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Protein viscosity is one of the major obstacles in preparing highly
concentrated protein formulations suitable for sub­
cutaneous
(subQ) injection. SubQ application of highly concentrated protein
formulations enables a higher patient convenience and might
thus lead to reduction in health costs. This can be achieved
by reducing the time requirement of the patient to administer
therapy, e.g. by enabling self-injection at home and reducing
The Viscosity Reduction
Platform: Viscosity-
reducing excipients
for protein formulation
Stefan Braun, Niels Banik, Jennifer J. Widera, Alana Gouveia,
Dr. Jan Gerit Brandenburg, Dr. Can Araman and Dr. Tobias Rosenkranz
Introduction
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0 50 100
Viscosity
[mPa·s]
Concentration [mg/mL]
150 200 250 300
Limit of
injectability
Interactions Crowding
mAbA
mAbB
mAbC
mAbD
mAbE
mAbF
mAbG
mAbH
mAbL
mAbJ
mAbK
Concentration dependency of
viscosity for market formulations
Figure 1.
Dependency of viscosity on antibody concentration and likely underlying causes.
Red lines show injectability limit.
White Paper
time required to do so. However, highly
viscous protein solutions would require a
significant force to be applied to the syringe
for injection. As a result, the patient could
experience a considerable amount of pain.
In many cases, injectability would not be
possible.1,2
When characterizing protein viscosity
behavior, one can differentiate two different
concentration regimes as shown in Figure 1.
At concentrations below 75 mg/mL, proteins
are rarely viscous. When increasing the
concentration to between 100 and 200 mg/
mL, some proteins exhibit elevated viscosity
exceeding the limit of injectability, which
is typically between 20 and 25 mPa·s. At
this concentration regime, several proteins
exhibit an affinity for self-interaction, i.e.
forming transient clusters that give rise to
elevated viscosity. At concentrations above
200 mg/mL, the nearest neighbor distance
between the protein molecules shrinks
so that without a specific affinity for self-
interactions, said protein-protein interactions
take place. While viscosity-reducing
excipients can affect proteins exhibiting
either of these interaction patterns, they
are likely to be more efficient at protein
concentration regimes below 200 mg/mL.3,4
MilliporeSigma is the U.S. and
Canada Life Science business of
Merck KGaA, Darmstadt, Germany.
2
These intermolecular interactions between proteins
have the same molecular origin as the intramolecular
interactions that structurally stabilize the proteins.
This means viscosity-reducing excipients that affect
protein-protein interactions can potentially also
destabilize proteins. As such, it is essential to balance
an excipient’s viscosity-reducing ability against its
potential to destabilize a protein. For some excipients,
a concentration-dependent effect on protein stability
is well-documented. At lower concentrations, the
excipients act as stabilizers, but this behavior changes
as concentration increases, often with an adverse
effect on protein stability.5
Excipient concentration
is thus a critical factor in managing protein stability.
These two aspects can be better balanced by using an
excipient combination of an amino acid and an anionic
excipient. When used in combination, excipients are
more efficient in reducing viscosity and may even do
so in an over-additive manner. Consequently, lower
concentrations of the individual excipients can be used,
which is more favorable for protein stability.
This white paper evaluates the viscosity-reducing
capacities of excipients and excipient combinations. It
shows the over-additive effect of using two excipients
together and addresses how excipients’ viscosity-
reducing ability depends on pH. The results show
the effect of protein viscosity on injection force and
highlight the platform’s ability to balance viscosity
reduction with protein stability. The case studies
presented demonstrate that using a combination of
two excipients at lower concentrations instead of a
single excipient at a higher concentration enables
balancing protein viscosity and protein stability in
a favorable way.
Table 1: Excipients and abbreviations
Excipient Abbrev.
L-Arginine Arg
L-Ornithine monohydrochloride Orn
L-Phenylalanine Phe
Thiamine phosphoric acid ester chloride dihydrate TMP
Benzenesulfonic acid BSAcid
Pyridoxine hydrochloride Pyr
Results & Discussion
Table 1 summarizes the excipients that are part of
the Viscosity Reduction Platform. For clarity reasons,
abbreviations mentioned in Table 1 are used in the
fol­
lowing. L-Arginine (Arg) is the industry standard
for viscosity reduction using a single excipient and
consequently serves as the benchmark excipient.
Single excipients often reduce viscosity
but may impact protein stability
A single excipient is often used to reduce the viscosity
of a protein formulation. Figure 2 shows two model
proteins, infliximab and evolocumab, where each
component of the Viscosity Reduction Platform has
been used individually. Infliximab has a viscosity of
about 40 mPa·s at a concentration of 120 mg/mL in
its concentrated marketed formulation (see Figure 2A).
Adding 75 mM of the single excipients reduces the
viscosity by anywhere from 10 to 80%. A similar
viscosity reduction is observed when doubling the
excipient concentration to 150 mM. Comparing the
performance of an excipient at 75 and 150 mM shows
that the greatest difference in viscosity reduction
between the two concentrations is seen with excipients
that are not particularly effective. Excipients able
to halve the viscosity of infliximab do not show a
proportionally strong viscosity-reducing effect when
their concentration is increased. Used individually,
Arg and Orn do not reduce infliximab viscosity ­
effec­
tively. However, we will show that these two
excipients can indeed be valuable when used in
excipient combinations.
