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IVT Forum – Stability
                                                  Programs
                                                                              Geoff Carr
                        http://www.patheon.com                    geoff.carr@patheon.com



                                                   Philadelphia, 07th Dec 2010



       Designing Stability Programs for Early
                     Stages of Development
For more information on stability programs or to download the full presentation, please visit
                                                                 http://www.ivtnetwork.com
Introduction

β€’β€― Requirements for conducting stability studies for
   Marketing Authorisation Applications eg NDAs clearly set
   out within ICH Q1 series of guidelines
β€’β€― Very explicit on
   –  How many batches
   –  Nature of batches
   –  Duration of study required at time of application
   –  How to evaluate the data
   –  Etc
   –  Etc



IQPC Conf – Stability Testing – Early Stage Stability Studies 2
Introduction

β€’β€― During development stages, stability studies are also
   required
   –  Provide initial indications of drug substance and drug
      product stability
   –  To monitor the suitability of clinical trial batches
   –  To establish suitability of experimental formulations




IQPC Conf – Stability Testing – Early Stage Stability Studies 3
Introduction

β€’β€― As a baseline, a typical full ICH stability protocol
   something like this:




IQPC Conf – Stability Testing – Early Stage Stability Studies 4
Introduction
Typical Study Schedule for an ICH Stability Program




* 30Β°C/65%RH stability samples to be pulled at their designated time points. Samples will be tested if those at 40Β°C/75%RH show significant
     changes as defined by ICH Q1A: A 5% change in potency loss from initial assay, any specified degradant exceeding its specification limit,
                                     failure to meet specifications for appearance and physical properties.




   IQPC Conf – Stability Testing – Early Stage Stability Studies 5
Introduction

β€’β€― Presentation will discuss some examples of suitable
   stability protocols as follows:




IQPC Conf – Stability Testing – Early Stage Stability Studies 6
Main Menu
Introduction
Experimental Stability Protocols
Stability Protocols for Phase 1
Stability Protocols for Phase 2/3
Placebo Stability
Dealing with Blinded Clinical
 Comparators
Conclusions




7
IQPC Conf – Stability Testing – Early Stage Stability Studies 7   Confidential
Main Menu
Introduction
Experimental Stability Protocols
Stability Protocols for Phase 1
Stability Protocols for Phase 2/3
Placebo Stability
Dealing with Blinded Clinical
 Comparators
Conclusions




8
IQPC Conf – Stability Testing – Early Stage Stability Studies 8   Confidential
Experimental Stability Protocols

β€’β€― Early studies that may be conducted to prepare for later
   long term studies eg
   –  Forced Degradation Studies
   –  Very important but being covered in separate presentations
β€’β€― Conducted to assist with product development studies
   eg
   –  Drug Excipient Compatibility Studies




IQPC Conf – Stability Testing – Early Stage Stability Studies 9
Experimental Stability Studies –
Excipient Compatibility Studies
β€’β€― Very important to provide Formulation Development
   Scientists with some initial data to help select
   appropriate excipients
β€’β€― Or more importantly to help deselect
   inappropriate excipients




IQPC Conf – Stability Testing – Early Stage Stability Studies 10
Experimental Stability Studies –
Excipient Compatibility Studies
β€’β€― Study may be conducted using binary mixtures of API +
   excipient
β€’β€― Design of experiments approach may be more
   appropriate but a suitable schedule will look something
   like:




IQPC Conf – Stability Testing – Early Stage Stability Studies 11
Experimental Stability Studies –
Excipient Compatibility Studies
                STABILITY TESTING SCHEDULE FOR A DRUG EXCIPIENT
                              COMPATIBILITY STUDY




* 40Β°C/75%RH and 25Β°C/60%RH stability samples to be pulled at their designated time points. Samples will be tested if
                                    those at 60˚C show excessive degradation




 IQPC Conf – Stability Testing – Early Stage Stability Studies 12
Experimental Stability Studies –
Excipient Compatibility Studies
β€’β€― Samples will typically be tested for:
   –  Appearance
   –  Potency assay by HPLC
   –  Related substances by HPLC




IQPC Conf – Stability Testing – Early Stage Stability Studies 13
Main Menu
Introduction
Experimental Stability Protocols
Stability Protocols for Phase 1
Stability Protocols for Phase 2/3
Placebo Stability
Dealing with Blinded Clinical
 Comparators
Conclusions




14
IQPC Conf – Stability Testing – Early Stage Stability Studies 14   Confidential
Stability Protocols for Phase 1

β€’β€― Company requirements for speed
β€’β€― No time to develop a robust formulation and this is
   probably not needed because:
   –  Clinical study of short duration eg a few weeks
   –  Limited number of subjects
   –  Small batch size
        β€’β€― Quite likely that API availability very limited




IQPC Conf – Stability Testing – Early Stage Stability Studies 15
Stability Protocols for Phase 1

β€’β€― Good example of Phase 1 formulation is Powder in Bottle
   (PIB)
β€’β€― Individual subject doses of API are accurately weighed
   into separate bottles and shipped to study centre
β€’β€― Prior to administration to subjects they are then
   constituted with appropriate vehicle (usually water but
   see later)




IQPC Conf – Stability Testing – Early Stage Stability Studies 16
Stability Protocols for Phase 1

