control of Component particulates occurs in the supply chain; Control of component cleanliness. Control of Environmental particulates occurs in filling, Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 336 Foreign Particulate Matter in OINDP Ideal: collect all and only FPM burden with minimal general or selective loss of FPM However do not know how much is there so do not know when this has been achieved. There is no “right” answer No or minimal gain of FPM Clean room conditions Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 337 Foreign Particulate Matterin OINDP All glassware must be scrupulously cleaned, Only distilled, deionized, filtered water must be used and plenty of it, with several rinses Glassware dried in a HEPA filtered hood All reagents must be filtered, Extensive use of blanks is essential Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 338 Foreign Particulate Matter in OINDP Under the Clean Air Act, EPA is required to review and, if appropriate, revise the air quality criteria for the primary (health-based) and secondary (welfare-based) national ambient air quality standards (NAAQS) every 5 years. On October 17, 2006, EPA published a final rule to revise the primary and secondary NAAQS for particulate matter to provide increased protection of public health and welfare. Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 339 Foreign Particulate Matter in OINDP Three major differences: 1. Method validation 2. Sampling/Sample Preparation 3. Speciation Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 340 Foreign Particulate Matter in OINDP Many suitable methods for particle sizing. Most are for providing particle sizes that are particles of the same material FPM are by definition heterogeneous and may differ in Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 341 Foreign Particulate Matter in OINDP Pharmaceutical Analytical Sciences Group (1999) Position Paper on Particle Sizing: Sample Preparation, Method Validation and Data Presentation Specificity: Not strictly applicable Detection Limit: Range; Instrument specifications Quantification Limit: Not considered useful Linearity: Effect of sample concentration, mass, other variables Range: Instrument specifications Robustness: Sensitivity to changes in the Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 342 Foreign Particulate Matter in OINDP Precision: Repeatability of entire technique, including sample preparation Intermediate Precision with different personnel and instrumentation Reproducibility Operation at different sites Foreign Particulate Matter in OINDP: General Considerations 25 March 2011 343 Foreign Particulate Issues: Safety Aspects and Considerations for Setting Limits Jim Blanchard, Ph.D. Principal Scientist Aradigm Corp. For the International Pharmaceutical Aerosol Consortium on Regulation and Science (IPACRS) Foreign Particulate Working Group Scope • Focus on foreign particulate in aerosolized drug products • Safety evaluation • Considerations for establishing safety limits • Sources and types • Clinical safety Slide 345 Safety of Foreign Particulate in Aerosolized Drug Products • Dependent on: – Size – Mass and number – Composition Slide 346 Safety of Foreign Particulate in Aerosolized Drug Products • Inhaled particles ≤ 10 µm in aerodynamic diameter can penetrate beyond the upper airways and deposit in the lungs – Larger particles have less deposition in the lungs. • Therefore, control of foreign particulate ≤ 10 µm should include both safety and quality considerations – Control of larger particulate can be based primarily on quality considerations. Slide 347 Particle Deposition in Respiratory Tract: Oral Breathing at Rest Deposition Fraction 1 Total 0.8 Head 0.6 0.4 Tracheobronchial tree 0.2 Pulmonary 0 0 5 10 15 20 Aerodynamic Diameter (µm) Multiple-Path Particle Dosimetry Model V2.0 Safety Evaluation of Foreign Particulate in Aerosolized Products • Conduct standard inhalation toxicology studies of the formulation – The dose of foreign particulate penetrating to the animals‘ lungs is adequate relative to the patients‘ dose of foreign particulate. • Safety assessment following identification and enumeration of foreign particulate – Any