claim & reasonable probability (part 2)
TRANSCRIPT
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Claim & Reasonable ProbabilityUnderstand Product, Control Process & Demonstrate Quality
Roohi B. Obaid & Obaid AliCivil Service Officer
Drugs Regulatory Authority of Pakistan
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Claim & Reasonable ProbabilityUnderstand Product, Control Process & Demonstrate Quality
Part BObaid Ali
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Warm up exercise
Fundamental Scenarios and Bio-studies or Dissolution Studies
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Drug must be available in the blood stream in the same pattern
on which clinical studies have been performed
Similarity & Equivalency?
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If a tablet is disintegrated, in which
situations, it will not reach to the blood
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If a tablet is dissolved, in which
situations, it will not reach to the blood
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Have you ever imagined a situation
where a tablet can come out from the
body as it is?
If so, can it produce effect
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Biopharmaceutical Evaluation
From Fiction to Reality
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Performance
should be the
same way
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No Worse
Performance
should be the
same way
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No Worse
No Better
Performance
should be the
same way
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Please make it clear
They are not
clinical studies
Nothing to do
with Safety &
Efficacy of
molecule
Evaluating the
Similarity of
Trends
&
Kinetics
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Drug Performance
Dosage Form
Drug in solution
Gut wall BloodSite of
ActivityTherapeutic
Effect
Dosage Form
Performance
Pharmacokinetic
Measurement
Clinical/PD
Measurement
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Science of Bioequivalence
Developed over the last few decades
Continues to evolve
Specific approaches depend on a number of factors
Can be simple or highly complex
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Generic Drug
….. equivalent drug products
that can be substituted at the
pharmacy level for the
reference /innovator drug, and
each other, without any
adjustment in dose or other
additional therapeutic
monitoring
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Pharmaceutical Equivalence
Same active ingredient
Same dosage form
Same route of administration
Identical in strength or concentration
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What is Substitutability?
Pharmaceutically equivalent
1Bioequivalent
2
Generic Drugs must be
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Generics not necessarily identical
Excipients Difference
Manufacturing Differences
Formulation Difference
Shape, color difference
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Bioequivalence & Generic Drugs
Pharmaceutical Equivalent & Bioequivalent
Pharmaceutical Equivalence
Does not mean equivalent performance
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Label1
CMC2 Bio-
studies
3 Plant GMP
4
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Brand Name Drug Generic Drug
1. Chemistry 1. Chemistry
2. Manufacturing 2. Manufacturing
3. Controls 3. Controls
4. Labeling 4. Labeling
5. Testing 5. Testing
6. Animal Studies
7. Clinical Studies 6. Bioequivalence
8. Bioavailability
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Bio-studies
Dissolution
Bioavailability Bioequivalence
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PK PD
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Clinical/PD Dose-
Response
Cli
nic
al/P
D R
esponse
Log Dose
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Plasma
Concentration-Dose
Dose
Pla
sma
Co
nc.