β€’β€― Requires minimal development or analytical support
   because:
   –  API not mixed with other ingredients prior to shipment to
      study centre and so no issues of possible incompatibilities or
      concerns about adequacy of blending
   –  Vehicle added very shortly before administration and so very
      little risk of inducing instability




IQPC Conf – Stability Testing – Early Stage Stability Studies 17
Stability Protocols for Phase 1
      Stability Testing Schedule for a Phase 1 Powder in Bottle (PIB)




* Samples stored at 5Β°C are available as controls and will only be tested if needed for an investigation




      IQPC Conf – Stability Testing – Early Stage Stability Studies 18
Stability Protocols for Phase 1

β€’β€― Samples to be tested for:
   –  Appearance
   –  Potency assay by HPLC
   –  Related substances by HPLC




IQPC Conf – Stability Testing – Early Stage Stability Studies 19
Stability Protocols for Phase 1

β€’β€― Must also consider β€œin use” stability
β€’β€― PIBs must be constituted prior to administration to
   subjects
β€’β€― In busy clinical centre likely to be conducted in
   pharmacy then taken to ward
β€’β€― Take into account that constitution immediately prior to
   administration could in reality mean constitution several
   hours prior to administration




IQPC Conf – Stability Testing – Early Stage Stability Studies 20
Stability Protocols for Phase 1

β€’β€― Constitution vehicle usually water but could be
   –  Aqueous surfactant to assist solubility
   –  Fruit juice to provide some taste masking
   –  In case of fruit juice, important to use the same batch for
        β€’β€― Development
        β€’β€― Stability
        β€’β€― Constitution for administration to subjects




IQPC Conf – Stability Testing – Early Stage Stability Studies 21
Stability Protocols for Phase 1

β€’β€― Constituted samples should be kept at
   –  25Β°C/60%RH
   –  5Β°C/Amb RH
β€’β€― Up to 24 hours and probably tested at intervals such as
   –  T=0
   –  T=5 hours
   –  T=12 hours
   –  T=24 hours
        β€’β€― Later time point(s) may also be applied for additional security
β€’β€― Duration limited by microbiological considerations.
   Product would need preservative for longer periods

IQPC Conf – Stability Testing – Early Stage Stability Studies 22
Main Menu
Introduction
Experimental Stability Protocols
Stability Protocols for Phase 1
Stability Protocols for Phase 2/3
Placebo Stability
Dealing with Blinded Clinical
 Comparators
Conclusions




23
IQPC Conf – Stability Testing – Early Stage Stability Studies 23   Confidential
Stability Protocols for Phase 2/3

β€’β€― Clinical trials conducted on large patient populations
β€’β€― Durations of clinical studies likely to be longer eg several
   months
β€’β€― Important now to be using formulations that are likely to
   more closely resemble future commercial products
β€’β€― Stability protocol likely to be very close to an ICH study




IQPC Conf – Stability Testing – Early Stage Stability Studies 24
Stability Protocols for Phase 2/3
                                      Stability Schedule for Phase 2/3 Studies




* 30Β°C/65%RH stability samples to be pulled at their designated time points. Samples will be tested if those at 40Β°C/75%RH show any
significant changes




     IQPC Conf – Stability Testing – Early Stage Stability Studies 25
Stability Protocols for Phase 2/3

β€’β€― Samples to be tested for:
   –  Appearance
   –  Potency assay by HPLC
   –  Related substances by HPLC
   –  Pharmaceutical performance eg
        β€’β€― Dissolution for solid oral dosage forms
        β€’β€― pH for solutions
        β€’β€― Viscosity for topicals




IQPC Conf – Stability Testing – Early Stage Stability Studies 26
Stability Protocols for Phase 2/3

β€’β€― Duration of stability studies may continue beyond clinical
   study
   –  Likely that by this stage, APIs and products much more
      freely available
   –  May be useful to use data from these studies as supportive
      for registration stability




IQPC Conf – Stability Testing – Early Stage Stability Studies 27
Main Menu
Introduction
Experimental Stability Protocols
Stability Protocols for Phase 1
Stability Protocols for Phase 2/3
Placebo Stability
Dealing with Blinded Clinical
 Comparators
Conclusions




28
IQPC Conf – Stability Testing – Early Stage Stability Studies 28   Confidential
Placebo Stability

β€’β€― Many clinical trials conducted using placebo controls
β€’β€― Double blinded studies
β€’β€― In order for blinding to be secure, placebos are designed
   to be visually identical to the active preparations
β€’β€― Security of clinical study could be compromised if this
   situation is not maintained
β€’β€― Therefore important for placebos to be included in the
   stability program
β€’β€― Likely that the most important stability test will be
   appearance in the case of dosage forms such as tablets
   and capsules
   –  Sometimes, moisture content and disintegration also
      requested

IQPC Conf – Stability Testing – Early Stage Stability Studies 29
Placebo Stability

β€’β€― For formulations containing preservatives additional tests
   that should be considered:
   –  Preservative assay
   –  Preservative efficacy test (PET)




IQPC Conf – Stability Testing – Early Stage Stability Studies 30
Main Menu
Introduction
Experimental Stability Protocols
Stability Protocols for Phase 1
Stability Protocols for Phase 2/3
Placebo Stability
Dealing with Blinded Clinical
 Comparators
Conclusions