particles with safety concerns should be eliminated, if possible, or minimized. – Action or safety limits can be developed. Slide 349 Safety Evaluation of Foreign Particulate in Aerosolized Products • To develop safety limits, the levels of foreign particulate can be compared to the levels allowed for particulate in ambient air • Use safety limits for foreign particulate ≤ 10 µm based on the U.S. Environmental Protection Agency‘s (EPA) National Ambient Air Quality Standard (NAAQS) for particulate matter with an aerodynamic diameter ≤ 10 µm (PM10). Slide 350 Aerodynamic Diameter Definition • Aerodynamic diameter (Da) = diameter of a sphere with density of 1 g/cm3 that has the same settling velocity as the particle • Da = DStokes (sphere) x (density)1/2 – Stokes diameter = diameter of a sphere that has the same settling velocity and density as the particle • Da = Dgeometric x (density/shape factor)1/2 – Shape factor = 1 for sphere, = 1.71 for glass fiber (L/D=5); 2.04 for talc Slide 351 Advantages of NAAQS PM10 Standard • Designed to protect both healthy and ―sensitive‖ populations, e.g., asthmatics or patients with other lung diseases, children, and the elderly over their lifetime. – Therefore, it is appropriate to protect patients receiving acute or chronic aerosolized therapy. Slide 352 Advantages of NAAQS PM10 Standard • More appropriate than occupational exposure standards – Occupational standards are designed to protect nearly all workers exposed repeatedly 8 hrs/day, 40 hrs/week over a working lifetime, therefore these are higher and inappropriate for ―sensitive‖ people – For ―inert‖ dusts, the US Occupational Safety and Health Administration (OSHA) permissible exposure limit is 15 mg/m3 total particulate and 5 mg/m3 for respirable particulate (<3.5 µm) vs. 150 µg/m3 for PM10 Slide 353 Advantages of NAAQS PM10 Standard • Based on particle mass and is independent of particle composition, therefore it is applicable to all foreign particulates regardless of composition. – Allows assessment of the overall safety of foreign particulates without necessarily identifying all the particles. Slide 354 Use of NAAQS PM10 Standard • To provide added safety, the IPAC-RS Working Group recommends using limits for foreign particulates that are only 1-5% of the NAAQS PM10 – The patients‘ exposure to the foreign particulates in the formulation is small compared to their allowable exposure to other particulates in the ambient air. Slide 355 Use of NAAQS PM10 Standard • NAAQS for PM10 is 150 µg/m3 (24-hr average). – EPA assumes a person breathes 20 m3 of air per day • PM10 standard corresponds to 3 mg/day • 1-5% level corresponds to 30-150 µg/day of foreign particulate. – Poses little added risk to the patient Slide 356 Use of NAAQS PM10 Standard • In December 2006, EPA revoked the PM10 standard determined as the annual arithmetic mean, which was 50 µg/m3 – EPA cited lack of evidence of health problems from chronic long-term exposure to these particles – The 50 µg/m3 was the PM10 standard used in the two IPAC-RS foreign particulate papers in 2003 and 2007 Slide 357 Use of NAAQS PM10 Standard • EPA has lower standards for PM2.5 (≤ 2.5 µm) – 15 µg/m3 annual arithmetic average – 35 µg/m3 24-hr average • However, in ambient air, these particles are mainly from smog and combustion sources and have at different chemical composition and safety profile than foreign particulate in inhaled drug products • Therefore, the IPAC-RS Working Group considered that the PM2.5 standard was inappropriate Slide 358 Use of NAAQS PM10 Standard • Mass of particles = number of particles x density • To relate 30-150 µg/day to the number of foreign particles in a drug product, an aggregate density of particles must be determined – Measured analytically (e.g., SEM/EDX and FTIR/Raman) – Assume a worst-case maximum density for all foreign particles based on the materials that the formulation contacts, e.g. stainless steel with density of 8 g/cm3 Slide 359 Use of NAAQS PM10 Standard • Based on 5% safety level (150 µg/day) maximum acceptable number of foreign particulate (spherical) Density, g/cm3 Diameter, µm 1 8 2 3.6 x 107 4.5 x 106 3 1.1 x 107 1.3 x 106 4 4.5 x 106 5.6 x 105 6 1.3 x 