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Viscosity
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Infliximab
Control
75 mM
150 mM
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Viscosity
[mPa·s]
Evolocumab
Control
75 mM
150 mM
B
Figure 2.
Influence of increased excipient concentrations on protein formulation viscosity.
3
Similarly, Figure 2B shows that many excipients lead
to an improved viscosity reduction for 170 mg/mL
evolocumab when used at higher concentrations.
By contrast, Phe actually increases protein viscosity
when its concentration is increased. Overall, for both
model antibodies, it was observed that doubling the
concentration of an excipient does not typically lead ­
to improved viscosity reduction.
Balancing viscosity reduction and protein stability
is crucial to successfully develop a stable, highly
concentrated protein formulation. A forced degradation
study was thus conducted to evaluate the effect of
elevated excipient concentrations (125–150 mM) on
protein stability. Figure 3 summarizes the monomer
content of infliximab and evolocumab formulations
after 28 days at 40 °C and 75% relative humidity.
Infliximab was formulated at a concentration of
120 mg/mL, while evolocumab was formulated at a
concentration of 170 mg/mL. The amino acids do not
show an adverse effect on protein stability, with the
exception of Phe, which is the most effective viscosity-
reducing amino acid for infliximab. Phe’s observed
destabilizing effect highlights the importance of
bal­
ancing protein stability and protein viscosity.
The three anionic excipients show a clear destabilizing
effect on both proteins, as can be seen in Figure 3.
With TMP, a substantial loss of monomer content is
seen, likely due to the known instability of the vitamin
derivate itself at high temperatures.6
In summary,
highly efficient viscosity-reducing excipients used
at concentrations between 125 mM and 150 mM
can desta­
bilize a protein. In contrast, amino acids
typi­
cally allow protein stability to be maintained.
To conclude, while increasing the excipient concen­
tration may allow for improved viscosity reduction,
some excipients can destabilize proteins when used
at high concentrations. Furthermore, even these
increased excipient concentrations may not be able
to lower viscosity sufficiently to reach the targeted
formulation viscosity.
Effect of protein formulation pH on
excipient performance
As demonstrated, excipients’ viscosity-reducing ability
can differ depending on the protein they are used
for. As a next step, it is important to consider the
formulation conditions. Figure 4 shows the viscosity
of 170 mg/mL evolocumab formulated at pH 5 (acetate
buffer) and pH 7.2 (phosphate buffer). The materials
used to prepare the base buffer are listed in Table 2.
Table 2: Materials used for base buffer preparation
Buffer Buffer Components
Acetate buffer
Acetic acid (glacial) 100%
EMPROVE®
EXPERT Ph Eur,BP,JP,USP
Sodium hydroxide solution 32%
EMPROVE®
EXPERT
Phosphate buffer
Sodium dihydrogen phosphate monohydrate
EMPROVE®
EXPERT BP,USP
di-Sodium hydrogen phosphate heptahydrate
EMPROVE®
EXPERT DAC,USP
Optional addition: Sodium chloride
EMPROVE®
EXPERT Ph Eur,BP,ChP,JP,USP
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Infliximab Evolocumab
Residual
Monomer
Content
[%]
Figure 3.
Effect of single excipients at concentrations between 125–150 mM
on monomer content of infliximab and evolocumab stored at 40 °C/­
75% rH for 28 days.
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pH 5.0
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Viscosity
[mPa·s]
pH dependent excipient performance
Figure 4.
pH dependency of evolocumab formulation at 170 mg/mL:
Comparison using pH 5 acetate and pH 7.2 phosphate buffers.
Formulated in the respective base buffers, the viscosity
is much higher than 20 mPa·s. At pH 5.0, it is 59 mPa·s,
and at pH 7.2, it is 72 mPa·s. Adding sodium chloride has
a stronger effect at pH 7.2 than at pH 5, potentially due
to the lower number of charges present on the protein
at pH 7.2, which is closer to the protein’s isoelectric
point of about 7.6. The Viscosity Reduction Platform
excipients (see Table 1) show differing trends. The
performance of Phe is stable with respect to the pH
condition. The excipients Arg, Orn, BSAcid, Pyr, and
TMP exhibit changes in performance at different pH
levels. Computational chemistry techniques were used
to calculate a selection of relevant excipient properties
across a pH range of 4 to 8.9–12
These parameters were
used to determine whether this difference in viscosity
reduction could be explained by changes in excipient or
protein properties. The underlying molecular pKa values
significantly impact these properties and were confirmed
experimentally by titration studies. A summary is given
in Table 3.
4
Table 3: Physical properties of excipient molecules at pH 5 and pH 7
Charge
[atomic units]
Dipole moment
[Debye]
Solvent-accessible
surface area (SASA) [Ă…2
]
MolLogP
Excipient pH 5.0 pH 7.2 pH 5.0 pH 7.2 pH 5.0 pH 7.2 pH 5.0 pH 7.2
L-Ornithine hydrochloride 1.0 1.0 25.5 25.5 304 304 –5.3 –5.3
L-Phenylalanine 0.0 0.0 11.3 11.3 275 275 –1.4 –1.4
Benzenesulfonic acid –1.0 –1.0 13.7 13.7 231 231 0.6 0.6
Thiamine phosphoric acid ester chloride –0.2 –1.7 29.6 26.2 442 469 –3.7 –4.9
L-Arginine 1.0 1.0 9.0 9.1 290 289 –5.5 –5.5
Pyridoxine 0.8 0.0 3.3 3.7 276 274 –0.4 0.1
Only in the case of TMP a change in protonation
state was found when the pH was reduced to 5.