31
IQPC Conf – Stability Testing – Early Stage Stability Studies 31   Confidential
Dealing with Blinded Comparators

β€’β€― The challenge – how to make the comparator look like
   the product under investigation without compromising
   its integrity and also demonstrating that this has been
   achieved




IQPC Conf – Stability Testing – Early Stage Stability Studies 32
Dealing with Blinded Comparators

β€’β€― Common practice in Phase 2/3 studies to look for clinical
   comparisons between the drug under investigation and a
   well established product already on the market –
   Comparator
β€’β€― Regulatory Agencies require this as part of proof of
   efficacy
   –  Usually done using the generally accepted market leader
      product
β€’β€― Quite likely that the comparator is manufactured by a
   different Company



IQPC Conf – Stability Testing – Early Stage Stability Studies 33
Dealing with Blinded Comparators

β€’β€― Important that neither investigators nor patients know
   whether product being administered is:
   –  NCE under investigation
   –  Comparator
   –  Placebo




IQPC Conf – Stability Testing – Early Stage Stability Studies 34
Dealing with Blinded Comparators

β€’β€― Various ways of achieving this
   –  Blinded comparators in which
        β€’β€― NCE under investigation
        β€’β€― Comparator
        β€’β€― Placebo
   –  All made to look alike
β€’β€― Double dummy design in which
   –  NCE under investigation + placebo look alike
   –  Comparator + different placebo look alike
β€’β€― Use of blinded comparator preferred and more powerful
   study design



IQPC Conf – Stability Testing – Early Stage Stability Studies 35
Dealing with Blinded Comparators

β€’β€― Blinding a comparator involves some manipulation of a
   commercial product and we probably know very little
   about the chemistry of the API
β€’β€― So how can we really claim that this is now a valid
   comparator??
   –  Possible changes to pharmaceutical performance
β€’β€― How can we be sure that we are not placing clinical
   subjects at risk??
   –  Due to inadvertently causing some degradation to a toxic
      impurity



IQPC Conf – Stability Testing – Early Stage Stability Studies 36
Dealing with Blinded Comparators

β€’β€― Approaches to blinding a comparator taking a tablet/
   capsule as example could include:
   –  Encapsulation of tablets and add a back fill
   –  May require more than 1 tablet per capsule
        β€’β€― Back fill should be a major diluent ingredient of the comparator
        β€’β€― Considered minimal manipulation
   –  Break tablet then encapsulate pieces with a back fill
        β€’β€― May be necessary for very large tablets
             –  Or if required strength not available
        β€’β€― This is a more serious manipulation




IQPC Conf – Stability Testing – Early Stage Stability Studies 37
Dealing with Blinded Comparators

β€’β€― Approaches to blinding a comparator taking a tablet/
   capsule as example contd
   –  Mill tablet/capsule then fill into new capsule shells
        β€’β€― May be necessary for very large tablet/capsules and least
           preferred approach
        β€’β€― This is a very serious manipulation




IQPC Conf – Stability Testing – Early Stage Stability Studies 38
Dealing with Blinded Comparators

β€’β€― For any of these manipulations, we must conduct
   stability studies to demonstrate that we have not
   altered:
   –  Pharmaceutical performance
   –  Chemical stability
β€’β€― Of the comparator product




IQPC Conf – Stability Testing – Early Stage Stability Studies 39
Dealing with Blinded Comparators

β€’β€― Not addressed by FDA in IND Guidelines
β€’β€― Nor Health Canada
β€’β€― Addressed by EMA Guideline
   –  Guideline on the Requirements to the Chemical and
      Pharmaceutical Quality Documentation Concerning
      Investigational Medicinal Products in Clinical Trials
   –  Became effective in Oct 2006
β€’β€― See
   http://www.ema.europa.eu/docs/en_GB/
   document_library/Scientific_guideline/2009/09/
   WC500003484.pdf

IQPC Conf – Stability Testing – Early Stage Stability Studies 40
Dealing with Blinded Comparators

β€’β€― Refers to Investigational Medicinal Products (IMPs)
β€’β€― Investigational Medicinal Product Dossiers (IMPDs)
β€’β€― IMPD is equivalent to US IND
β€’β€― Section 3 of Guideline deals with Modified Comparator
   Products
β€’β€― Requires that we address the influence of modifications
   on product quality
β€’β€― Need to demonstrate that quality and stability
   comparable to unmodified product



IQPC Conf – Stability Testing – Early Stage Stability Studies 41
Dealing with Blinded Comparators

β€’β€― Typical stability protocol similar to the Phase 2/3
   protocol shown earlier:




IQPC Conf – Stability Testing – Early Stage Stability Studies 42
Dealing with Blinded Comparators
                         Stability Schedule for Blinded Comparator Studies




* 30Β°C/65%RH stability samples to be pulled at their designated time points. Samples will be tested if those at 40Β°C/75%RH show any significant
changes




    IQPC Conf – Stability Testing – Early Stage Stability Studies 43
Dealing with Blinded Comparators

β€’β€― Samples to be tested for:
                     1.β€― Appearance
                     2.β€― Potency assay by HPLC (Recommended but may not
                         be required by EMA Guideline)
                     3.β€― Related substances by HPLC
                     4.β€― Dissolution
β€’β€― Except that in the cases of tests 2., 3. and 4. would be
   done on the basis of comparisons with unblinded
   tablets/capsules from the same batch and in their
   primary commercial packaging



IQPC Conf – Stability Testing – Early Stage Stability Studies 44
Dealing with Blinded Comparators

β€’β€― Object of study
   –  Not to investigate the stability of our competitors’ products
   –  To demonstrate that we have not inadvertently altered
      stability
β€’β€― This is all very well but where we supposed to get the
   appropriate analytical methods from??