106 1.7 x 105 8 5.6 x 105 7.0 x 104 10 2.9 x 105 3.6 x 104 – Not all particles with density of 8 g/cm3 have aerodynamic diameter <10 µm (and be subject to PM10), however the worst-case density approach is both practical and provides a conservative safe level Slide 360 Use of NAAQS PM10 Standard • The IPAC-RS Working Group found for two drug products the mass of foreign particles from 2-10 µm were >100x less than that allowed by the 5% PM10 standard • These data support that the limit is a feasible starting point to develop safety limits on levels of foreign particulate Slide 361 Sources of Foreign Particulate • • • • • Active pharmaceutical ingredient (API) Excipients Container/closure system components Delivery devices Processing equipment Slide 362 Typical Foreign Particulate in Aerosolized Drug Products • The IPAC-RS Working Group also surveyed IPAC-RS member companies to identify foreign particulates typically found in aerosolized drug products Slide 363 Typical Foreign Particulate in Aerosolized Drug Products • acrylonitrile-butadienestyrene • aluminum • bromobutyl rubber • polytetrafluoroethylene • glass • iron • polychlorotriflouroethylene • paper/cardboard/cellulose • polyamide (nylon) • polyacetal • polycarbonate Slide 364 • polybutylene terephthalate • • • • • • • • • • polyethylene polyester polyoxymethylene polyimide polystyrene polypropylene stainless steel skin cells talc transparent synthetic fibers Clinical Safety of Typical Foreign Particulate in Aerosolized Drug Products • Possible types of clinical responses – ―Clinically‖ inert – Non-immunologic response, e.g., polyolefins, talc, aluminum – Immunologic response, e.g., nickel (as a component of stainless steel) • The determining factor is whether the particles are inhaled in a sufficiently high concentration. Slide 365 Clinical Safety: Polyolefins • Polyolefins, such as polypropylene, polyethylene and nylon, when inhaled as microfibers or ―flock,‖ have been reported to induce an interstitial lung disease, termed ―flock worker‘s lung.‖ • 20-26% of workers exposed to polypropylene flock (8 hr/day x 6 days/week) had abnormalities in lung function compared with 4.4% of unexposed controls (Atis 2005). – Inhalable and respirable dust concentrations were 4.4 mg/m3 and <0.2 mg/m3, dose = 44 - <2 mg/day, respectively; mean fiber diameter = 6.9 ± 2.1 (SD) µm; mean length = 96.7 ± 35.2 µm. • Therefore, a foreign particle exposure limit of 1-5% of the PM10 (30-150 µg/day) is well below that encountered in occupationally exposed individuals. Slide 366 Atis S et al, Eur Res J, 2005; 25:110-17 Clinical Safety: Talc • Talc is hydrated magnesium sulfate • Pulmonary disease has been reported in highly exposed workers or following obsessive inhalation of talcum powder • However, clinical and pathological evidence suggests talc itself does not cause pulmonary fibrosis • Most pulmonary abnormalities reported for talc are in fact due to contaminating substances, e.g., asbestos and silica (Fraser et al, 1999). • Therefore, talc itself appears to a low toxicity profile Slide 367 Fraser RS et al, Fraser and Paré‘s Diagnosis of Diseases of the Chest, 1999; 2449-2450 Clinical Safety: Iron • Workers exposed to high concentrations of iron, usually as iron oxide (Fe2O3) , may develop siderosis. – The only pathological finding is iron-laden macrophages in the peribronchovascular interstitium and alveoli – Not associated with pulmonary fibrosis or functional impairment (Harding et al, 1958; Nemery 1990) • However, when the iron is admixed with silica, exposed workers can develop silicosiderosis, which can lead to significant pulmonary fibrosis and disability • Therefore, iron itself appears to a low toxicity profile Slide 368 Harding HE et al, Lancet 1958; 2: 394-8 Nemery B, Eur Res J 1990; 3: 202-19 Clinical Safety: Aluminum • There are rare reports of pulmonary fibrosis following high exposure to aluminum dust and its oxides • The number of fibrous and nonfibrous aluminum particles in an aluminum pot worker who died from respiratory insufficiency were 1000-fold greater than in the general population (Gilks and Churg 1987) . Slide 369 Gilks B and Churg A, Am Rev Respir Dis 1987; 136: 176-9 Clinical