Accordingly, changes were observed in dipole
moment, accessible surface area, and the water-
octanol partition coefficient indicating the molecule’s
hydrophobicity. TMP was nevertheless a highly
efficient viscosity-reducing excipient for evolocumab
under both formulation conditions. As there is no pH-
dependent change for the other excipient molecules,
the difference in viscosity-reducing performance with
evolocumab likely has a protein origin. Evolocumab’s
hydrophobicity is pH-independent, leading to an
increased charge on the protein at a lower pH, which
affects protein-excipient interactions. This case study
suggests that different excipients may be required
to formulate a protein under different conditions.
An excipient toolbox would thus allow formulation
scientists to find the right excipients for the desired
formulation conditions.
Using excipient combinations to reduce
protein viscosity
As individual excipients may not be powerful enough
to reduce the viscosity of a highly concentrated protein
formulation on their own, the Viscosity Reduction
Platform is based on the use of excipient combinations.
An amino acid – i.e. Arg, Orn or Phe – is combined
with an anionic excipient. Being able to vary excipient
combinations in this way gives formulation scientists
a high degree of flexibility when it comes to balancing
viscosity reduction against protein stability and other
considerations like route of administration, which
may determine the pH of the formulation that is to
be developed.
Figure 5A shows the formulation viscosity of infliximab
at a concentration of 120 mg/mL with a variety of
excipient combinations. The grey control bar is the
unmodified marketed formulation concentrated to the
given protein concentration. The resulting viscosity
of about 40 mPa·s is too high for subQ administration.
The purple bar represents arginine as the benchmark
excipient, which by itself is only able to slightly
reduce the viscosity. In several cases, combining
Orn, Arg or Phe with an anionic excipient leads to a
more substantial reduction in viscosity – including
below the injectability limit, most importantly. With
each amino acid, there are multiple combinations
that would allow for injectability of infliximab. Orn is
particularly effective with Pyr. Arg can be combined
with TMP. Phe is best combined with BSAcid or TMP.
In summary, different excipient combinations are
efficient for infliximab. However, not all excipients
may be suitable for every route of administration due
to potential tissue-specific reactions, which is why
using an excipient portfolio is beneficial.8
0
20
60
Viscosity
[mPa·s]
120 mg/mL Infliximab
40
Injectability
Limit
Arg
Orn
Pyr
Phe
BSAcid TMP
Control
A
Injectability
Limit
170 mg/mL Evolocumab
Control
TMP
0
20
60
40
Viscosity
[mPa·s]
Arg
NaCl
BSAcid
Orn
Phe Pyr
B
Figure 5.
Combinations of Viscosity Reduction Platform excipients compared to experiments without a viscosity-reducing excipient (grey bar), with sodium
chloride as control (green bar) and the industry standard L-Arginine (Arg) (purple bar). The color codes of the split bars indicate the excipient
combinations used. A) Model antibody infliximab. B) Model antibody evolocumab.
5
Figure 5B shows the same approach using evolo­
cumab
as a model protein. Here, 150 mM of sodium chloride
was included as a control to monitor ionic effects.
In contrast to infliximab, evolocumab is marketed in
a low-salt formulation. Evolocumab’s viscosity can
be managed well with arginine. However, there are
conditions where arginine is not desirable because of
the route of administration or a local reaction to the
excipient. The Viscosity Reduction Platform presented
here provides a range of alternatives.
In summary, the data with these two model antibodies
shows that using excipient combinations can reduce
viscosity more effectively than the leading industry
standard.
Combined excipients are also more efficient than
highly concentrated single excipients and can even
perform synergistically. Moreover, an excipient
portfolio gives formulation scientists greater flexibility.
Depending on the nature of the antibody, the desired
pH, or the route of administration, having a variety
of options at hand can be beneficial when developing
the final formulation. The most suitable choice of
excipients will depend on the type of protein and the
formulation conditions.
Impact of reduced protein viscosity on
syringeability
To highlight the impact of viscosity and the Viscosity
Reduction Platform on syringeability, the following case
study investigates two relevant factors: aspiration
time and extraction force. First, the aspiration time
of infliximab and evolocumab was tested at high
concentrations (120 mg/mL and 170 mg/mL) with
and without the most effective viscosity-reducing
excipients (Figure 6A). Aspirating infliximab into a
1 mL syringe through a 27-gauge needle takes 75 s.
With Orn/TMP this time can be reduced by 19%, and
with Phe/TMP by 44%. For evolocumab, it takes 116
s to aspirate a highly concentrated solution into the
same syringe. With Orn/Pyr this time can be reduced
to 46 s, and with Arg/TMP to 37 s.