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What is Reference/Innovator Drug
Innovator
Brand
Authorized Brand
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AUC and Cmax 90% Confidence Intervals (CI) must
fit between 80%-125%
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To determine rate and extent of absorption of
generic, innovator
From 2009
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On healthy human volunteers but use patients if
there is a safety concern (Etoposide, Clozapine)
Male, Female both
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Bio-analytical method must be validated
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• In vivo measurement of
active moiety or moieties
in biologic fluid
• In vivo pharmacodynamic
comparison
• In vivo limited clinical
comparison
• In vitro comparison
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Single-dose, two-way
crossover, fasted
Single-dose, two-
waycrossover, fed
Alternatives
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1
• Single-dose, parallel, fasted
• Long Half-Life (wash-out) Amiodarone, Etidronate
2
• Single-dose, replicate design
• Highly Variable Drugs
3
• Multiple-dose, two-way crossover, fasted
• Less Sensitive Clozapine(Patient Trials) Chemotherapy Trials
4
• Clinical endpoint study
• Topicals Nasal Suspensions
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Urine may be used for measurement when drug cannot
be measured in plasma e.g. Potassium Chloride
Baseline in blood is too high to permit accurate
measurement
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Special Case: Alendronate Sodium (5 to 70 mg)
Problem with plasma detection because of low
concentration & re-distribution from bone
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Pharmacodynamics Approach
Generic topical corticosteroid, ability to produce
vasoconstriction
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Special Case: Tretinoin Acne Gel
Problem with plasma detection, endpoint related to
healing region is considered
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Special Case:
Highly Variable Drugs
3 period bio-studies TRR, RTR, RRT
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BioWaivers
IV solutions, Oral solutions, BCS class 1, old drugs
with no bio-equivalency problem
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Oral Solution
Must not contain an excipient that may significantly
affect absorption of API
e.g. Prednisolone sodium phosphate oral solution
Inactive must not have safety issue
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Solid Oral Dosage
Dissolution testing on all strengths
Strength proportionality must be similar to the biostrength
In-vivo BE must be established for higher strength
But for safety lower strength
E.g. Terazosin HCl 1, 2, 5 & 10 mg strength, 2 is acceptable
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Highly Soluble, Highly Permeable, Rapidly Dissolving
e.g. Ofloxacin
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Dissolution e.g. Omeprazole
Use of dissolution data for biowaiver of non-bio strength
Two stage dissolution testing
(acid medium & buffered medium)
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Dissolution as a tool
Batch to batch
consistency
Quality Assurance
Formulation development
Bio-waiver In vitro BE
studies
Alcohol induced dose
dumping
Post-approval manufacturing
changes
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Dissolution Method Development
Dissolution
Material Attributes
Process Parameters
Formulation Variables
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REMEMBER
Dissolution
method is
product specific
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Dissolution Method Development
Product Specific
Method Development Evaluation of
method
Discriminating
Ability
Acceptance
Criteria
1
2
3
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Evaluation of
method
1
Solubility ProfileApparatus Selection
Dissolution/Release Media
Rotation speed Sink conditionsSupportive data for surfactant
selection
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Discriminating
Ability
2
Differentiates DP manufactured under
target conditions vs. formulation with
meaningful variations for the most
relevant manufacturing variables
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Acceptance
Criteria
3
Bioequivalence batches
85% of drug is dissolved or
where plateau of drug dissolved is
reached
Selection of time points should be where Q=80% of drug is dissolved
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Common Deficiencies in Regulatory Submissions
Dissolution method development not
included in application
Failure to demonstrate
discriminatory power (information lacking on CMA &
PP)
Data not supportive of proposed
acceptance criteria
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Common Deficiencies in Regulatory Submissions
No dissolution data for lower
strength waivers,
multi-media testing for MR
products
No method transfer report on site change after method
validation
Dissolution data collected on aged lots
Individual dissolution data is not submitted
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Dissolution Failure
Formulation had not been properly validated (FDA 2008)
Therapeutic failure reported in 2007
Tropol XL (Sandoz) approved in 1992
Metoprolol Succinate Tabs ER Recall due to dissolution
What should we learn?
What do you think?
Recalled due to dissolution
2009 Ethex (KV Pharmaceuticals)
2014 Wockhardt & Ranbaxy
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Sometimes Math does not favor
ADHD
• Mallinckrodt
• Methyl Phenidate HCltab
• 18, 27, 36, 54 mg dose
Failure
• Fasting & fed had two different behavior in extended release
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Sometimes Math does not favor
BupripionHCl tab
• Study on low dose and waiver on high dose
Failure
• Desired kinetics was not achieved
Teva
• FDA asked to stop distribution in sep 2012
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Sometimes Math does not favor
Bupripion(Wellbutrin)
IR Tab of SKB 1985
Bupripion SR Tab 1996
& XL Tab 2003
Based on evidence
demonstrating BE with
low strength
In 2006, Generic
version Mfg by
Impax/Tevawere
approved
85 post marketing
reports from Jan-Jun 2007
Experienced undesirable
effects
Increased side effects,
Decreased therapeutic
effect
Re-switched on brand
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Sometimes Math does not favor
Temporal relationship
under question
FDA re-examined BE data
Conducted study
Withdrawal of Teva drug in Mar 2013 against Sep 2012 FDA
advice
Also generic of Actavis
withdraw their version
A new challenge
General rule will not
work always
Its life, please care
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