IQPC Conf – Stability Testing – Early Stage Stability Studies 45
Dealing with Blinded Comparators

β€’β€― Refer to compendial monographs
   –  USP
   –  Ph Eur for APIs
   –  BP
β€’β€― Since we are usually dealing with market leaders, very
   likely that compendial monographs will be available
β€’β€― For potency assays and related substances tests, no
   guarantees that these methods will be stability indicating
   so forced degradation study may be needed
   –  Methods will probably need to be validated
      β€’β€― Verified for USP as per <1226>

IQPC Conf – Stability Testing – Early Stage Stability Studies 46
Dealing with Blinded Comparators
β€’β€― Dissolution tests may be even more challenging
β€’β€― If dissolution tests provided in USP/BP generally single point
   tests based on requirements of β€œnot less than x% release in y
   minutes”
β€’β€― Not good enough to demonstrate no differences in
   performance
β€’β€― Better approach based on dissolution profile comparisons
β€’β€― Required by CHMP IMP Guideline in Section 3
β€’β€― Recommends to follow CHMP Guideline
   –  Note for Guidance on Bioavailability and Bioequivalence
      Annex II Dissolution Testing
β€’β€― This Guideline has been adopted and became effective in Oct
   2006


IQPC Conf – Stability Testing – Early Stage Stability Studies 47
Dealing with Blinded Comparators

β€’β€― Also well described in FDA Guidance for Industry
   –  β€œDissolution Testing of Immediate Release Solid Oral Dosage
      Forms”
   –  See
      http://www.fda.gov/downloads/Drugs/
      GuidanceComplianceRegulatoryInformation/Guidances/
      ucm070237.pdf
        β€’β€― Categorised under Biopharmaceutics section
β€’β€― CHMP and FDA Guidelines both recommend dissolution profile
   comparisons




IQPC Conf – Stability Testing – Early Stage Stability Studies 48
Dealing with Blinded Comparators

β€’β€― Guideline recommends profile comparisons for:
   –  SUPAC related changes
        β€’β€― SUPAC = Scale up and post approval changes
   –  Other situations where Company wishes to justify
      bioequivalence waivers
        β€’β€― Eg with blinded clinical comparators




IQPC Conf – Stability Testing – Early Stage Stability Studies 49
Dealing with Blinded Comparators

β€’β€― Guidance identifies 2 approaches
   –  f1 comparison – Difference Factor
   –  f2 comparison – Similarity Factor
β€’β€― For both cases we need a dissolution profile
   –  Probably 4 time points
   –  Must have only 1 time point with release value >85%
β€’β€― So a test method that meets these requirements must
   be developed and validated
   –  Probably using a compendial method as start point




IQPC Conf – Stability Testing – Early Stage Stability Studies 50
Dealing with Blinded Comparators

β€’β€― Comparisons require that 12 dosage units be tested for
   each of the 2 products being compared
β€’β€― Difference factor (f1) calculated from:
   –  f1 = {[Ξ£t=1t=n | Rt - Tt | ]/[Ξ£t=1t=n Rt ]}x100
β€’β€― Similarity factor (f2) calculated from:
   –  f2 = 50xlog{[1+(1/n)Ξ£t=1t=n ( Rt - Tt )2 ]-0.5x100}
β€’β€― For a satisfactory comparison
   –  f1 = 0 – 15
   –  f2 = 50 – 100




IQPC Conf – Stability Testing – Early Stage Stability Studies 51
Dealing with Blinded Comparators

β€’β€― In making judgments, beware of differences simply due
   to encapsulation ie lag time during which capsule
   dissolves
β€’β€― May be appropriate to remove the tablets from capsules
   first
β€’β€― CHMP IMP Guideline makes it clear that if we are unable
   to demonstrate in-vitro equivalence then it may be
   necessary to get clinical data to demonstrate
   equivalence of manipulated comparators




IQPC Conf – Stability Testing – Early Stage Stability Studies 52
Main Menu
Introduction
Experimental Stability Protocols
Stability Protocols for Phase 1
Stability Protocols for Phase 2/3
Placebo Stability
Dealing with Blinded Clinical
 Comparators
Conclusions




53
IQPC Conf – Stability Testing – Early Stage Stability Studies 53   Confidential
Conclusions

β€’β€― Early phase stability studies important for getting early
   information from excipient compatibility studies and on
   suitability of experimental formulations as well as
   monitoring quality of clinical trials materials
β€’β€― Useful to follow ICH Q1 principles but to modify in
   accordance with early development requirements
β€’β€― So for Phase 1 batches, very short term studies may be
   sufficient
β€’β€― May however require in use stability data eg for powder
   in bottle presentations that require constitution prior to
   administration