Figure 6B shows the syringe extraction force required
for different formulations of infliximab and evolocumab
using a 1 mL syringe through a 27-gauge needle (BD
Plastipak™ 1 mL syringe, 27G, 13 mm needle). The
syringe extraction force is very sensitive to the type
of syringe used, its dimension, the needle length,
and the inner needle diameter. In the present study
a flow rate of 0.2 mL/s is used to showcase the
impact of the Viscosity Reduction Platform on the
injection force. Flow rates of 0.15 mL/s and 0.45 mL/s
are described in literature.7
Evolocumab is supplied
by the manufacturer in a pen to self-inject using a
flow rate of 0.2 mL/s. Therefore this flow rate was
chosen as an example. An extraction force of about
20 N was observed for 120 mg/mL infliximab in its
marketed formulation. Viscosity-reducing excipients
can reduce this to about 15 N. For 170 mg/mL
evolocumab, the difference is even more pronounced.
In the standard buffer, an extraction force of 30 N
was measured. Both excipient combinations are able
to reduce the extraction force by about 50%. These
examples highlight the practical impact that reduced
formulation viscosity has on the syringeability of highly
concentrated protein solutions.
Control
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Infliximab Evolocumab
B
Figure 6.
A) The aspiration time of infliximab and evolocumab in their reference buffers versus formulated with the best-performing viscosity-reducing
excipient combinations, and B) the extraction force of the two molecules in the same formulation.
6
Addressing protein stability with the
Viscosity Reduction Platform
As previously discussed, the balance between protein
viscosity and protein stability is rather delicate.
Focusing on protein stability, a forced degradation
study was performed using combinations of excipients
with varying concentrations of the individual compo­
nents. As shown in Figure 7, excipient combinations
can overcome the adverse effect of using an anionic
excipient alone. The formulations used were not
optimized further after addition of the viscosity-
reducing excipients. Instead, the stability of the
two model proteins was investigated over a longer
period at 2–8 °C and 25 °C/60% relative humidity.
Figure 8A shows for all selected excipient combinations
that infliximab and evolocumab were able to retain a
high monomer content after 24 weeks at 2–8 °C. This
high stability was achieved without further optimization
of the formulation and could thus be potentially
improved even more if the antibody were to undergo
thorough formulation development. It is particularly
noteworthy that the combination of Phe and TMP is
able to maintain a high monomer content at 2–8 °C.
At 25 °C, formulations containing TMP showed a strong
destabilizing effect up to a total loss of monomer. This
further supports the hypothesis that the decrease in
protein stability is due to the decomposition of the
excipient molecule. When stored under accelerated
conditions, i.e. 25 °C/60% rH, a high monomer content
(even above 95% in some cases) was observed for
selected excipient combinations. Overall, it was shown
that using viscosity-reducing excipients in combination
with each other can maintain formulation stability under
relevant storage conditions.
0
25
100
125
Monomer
Content
[%]
Monomer content of infliximab
stabilized by excipient combinations
75
50
Control
Orn
Phe
BSAcid
Pyr
TMP
Arg
A
Monomer
Content
[%]
Monomer content of evolocumab
stabilized by using combinations
Control
Orn
Phe
BSAcid
Pyr
TMP
Arg
0
25
100
125
75
50
B
Figure 7.
Monomer content of A) infliximab and B) evolocumab formulations after a forced degradation study of 28 days at 40 °C/75% rH. Solid bars
represent data with only one excipient, split bars represent excipient combinations, where the color code indicates which excipients were used.
0
50
100
150
Monomer
Content
[%]
Stability when stored at 25 °C/60% rH
Infliximab Evolocumab
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Start 8 weeks 16 weeks 24 weeks 52 weeks
B
Figure 8.
Long-term stability of selected formulations with excipient combinations that successfully reduced viscosity. A) Stability at 2–8 °C and B) stability
at 25 °C/60% rH.
Stability when stored at 2–8°C
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Infliximab Evolocumab
Start 8 weeks 16 weeks 24 weeks 52 weeks
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7
Use of Viscosity Reduction Platform on
plasma-derived protein therapeutics
Plasma-derived proteins (PDPs) are effective thera­
peutics for various forms of diseases. Applications can
range from viral infections such as cytomegalovirus
and rabies, over treating chronic diseases affecting
the immune or nervous system, to antibody deficiency
syndrome.13–15
For therapy induction, i.v. administration
is beneficial due to the rapid rise in IgG levels in the
blood stream. For subsequent maintenance doses, subQ
formulations of plasma IgGs can have ­
a profoundly
positive effect on the patient’s treatment, since higher
and more stable IgG plasma levels can be reached.16,17
Additionally, highly concentrated subQ PDP products
could lower the total medication volume required or
reduce the number of required administrations per
week. Alternatively, viscosity-reducing excipients could
help to deliver a higher amount of protein per volume or
enabling a faster delivery by reducing the force required
to inject. These could be important factors to reduce the
burden of treatment, which should not be greater than
the burden of the disease itself. Hence, the Viscosity
Reduction Platform was utilized to overcome application
limitations of highly concentrated PDPs related to
viscosity. The results are presented in this section.