Safety: Aluminum (2) • Eklund et al (1989) measured pulmonary function and performed bronchoalveolar lavage (BAL) in 14 aluminum pot room workers. • The mean duration of employment was 12.9 ± 9.0 years with a mean exposure (8-hour samples) of 1.77 mg/m3 (range 0.49-4.50); dose = 49-450 mg/day. • The workers all had normal chest x-rays and normal vital capacity, total lung capacity and diffusing capacity. • There was no evidence of an alveolitis in BAL. • Thus, using the 1-5% PM10 standard (30-150 µg/day) should further minimize any potential risk from aluminum foreign particles. Slide 370 Eklund A et al, Br J Ind Med 1989; 46: 782-86 Clinical Safety: Nickel and Stainless Steel • Disease has been recognized with nickel and nickel salts used in stainless steel and other metal alloys. • Workers refining nickel ore had increased risk of malignancy in both the lungs and nasal mucosa related to exposure to nickel sulfate and the combination of nickel sulfides and oxides. • In contrast, workers involved in the manufacture of nickel alloys did not seem to be at an excess risk for pulmonary carcinoma (Steenland et al, 1996). • Therefore, patients exposed to stainless steel in inhaled drug products should not be at an increased risk for respiratory tract malignancy Slide 371 Steenland K et al, Am J Ind Med 1996; 29: 474-90 Clinical Safety: Nickel (2) • Nickel allergy, i.e. to nickel sulfate, is one of the most common forms of allergic contact dermatitis, with prevalence rates of 10-15%. • Yet, nickel has only rarely been associated with the development of bronchial asthma. (Dolovich et al, 1984; Nemery 1990) • Asthma appears to be IgE mediated whereas contact dermatitis is a delayed hypersensitivity reaction. (Nieboer et al, 1984) Slide 372 Dolovich J et al, Br J Ind Med 1984; 41: 51-5 Nemery B, Eur Res J 1990; 3: 202-19 Nieboer E et al, Br J Ind Med 1984; 56-63 Clinical Safety: Nickel (3) • A large fraction of the inhaled dose may be swallowed, which may lead to an endogenous nickel reaction. • However, nickel is found in many foods; the average human intake of nickel is 200 µg/day. • Oral challenge trials to elicit nickel dermatitis have utilized higher doses of 500-5,600 µg (Ricciardi 2001). • Therefore, using safety limits based upon 1-5% of the NAAQS (30-150 µg/day) should provide an adequate safety margin against allergic manifestations. Slide 373 Ricciardi L et al, Allergy 201; 56 (Suppl 67) : 109-112 Other Safety Considerations • For foreign particles where the threshold data for clinical disease are lacking, manufacturers may need to rely upon toxicology studies or other safety data • It should also be recognized there are subpopulations of extremely sensitive individuals who may react adversely to very low levels of certain types of foreign particulate Slide 374 Conclusions • Safety limits can be developed once foreign particulates have been characterized in terms of number and identity • Safety limits for foreign particulates ≤ 10 µm are most appropriate since these can penetrate into the lungs • Establishing safety limits based on 1-5% of the EPA NAAQS PM10 (30-150 µg/day) should provide adequate protection for most types of foreign particulates, but not necessarily all. Slide 375 Acknowledgements • IPAC-RS Foreign Particulate Working Group • Courtney Crim, MD, GSK for clinical safety assessments • Ron Wolff, PhD, Novartis for development of the NAAQS safety assessment Slide 376 References • Blanchard, J., J. Coleman, C. D‘Abreu Hayling, R. Ghaderi, B. Haeberlin, S. Jensen, R. Malcolmson, S. Mittelman, L.M. Nagao, I. Saracovan, C. Snodgrass-Pilla, M. Sundahl, and R. Wolff. Commentary: Foreign particles testing in orally inhaled and nasal drug products. Pharm. Res. 21: 2137-2147, 2004. • Blanchard, J., J. Coleman, C. Crim, C. D‘Abreu Hayling, L. Fries, R. Ghaderi, B. Haeberlin, R. Malcolmson, S. Mittelman, L.M. Nagao, I. Saracovan, L. Shtohyrn, C. Snodgrass-Pilla, M. Sundahl, and R. Wolff. Commentary: Best practices for managing quality and safety of foreign particles in orally inhaled and nasal drug products, and an evaluation of clinical relevance. Pharm. Res. 24: 471-479, 2007. Slide 377
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