IQPC Conf – Stability Testing – Early Stage Stability Studies 54
Conclusions

β€’β€― Phase 2/3 stability data may provide useful supportive
   data for Marketing Authorisation Applications so could be
   useful to continue them beyond clinical requirements
β€’β€― Necessary to monitor stability of placebos especially for
   appearance
β€’β€― Clinical comparators present a special challenge and very
   important to demonstrate that any manipulations carried
   out in order to blind them does not adversely affect their
   stability or pharmaceutical performance
β€’β€― Important to take note of requirements of CHMP IMP
   Guideline
   –  Became effective Oct 2006



IQPC Conf – Stability Testing – Early Stage Stability Studies 55

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Designing Stability Studies for Early Stages of Pharmaceutical Development

  • 1. IVT Forum – Stability Programs Geoff Carr http://www.patheon.com geoff.carr@patheon.com Philadelphia, 07th Dec 2010 Designing Stability Programs for Early Stages of Development For more information on stability programs or to download the full presentation, please visit http://www.ivtnetwork.com
  • 2. Introduction β€’β€― Requirements for conducting stability studies for Marketing Authorisation Applications eg NDAs clearly set out within ICH Q1 series of guidelines β€’β€― Very explicit on –  How many batches –  Nature of batches –  Duration of study required at time of application –  How to evaluate the data –  Etc –  Etc IQPC Conf – Stability Testing – Early Stage Stability Studies 2
  • 3. Introduction β€’β€― During development stages, stability studies are also required –  Provide initial indications of drug substance and drug product stability –  To monitor the suitability of clinical trial batches –  To establish suitability of experimental formulations IQPC Conf – Stability Testing – Early Stage Stability Studies 3
  • 4. Introduction β€’β€― As a baseline, a typical full ICH stability protocol something like this: IQPC Conf – Stability Testing – Early Stage Stability Studies 4
  • 5. Introduction Typical Study Schedule for an ICH Stability Program * 30Β°C/65%RH stability samples to be pulled at their designated time points. Samples will be tested if those at 40Β°C/75%RH show significant changes as defined by ICH Q1A: A 5% change in potency loss from initial assay, any specified degradant exceeding its specification limit, failure to meet specifications for appearance and physical properties. IQPC Conf – Stability Testing – Early Stage Stability Studies 5
  • 6. Introduction β€’β€― Presentation will discuss some examples of suitable stability protocols as follows: IQPC Conf – Stability Testing – Early Stage Stability Studies 6
  • 7. Main Menu Introduction Experimental Stability Protocols Stability Protocols for Phase 1 Stability Protocols for Phase 2/3 Placebo Stability Dealing with Blinded Clinical Comparators Conclusions 7 IQPC Conf – Stability Testing – Early Stage Stability Studies 7 Confidential
  • 8. Main Menu Introduction Experimental Stability Protocols Stability Protocols for Phase 1 Stability Protocols for Phase 2/3 Placebo Stability Dealing with Blinded Clinical Comparators Conclusions 8 IQPC Conf – Stability Testing – Early Stage Stability Studies 8 Confidential
  • 9. Experimental Stability Protocols β€’β€― Early studies that may be conducted to prepare for later long term studies eg –  Forced Degradation Studies –  Very important but being covered in separate presentations β€’β€― Conducted to assist with product development studies eg –  Drug Excipient Compatibility Studies IQPC Conf – Stability Testing – Early Stage Stability Studies 9
  • 10. Experimental Stability Studies – Excipient Compatibility Studies β€’β€― Very important to provide Formulation Development Scientists with some initial data to help select appropriate excipients β€’β€― Or more importantly to help deselect inappropriate excipients IQPC Conf – Stability Testing – Early Stage Stability Studies 10
  • 11. Experimental Stability Studies – Excipient Compatibility Studies β€’β€― Study may be conducted using binary mixtures of API + excipient β€’β€― Design of experiments approach may be more appropriate but a suitable schedule will look something like: IQPC Conf – Stability Testing – Early Stage Stability Studies 11
  • 12. Experimental Stability Studies – Excipient Compatibility Studies STABILITY TESTING SCHEDULE FOR A DRUG EXCIPIENT COMPATIBILITY STUDY * 40Β°C/75%RH and 25Β°C/60%RH stability samples to be pulled at their designated time points. Samples will be tested if those at 60˚C show excessive degradation IQPC Conf – Stability Testing – Early Stage Stability Studies 12
  • 13. Experimental Stability Studies – Excipient Compatibility Studies β€’β€― Samples will typically be tested for: –  Appearance –  Potency assay by HPLC –  Related substances by HPLC IQPC Conf – Stability Testing – Early Stage Stability Studies 13
  • 14. Main Menu Introduction Experimental Stability Protocols Stability Protocols for Phase 1 Stability Protocols for Phase 2/3 Placebo Stability Dealing with Blinded Clinical Comparators Conclusions 14 IQPC Conf – Stability Testing – Early Stage Stability Studies 14 Confidential
  • 15. Stability Protocols for Phase 1 β€’β€― Company requirements for speed β€’β€― No time to develop a robust formulation and this is probably not needed because: –  Clinical study of short duration eg a few weeks –  Limited number of subjects –  Small batch size β€’β€― Quite likely that API availability very limited IQPC Conf – Stability Testing – Early Stage Stability Studies 15