Viscosity of PDPs is driven by molecular crowding
Octagam®
, Pentaglobin®
and Berirab®
were used
as model drug products to highlight the impact
that viscosity-reducing excipients can have on PDP
formulations. These three drug products represent
different classes of PDP therapeutics (for base buffer
compositions, see Table 4). Octagam®
is an IgG
formulation that is used to treat congenital and acquired
immunodeficiencies.18,19
It comprises of different
types of IgGs that are circu­
lating in the general donor
population. Berirab®
is applied during post exposure
prophylactics for bites of rabite animals.20
Like
Octagam®
, it is an IgG formulation, but it is enriched
with anti-rabies antibodies. Penta­
globin®
is a drug
product used to treat bacterial infections in comprises
of different types of immune globulins, IgG IgM and IgA
antibodies.21
At first, viscosity of PDPs was measured to profile
the concentration range at which PDPs adopt high
viscosity levels beyond injectability (25 mPa·s). The
results showed that all PDPs tested cross the threshold
of injectability at protein concentrations of approx.
≥200 mg/mL (Figure 9). To compare, infliximab and
cetuximab crossed this threshold already at lower
concentrations (~120–150 mg/mL). To demonstrate the
impact of aforementioned heterogeneity in viscosity,
diffusion interaction parameters (kD) of different PDP
formulations were compared to the kD of infliximab
(Figure 10). kD is a measure for self-interaction of
proteins and to some extent correlates with the solution
viscosity. mAbs such as infliximab have a particularly
strong tendency to attractive PPIs as highlighted by the
strongly negative kD. Remaining formulations exhibit
less negative to neutral kD changes and accordingly
become viscous at higher protein concentrations
compared to those of mAbs.
The reason for this difference is the higher tendency of
inter- and intramolecular interactions of homogeneous
(mAbs) over heterogeneous (PDPs) bioformulations as
well as molecular crowding.22
Compared to these mAbs,
plasma proteins have a lower tendency to self-interact.
As highlighted earlier, at concentrations ≥200 mg/mL,
protein crowding takes the upper hand over intramo­
lecular PPIs leading to non-specific PPIs and desta­
bi­
li­
zation of protein structure as well as a rapid increase in
solution viscosity.
0,00E+00
2,00E+00
1,00E+00
1,20E+00
6,00E+00
8,00E+00
4,00E+00
12
10 14 16 18
0 2 4 6 8
1,40E+00 m=7,50E-03
m=-4,10E-03
m=-3,80E-03
m=-1,89E-02
m=-2,84E-02
Diffusion
Coefficient
[cm
2
/s]
Protein Concentration [mg/mL]
Normalized kD comparison
mAbs vs. plasma proteins
Octagam®
Pentaglobin®
Berirab®
Cetuximab
Infliximab
Figure 10.
Comparison of kD mAbs and PDPs.
Figure 9.
Dependence of formulation viscosity on protein concentration for mAbs
and PDPs.
0
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0
200
Viscosity
[mPa·s]
Concentration [mg/mL]
Viscosity profiles comparison
mAbs vs. plasma proteins
Octagam®
Pentaglobin®
Berirab®
Cetuximab
Infliximab
Table 4: 
Buffer components for
different PDP base buffers
PDP Buffer Components
Octagam®
Maltose monohydrate EMPROVE®
ESSENTIAL
Sodium chloride EMPROVE®
EXPERT
Ph Eur,BP,ChP,JP,USP
Pentaglobin®
Sodium chloride EMPROVE®
EXPERT
Ph Eur,BP,ChP,JP,USP
D-(+)-Glucose, anhydrous EMPROVE®
EXPERT
Ph Eur,BP,USP,ACS
Berirab® Glycine granulated EMPROVE®
EXPERT
Ph Eur,BP,ChP,JP,USP
8
Viscosity Reduction Platform excipient
combinations efficiently reduce viscosity at
highly concentrated PDPs
As discussed previously, the protein-protein interactions
that give rise to the high viscosity of PDPs are driven
by molecular crowding. Nevertheless, said protein-
protein interactions can still be weakened in strength
and/or reduced in number using excipients. In order
to confirm this hypothesis, viscosity measurements
were performed in concentrated market formulation
of Octagam®
as a model PDP (250 mg/mL) with the
Viscosity Reduction Platform (concentration at market
formulation 50 or 100 mg/mL). The concentration was
selected due to the favorable concentration-viscosity
correlation at 250 mg/mL as can be seen in Figure 9.
The results of viscosity measurements are depicted
in Figure 11 and show that single excipients Orn and
BSAcid exhibit higher viscosity values compared to that
of market formulation, whereas other single excipients
resulted in viscosity reduction (5–15%). Interestingly,
Arg did reduce solution viscosity only marginally (~5%).
Using Viscosity Reduction Platform combinations, this
reduction could further be increased by up to 38%
(75 mM Arg + 75 mM TMP). The results with the Phe/
TMP combination are even more intriguing (40%),
however the protein concentration in this formulation
was approx. 10 mg/mL lower than that of the control
sample, preventing a direct comparison. Hence,
Viscosity Reduction Platform combination Arg/TMP is
considered as the best lead and was evaluated for a
concentration-based lead profiling study as outlined
below.
Concentration ratios of excipient
combinations do not have a critical impact on
viscosity reduction of Octagam®
in solution
Typically, excipient concentrations are optimized
using a Design of Experiments (DoE) approach.
It is therefore conceivable that by changing the
ratio of the two viscosity-reducing excipients, an
additional improvement could be achieved. To test this
hypothesis, Arg and TMP were combined in various
ratios and the viscosity was measured. The respective
viscosities of the concentrated market formulation
(246 mg/mL) and formulations comprising one
excipient, either Arg or TMP, were used as a reference.