  • 16. Stability Protocols for Phase 1 β€’β€― Good example of Phase 1 formulation is Powder in Bottle (PIB) β€’β€― Individual subject doses of API are accurately weighed into separate bottles and shipped to study centre β€’β€― Prior to administration to subjects they are then constituted with appropriate vehicle (usually water but see later) IQPC Conf – Stability Testing – Early Stage Stability Studies 16
  • 17. Stability Protocols for Phase 1 β€’β€― Requires minimal development or analytical support because: –  API not mixed with other ingredients prior to shipment to study centre and so no issues of possible incompatibilities or concerns about adequacy of blending –  Vehicle added very shortly before administration and so very little risk of inducing instability IQPC Conf – Stability Testing – Early Stage Stability Studies 17
  • 18. Stability Protocols for Phase 1 Stability Testing Schedule for a Phase 1 Powder in Bottle (PIB) * Samples stored at 5Β°C are available as controls and will only be tested if needed for an investigation IQPC Conf – Stability Testing – Early Stage Stability Studies 18
  • 19. Stability Protocols for Phase 1 β€’β€― Samples to be tested for: –  Appearance –  Potency assay by HPLC –  Related substances by HPLC IQPC Conf – Stability Testing – Early Stage Stability Studies 19
  • 20. Stability Protocols for Phase 1 β€’β€― Must also consider β€œin use” stability β€’β€― PIBs must be constituted prior to administration to subjects β€’β€― In busy clinical centre likely to be conducted in pharmacy then taken to ward β€’β€― Take into account that constitution immediately prior to administration could in reality mean constitution several hours prior to administration IQPC Conf – Stability Testing – Early Stage Stability Studies 20
  • 21. Stability Protocols for Phase 1 β€’β€― Constitution vehicle usually water but could be –  Aqueous surfactant to assist solubility –  Fruit juice to provide some taste masking –  In case of fruit juice, important to use the same batch for β€’β€― Development β€’β€― Stability β€’β€― Constitution for administration to subjects IQPC Conf – Stability Testing – Early Stage Stability Studies 21
  • 22. Stability Protocols for Phase 1 β€’β€― Constituted samples should be kept at –  25Β°C/60%RH –  5Β°C/Amb RH β€’β€― Up to 24 hours and probably tested at intervals such as –  T=0 –  T=5 hours –  T=12 hours –  T=24 hours β€’β€― Later time point(s) may also be applied for additional security β€’β€― Duration limited by microbiological considerations. Product would need preservative for longer periods IQPC Conf – Stability Testing – Early Stage Stability Studies 22
  • 23. Main Menu Introduction Experimental Stability Protocols Stability Protocols for Phase 1 Stability Protocols for Phase 2/3 Placebo Stability Dealing with Blinded Clinical Comparators Conclusions 23 IQPC Conf – Stability Testing – Early Stage Stability Studies 23 Confidential
  • 24. Stability Protocols for Phase 2/3 β€’β€― Clinical trials conducted on large patient populations β€’β€― Durations of clinical studies likely to be longer eg several months β€’β€― Important now to be using formulations that are likely to more closely resemble future commercial products β€’β€― Stability protocol likely to be very close to an ICH study IQPC Conf – Stability Testing – Early Stage Stability Studies 24
  • 25. Stability Protocols for Phase 2/3 Stability Schedule for Phase 2/3 Studies * 30Β°C/65%RH stability samples to be pulled at their designated time points. Samples will be tested if those at 40Β°C/75%RH show any significant changes IQPC Conf – Stability Testing – Early Stage Stability Studies 25
  • 26. Stability Protocols for Phase 2/3 β€’β€― Samples to be tested for: –  Appearance –  Potency assay by HPLC –  Related substances by HPLC –  Pharmaceutical performance eg β€’β€― Dissolution for solid oral dosage forms β€’β€― pH for solutions β€’β€― Viscosity for topicals IQPC Conf – Stability Testing – Early Stage Stability Studies 26
  • 27. Stability Protocols for Phase 2/3 β€’β€― Duration of stability studies may continue beyond clinical study –  Likely that by this stage, APIs and products much more freely available –  May be useful to use data from these studies as supportive for registration stability IQPC Conf – Stability Testing – Early Stage Stability Studies 27
  • 28. Main Menu Introduction Experimental Stability Protocols Stability Protocols for Phase 1 Stability Protocols for Phase 2/3 Placebo Stability Dealing with Blinded Clinical Comparators Conclusions 28 IQPC Conf – Stability Testing – Early Stage Stability Studies 28 Confidential
  • 29. Placebo Stability β€’β€― Many clinical trials conducted using placebo controls β€’β€― Double blinded studies β€’β€― In order for blinding to be secure, placebos are designed to be visually identical to the active preparations β€’β€― Security of clinical study could be compromised if this situation is not maintained β€’β€― Therefore important for placebos to be included in the stability program β€’β€― Likely that the most important stability test will be appearance in the case of dosage forms such as tablets and capsules –  Sometimes, moisture content and disintegration also requested IQPC Conf – Stability Testing – Early Stage Stability Studies 29
  • 30. Placebo Stability β€’β€― For formulations containing preservatives additional tests that should be considered: –  Preservative assay –  Preservative efficacy test (PET) IQPC Conf – Stability Testing – Early Stage Stability Studies 30
  • 31. Main Menu Introduction Experimental Stability Protocols Stability Protocols for Phase 1 Stability Protocols for Phase 2/3 Placebo Stability Dealing with Blinded Clinical Comparators Conclusions 31 IQPC Conf – Stability Testing – Early Stage Stability Studies 31 Confidential
  • 32. Dealing with Blinded Comparators β€’β€― The challenge – how to make the comparator look like the product under investigation without compromising its integrity and also demonstrating that this has been achieved IQPC Conf – Stability Testing – Early Stage Stability Studies 32
  • 33. Dealing with Blinded Comparators β€’β€― Common practice in Phase 2/3 studies to look for clinical comparisons between the drug under investigation and a well established product already on the market – Comparator β€’β€― Regulatory Agencies require this as part of proof of efficacy –  Usually done using the generally accepted market leader product β€’β€― Quite likely that the comparator is manufactured by a different Company IQPC Conf – Stability Testing – Early Stage Stability Studies 33
  • 34. Dealing with Blinded Comparators β€’β€― Important that neither investigators nor patients know whether product being administered is: –  NCE under investigation –  Comparator –  Placebo IQPC Conf – Stability Testing – Early Stage Stability Studies 34
  • 35. Dealing with Blinded Comparators β€’β€― Various ways of achieving this –  Blinded comparators in which β€’β€― NCE under investigation β€’β€― Comparator β€’β€― Placebo –  All made to look alike β€’β€― Double dummy design in which –  NCE under investigation + placebo look alike –  Comparator + different placebo look alike β€’β€― Use of blinded comparator preferred and more powerful study design IQPC Conf – Stability Testing – Early Stage Stability Studies 35
  • 36. Dealing with Blinded Comparators β€’β€― Blinding a comparator involves some manipulation of a commercial product and we probably know very little about the chemistry of the API β€’β€― So how can we really claim that this is now a valid comparator?? –  Possible changes to pharmaceutical performance β€’β€― How can we be sure that we are not placing clinical subjects at risk?? –  Due to inadvertently causing some degradation to a toxic impurity IQPC Conf – Stability Testing – Early Stage Stability Studies 36
  • 37. Dealing with Blinded Comparators β€’β€― Approaches to blinding a comparator taking a tablet/ capsule as example could include: –  Encapsulation of tablets and add a back fill –  May require more than 1 tablet per capsule β€’β€― Back fill should be a major diluent ingredient of the comparator β€’β€― Considered minimal manipulation –  Break tablet then encapsulate pieces with a back fill β€’β€― May be necessary for very large tablets –  Or if required strength not available β€’β€― This is a more serious manipulation IQPC Conf – Stability Testing – Early Stage Stability Studies 37
  • 38. Dealing with Blinded Comparators β€’β€― Approaches to blinding a comparator taking a tablet/ capsule as example contd –  Mill tablet/capsule then fill into new capsule shells β€’β€― May be necessary for very large tablet/capsules and least preferred approach β€’β€― This is a very serious manipulation IQPC Conf – Stability Testing – Early Stage Stability Studies 38
  • 39. Dealing with Blinded Comparators β€’β€― For any of these manipulations, we must conduct stability studies to demonstrate that we have not altered: –  Pharmaceutical performance –  Chemical stability β€’β€― Of the comparator product IQPC Conf – Stability Testing – Early Stage Stability Studies 39
  • 40. Dealing with Blinded Comparators β€’β€― Not addressed by FDA in IND Guidelines β€’β€― Nor Health Canada β€’β€― Addressed by EMA Guideline –  Guideline on the Requirements to the Chemical and Pharmaceutical Quality Documentation Concerning Investigational Medicinal Products in Clinical Trials –  Became effective in Oct 2006 β€’β€― See http://www.ema.europa.eu/docs/en_GB/ document_library/Scientific_guideline/2009/09/ WC500003484.pdf IQPC Conf – Stability Testing – Early Stage Stability Studies 40
  • 41. Dealing with Blinded Comparators β€’β€― Refers to Investigational Medicinal Products (IMPs) β€’β€― Investigational Medicinal Product Dossiers (IMPDs) β€’β€― IMPD is equivalent to US IND β€’β€― Section 3 of Guideline deals with Modified Comparator Products β€’β€― Requires that we address the influence of modifications on product quality β€’β€― Need to demonstrate that quality and stability comparable to unmodified product IQPC Conf – Stability Testing – Early Stage Stability Studies 41
  • 42. Dealing with Blinded Comparators β€’β€― Typical stability protocol similar to the Phase 2/3 protocol shown earlier: IQPC Conf – Stability Testing – Early Stage Stability Studies 42
  • 43. Dealing with Blinded Comparators Stability Schedule for Blinded Comparator Studies * 30Β°C/65%RH stability samples to be pulled at their designated time points. Samples will be tested if those at 40Β°C/75%RH show any significant changes IQPC Conf – Stability Testing – Early Stage Stability Studies 43
  • 44. Dealing with Blinded Comparators β€’β€― Samples to be tested for: 1.β€― Appearance 2.β€― Potency assay by HPLC (Recommended but may not be required by EMA Guideline) 3.β€― Related substances by HPLC 4.β€― Dissolution β€’β€― Except that in the cases of tests 2., 3. and 4. would be done on the basis of comparisons with unblinded tablets/capsules from the same batch and in their primary commercial packaging IQPC Conf – Stability Testing – Early Stage Stability Studies 44