While single excipient-containing solutions delivered a
moderate reduction in solution viscosity (12–15%), all
Viscosity Reduction Platform combinations exhibited
≥29% viscosity reduction, with 75 mM Arg/75 mM TMP
showing the highest relevant reduction in solution
viscosity (~38%).
Even though the viscosity for PDP formulation with
Viscosity Reduction Platform combinations are still
slightly beyond injectability (25 mPa·s), the objective
of reducing viscosity for PDPs is not to create an
injectable formulation that can otherwise not be
made but to improve patient convenience. Hence,
lowering the number of repetitive applications with
higher protein loads is the first step to enable this.
In conclusion, the Viscosity Reduction Platform is a
strong viscosity reduction tool not only for utilization
in highly concentrated mAb products but also for other
biologics formulations. We have demonstrated that
using the Viscosity Reduction Platform, a higher protein
concentration for PDP formulations compared to market
formulations could be achieved. Furthermore, Viscosity
Reduction Platform combinations performed better than
formulations containing only one Viscosity Reduction
Platform excipient.
0
60
40
20
80
100
C
o
n
t
r
o
l
1
2
5
m
M
A
r
g
1
5
0
m
M
O
m
1
2
5
m
M
P
h
e
1
5
0
m
M
B
S
A
c
i
d
1
5
0
m
M
P
y
r
-
H
C
I
1
5
0
m
M
T
M
P
7
5
m
M
O
m
+
7
5
m
M
B
S
A
c
i
d
7
5
m
M
O
m
+
7
5
m
M
P
y
r
-
H
C
I
7
5
m
M
O
m
+
7
5
m
M
T
M
P
7
5
m
M
A
r
g
+
7
5
m
M
B
S
A
c
i
d
7
5
m
M
A
r
g
+
7
5
m
M
P
y
r
-
H
C
I
7
5
m
M
A
r
g
+
7
5
m
M
T
M
P
7
5
m
M
P
h
e
+
7
5
m
M
B
S
A
c
i
d
7
5
m
M
P
h
e
+
7
5
m
M
P
y
r
-
H
C
I
7
5
m
M
P
h
e
+
7
5
m
M
T
M
P
Viscosity
[mPa·s]
Octagam®
246 mg/mL
Figure 11.
Viscosity screening for Octagam®
at 246 mg/mL. Combinations of
Viscosity Reduction Platform excipients compared to experiments
without a viscosity-reducing excipient (grey bar), with the industry
standard Arg as benchmark (purple bar). The color codes of the
split bars indicate the excipient combinations.
Figure 12.
Profiling of Viscosity Reduction Platform lead combination for Octagam®
(243 mg/mL) at different excipient ratios. Samples were compared to
control experiments without reducing excipient (grey bar) and to the
single excipients of the lead combination Arg (purple bar) and TMP
(blue bar), respectively. The color codes of the split bars indicate the
excipient combinations used.
0
20
40
60
C
o
n
t
r
o
l
1
5
0
m
M
A
r
g
1
5
0
m
M
T
M
P
Viscosity
[mPa·s]
Octagam®
243 mg/mL
1
5
0
m
M
A
r
g
/
5
0
m
M
T
M
P
5
0
m
M
A
r
g
/
1
0
0
m
M
T
M
P
7
5
m
M
A
r
g
/
7
5
m
M
T
M
P
Conclusion
The Viscosity Reduction Platform contains a portfolio
of excipients and is based on combining an amino acid
with a second viscosity-reducing excipient. The latter
excipients are ones that often adversely affect protein
stability when used individually at high concentrations
but combining them with an amino acid circumvents
this and improves viscosity-reducing capacity. The
Viscosity Reduction Platform allows for a better
balance of protein stability versus protein viscosity.
This platform therefore enables subcutaneous delivery
while preserving long-term stability. It also makes
the application through a device both more patient-
friendly and more economical. The Viscosity Reduction
Platform provides formulation scientists with a variety
of options for formulation development that take the
route of administration and the requirements of the
protein into account. Beyond monoclonal antibodies,
also formulations of plasma-derived proteins can be
improved by the application of the platform.
Please visit: sigmaaldrich.com/viscosity-reduction
for a detailed user guide for the Viscosity Reduction
Platform. For the technical sample kit as well as
information on commercial licensing options, please
reach out to your local sales representative.
References
1. Viola, M. et al. Subcutaneous delivery of monoclonal antibodies:
How do we get there? Journal of Controlled Release 286, 301–314,
2018. doi:10.1016/j.jconrel.2018.08.001
2. Shire, S. J., Shahrokh, Z.  Liu, J. Challenges in the development
of high protein concentration formulations. Journal of pharmaceutical
sciences 93, 1390–1402, 2004. doi:10.1002/jps.20079
3. Xu, A. Y., Castellanos, M. M., Mattison, K., Krueger, S.  Curtis, J. E.
Studying Excipient Modulated Physical Stability and Viscosity of
Monoclonal Antibody Formulations Using Small-Angle Scattering.
Molecular pharmaceutics 16, 4319–4338, 2019.
doi:10.1021/acs.molpharmaceut.9b00687
4. Yadav, S., Shire, S. J.  Kalonia, D. S. Viscosity behavior of
high­
concentration monoclonal antibody solutions: correlation
with interaction parameter and electroviscous effects. Journal of
pharmaceutical sciences 101, 998–1011, 2012.
doi:10.1002/jps.22831
5. Platts, L., Falconer, R. J. Controlling protein stability: Mechanisms
revealed using formulations of arginine, glycine and guanidinium
HCl with three globular proteins, International Journal of
Pharmaceutics, Volume 486, Issues 1–2, 131–135, 2015.
doi:10.1016/j.ijpharm.2015.03.051
6. Schnellbaecher, A., Binder, D., Bellemaine, S., Zimmer, A. Vitamins
in cell culture media: Stability and stabilization strategies,
Biotechnology and Bioengineering, 116:1537–1555, 2019.
doi:10.1002/bit.26942
7. Usach, I., Martinez, R., Festini, T., Peris, E. Subcutaneous
Injection of Drugs: Literature Review of Factors Influencing Pain
Sensation at the Injection Site; Adv Ther., 36:2986–2996, 2019.
doi:/10.1007/s12325-019-01101-6
8. Mendrinos, E., Petropoulos, I. K., Mangioris, G., Papadopoulou, D. N.,
Pournaras, C. J. Intravitreal L-Arginine injection reverses the
retinal arteriolar vasoconstriction that occurs after experimental
acute branch retinal vein occlusion, Experimental Eye Research,
91:205e210, 2010. doi:10.1016/j.exer.2010.05.002
9. Pracht P., Bohle F., Grimme, S. Automated exploration of the low­­
energy chemical space with fast quantum chemical methods;
Phys. Chem. Chem. Phys., 22, 7169–7192, 2020.
doi:10.1039/C9CP06869D
10. Bannwarth, C., Caldeweyher, E., Ehlert, S., Hansen, A., Pracht, P.,
Seibert, J., Spicher, S., Grimme, S. Extended tight-binding quantum
chemistry methods; WIREs Comput Mol Sci., 11:e1493, 2021.
doi:10.1002/wcms.1493
11. Brandenburg, J. G., Bannwarth, C., Hansen, A., Grimme, S. B97-3c:
A revised low-cost variant of the B97-D density functional method,
J. Chem. Phys., 148, 064104, 2018. doi:10.1063/1.5012601
12. Klamt, A. Conductor-like Screening Model for Real Solvents:
A New Approach to the Quantitative Calculation of Solvation
Phenomena; J. Phys. Chem., 99, 7, 2224–2235, 1995.
doi:10.1021/j100007a062
13. Pelletier, J. P. R.  Mukhtar, F. in Immunologic Concepts in
Transfusion Medicine 251–348 (2020)
14. Leussink, V. I., Hartung, H. P., Kieseier, B. C.  Stettner, M.
Subcutaneous immunoglobulins in the treatment of chronic
immune-mediated neuropathies. Ther Adv Neurol Disord 9, 336–343,
2016. doi:10.1177/1756285616641583
15. Overton, P. M., Shalet, N., Somers, F.  Allen, J. A. Patient
Preferences for Subcutaneous versus Intravenous Administration
of Treatment for Chronic Immune System Disorders: A Systematic
Review. Patient Prefer Adherence 15, 811–834, 2021.
doi:10.2147/PPA.S303279
16. Goyal, N. A., Karam, C., Sheikh, K. A.  Dimachkie, M. M.
Subcutaneous immunoglobulin treatment for chronic inflammatory
demyelinating polyneuropathy. Muscle Nerve 64, 243–254, 2021.
doi:10.1002/mus.27356
17. Chen, Y., Wang, C., Xu, F., Ming, F.  Zhang, H. Efficacy and
Tolerability of Intravenous Immunoglobulin and Subcutaneous
Immunoglobulin in Neurologic Diseases. Clin Ther 41, 2112–2136,
2019. doi:10.1016/j.clinthera.2019.07.009
18. Wietek, S. Octagam®
for chronic inflammatory demyelinating
polyneuropathy: results from three observational studies.
Neurodegener Dis Manag 8, 227–231, 2018.
doi:10.2217/nmt-2018-0006
19. Wietek, S., Svorc, D., Debes, A.  Svae, T. E. Tolerability and
safety of the intravenous immunoglobulin Octagam®
10% in
patients with immune thrombocytopenia: a post-authorisation
safety analysis of two non-interventional phase IV trials.
Hematology 23, 242–247, 2018.
doi:10.1080/10245332.2017.1385892
20. CSL Behring. https://www.berirab.de/,
https://www.berirab.de/ (2022)
21. Neilson, A. R., Burchardi, H.  Schneider, H. Cost-effectiveness of
immunoglobulin M-enriched immunoglobulin (Pentaglobin®
) in the
treatment of severe sepsis and septic shock. J Crit Care 20, 239–249,
2005. doi:10.1016/j.jcrc.2005.03.003
22. Burckbuchler, V. et al. Rheological and syringeability properties of
highly concentrated human polyclonal immunoglobulin solutions.
Eur J Pharm Biopharm 76, 351–356, 2010.
doi:10.1016/j.ejpb.2010.08.002
For additional information, please visit www.SigmaAldrich.com
To place an order or receive technical assistance, please visit www.SigmaAldrich.com/Contact-Formulation
MilliporeSigma
400 Summit Drive
Burlington, MA 01803
Lit. No. MS_WP8385EN
05/2023
© 2023 Merck KGaA, Darmstadt, Germany and/or its affiliates. All Rights Reserved.