  • 45. Dealing with Blinded Comparators β€’β€― Object of study –  Not to investigate the stability of our competitors’ products –  To demonstrate that we have not inadvertently altered stability β€’β€― This is all very well but where we supposed to get the appropriate analytical methods from?? IQPC Conf – Stability Testing – Early Stage Stability Studies 45
  • 46. Dealing with Blinded Comparators β€’β€― Refer to compendial monographs –  USP –  Ph Eur for APIs –  BP β€’β€― Since we are usually dealing with market leaders, very likely that compendial monographs will be available β€’β€― For potency assays and related substances tests, no guarantees that these methods will be stability indicating so forced degradation study may be needed –  Methods will probably need to be validated β€’β€― Verified for USP as per <1226> IQPC Conf – Stability Testing – Early Stage Stability Studies 46
  • 47. Dealing with Blinded Comparators β€’β€― Dissolution tests may be even more challenging β€’β€― If dissolution tests provided in USP/BP generally single point tests based on requirements of β€œnot less than x% release in y minutes” β€’β€― Not good enough to demonstrate no differences in performance β€’β€― Better approach based on dissolution profile comparisons β€’β€― Required by CHMP IMP Guideline in Section 3 β€’β€― Recommends to follow CHMP Guideline –  Note for Guidance on Bioavailability and Bioequivalence Annex II Dissolution Testing β€’β€― This Guideline has been adopted and became effective in Oct 2006 IQPC Conf – Stability Testing – Early Stage Stability Studies 47
  • 48. Dealing with Blinded Comparators β€’β€― Also well described in FDA Guidance for Industry –  β€œDissolution Testing of Immediate Release Solid Oral Dosage Forms” –  See http://www.fda.gov/downloads/Drugs/ GuidanceComplianceRegulatoryInformation/Guidances/ ucm070237.pdf β€’β€― Categorised under Biopharmaceutics section β€’β€― CHMP and FDA Guidelines both recommend dissolution profile comparisons IQPC Conf – Stability Testing – Early Stage Stability Studies 48
  • 49. Dealing with Blinded Comparators β€’β€― Guideline recommends profile comparisons for: –  SUPAC related changes β€’β€― SUPAC = Scale up and post approval changes –  Other situations where Company wishes to justify bioequivalence waivers β€’β€― Eg with blinded clinical comparators IQPC Conf – Stability Testing – Early Stage Stability Studies 49
  • 50. Dealing with Blinded Comparators β€’β€― Guidance identifies 2 approaches –  f1 comparison – Difference Factor –  f2 comparison – Similarity Factor β€’β€― For both cases we need a dissolution profile –  Probably 4 time points –  Must have only 1 time point with release value >85% β€’β€― So a test method that meets these requirements must be developed and validated –  Probably using a compendial method as start point IQPC Conf – Stability Testing – Early Stage Stability Studies 50
  • 51. Dealing with Blinded Comparators β€’β€― Comparisons require that 12 dosage units be tested for each of the 2 products being compared β€’β€― Difference factor (f1) calculated from: –  f1 = {[Ξ£t=1t=n | Rt - Tt | ]/[Ξ£t=1t=n Rt ]}x100 β€’β€― Similarity factor (f2) calculated from: –  f2 = 50xlog{[1+(1/n)Ξ£t=1t=n ( Rt - Tt )2 ]-0.5x100} β€’β€― For a satisfactory comparison –  f1 = 0 – 15 –  f2 = 50 – 100 IQPC Conf – Stability Testing – Early Stage Stability Studies 51
  • 52. Dealing with Blinded Comparators β€’β€― In making judgments, beware of differences simply due to encapsulation ie lag time during which capsule dissolves β€’β€― May be appropriate to remove the tablets from capsules first β€’β€― CHMP IMP Guideline makes it clear that if we are unable to demonstrate in-vitro equivalence then it may be necessary to get clinical data to demonstrate equivalence of manipulated comparators IQPC Conf – Stability Testing – Early Stage Stability Studies 52
  • 53. Main Menu Introduction Experimental Stability Protocols Stability Protocols for Phase 1 Stability Protocols for Phase 2/3 Placebo Stability Dealing with Blinded Clinical Comparators Conclusions 53 IQPC Conf – Stability Testing – Early Stage Stability Studies 53 Confidential
  • 54. Conclusions β€’β€― Early phase stability studies important for getting early information from excipient compatibility studies and on suitability of experimental formulations as well as monitoring quality of clinical trials materials β€’β€― Useful to follow ICH Q1 principles but to modify in accordance with early development requirements β€’β€― So for Phase 1 batches, very short term studies may be sufficient β€’β€― May however require in use stability data eg for powder in bottle presentations that require constitution prior to administration IQPC Conf – Stability Testing – Early Stage Stability Studies 54
  • 55. Conclusions β€’β€― Phase 2/3 stability data may provide useful supportive data for Marketing Authorisation Applications so could be useful to continue them beyond clinical requirements β€’β€― Necessary to monitor stability of placebos especially for appearance β€’β€― Clinical comparators present a special challenge and very important to demonstrate that any manipulations carried out in order to blind them does not adversely affect their stability or pharmaceutical performance β€’β€― Important to take note of requirements of CHMP IMP Guideline –  Became effective Oct 2006 IQPC Conf – Stability Testing – Early Stage Stability Studies 55