MilliporeSigma, the Vibrant M, SAFC, Plastipak and EMPROVE are trademarks of Merck KGaA, Darmstadt, Germany and/or its affiliates.
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The Viscosity Reduction Platform: Viscosity-reducing excipients for improvement of filtration processes

  • 1. Protein viscosity is one of the major obstacles in preparing highly concentrated protein formulations suitable for sub­ cutaneous (subQ) injection. SubQ application of highly concentrated protein formulations enables a higher patient convenience and might thus lead to reduction in health costs. This can be achieved by reducing the time requirement of the patient to administer therapy, e.g. by enabling self-injection at home and reducing The Viscosity Reduction Platform: Viscosity- reducing excipients for protein formulation Stefan Braun, Niels Banik, Jennifer J. Widera, Alana Gouveia, Dr. Jan Gerit Brandenburg, Dr. Can Araman and Dr. Tobias Rosenkranz Introduction 0 200 150 100 50 0 50 100 Viscosity [mPa·s] Concentration [mg/mL] 150 200 250 300 Limit of injectability Interactions Crowding mAbA mAbB mAbC mAbD mAbE mAbF mAbG mAbH mAbL mAbJ mAbK Concentration dependency of viscosity for market formulations Figure 1. Dependency of viscosity on antibody concentration and likely underlying causes. Red lines show injectability limit. White Paper time required to do so. However, highly viscous protein solutions would require a significant force to be applied to the syringe for injection. As a result, the patient could experience a considerable amount of pain. In many cases, injectability would not be possible.1,2 When characterizing protein viscosity behavior, one can differentiate two different concentration regimes as shown in Figure 1. At concentrations below 75 mg/mL, proteins are rarely viscous. When increasing the concentration to between 100 and 200 mg/ mL, some proteins exhibit elevated viscosity exceeding the limit of injectability, which is typically between 20 and 25 mPa·s. At this concentration regime, several proteins exhibit an affinity for self-interaction, i.e. forming transient clusters that give rise to elevated viscosity. At concentrations above 200 mg/mL, the nearest neighbor distance between the protein molecules shrinks so that without a specific affinity for self- interactions, said protein-protein interactions take place. While viscosity-reducing excipients can affect proteins exhibiting either of these interaction patterns, they are likely to be more efficient at protein concentration regimes below 200 mg/mL.3,4 MilliporeSigma is the U.S. and Canada Life Science business of Merck KGaA, Darmstadt, Germany.
  • 2. 2 These intermolecular interactions between proteins have the same molecular origin as the intramolecular interactions that structurally stabilize the proteins. This means viscosity-reducing excipients that affect protein-protein interactions can potentially also destabilize proteins. As such, it is essential to balance an excipient’s viscosity-reducing ability against its potential to destabilize a protein. For some excipients, a concentration-dependent effect on protein stability is well-documented. At lower concentrations, the excipients act as stabilizers, but this behavior changes as concentration increases, often with an adverse effect on protein stability.5 Excipient concentration is thus a critical factor in managing protein stability. These two aspects can be better balanced by using an excipient combination of an amino acid and an anionic excipient. When used in combination, excipients are more efficient in reducing viscosity and may even do so in an over-additive manner. Consequently, lower concentrations of the individual excipients can be used, which is more favorable for protein stability. This white paper evaluates the viscosity-reducing capacities of excipients and excipient combinations. It shows the over-additive effect of using two excipients together and addresses how excipients’ viscosity- reducing ability depends on pH. The results show the effect of protein viscosity on injection force and highlight the platform’s ability to balance viscosity reduction with protein stability. The case studies presented demonstrate that using a combination of two excipients at lower concentrations instead of a single excipient at a higher concentration enables balancing protein viscosity and protein stability in a favorable way. Table 1: Excipients and abbreviations Excipient Abbrev. L-Arginine Arg L-Ornithine monohydrochloride Orn L-Phenylalanine Phe Thiamine phosphoric acid ester chloride dihydrate TMP Benzenesulfonic acid BSAcid Pyridoxine hydrochloride Pyr Results & Discussion Table 1 summarizes the excipients that are part of the Viscosity Reduction Platform. For clarity reasons, abbreviations mentioned in Table 1 are used in the fol­ lowing. L-Arginine (Arg) is the industry standard for viscosity reduction using a single excipient and consequently serves as the benchmark excipient. Single excipients often reduce viscosity but may impact protein stability A single excipient is often used to reduce the viscosity of a protein formulation. Figure 2 shows two model proteins, infliximab and evolocumab, where each component of the Viscosity Reduction Platform has been used individually. Infliximab has a viscosity of about 40 mPa·s at a concentration of 120 mg/mL in its concentrated marketed formulation (see Figure 2A). Adding 75 mM of the single excipients reduces the viscosity by anywhere from 10 to 80%. A similar viscosity reduction is observed when doubling the excipient concentration to 150 mM. Comparing the performance of an excipient at 75 and 150 mM shows that the greatest difference in viscosity reduction between the two concentrations is seen with excipients that are not particularly effective. Excipients able to halve the viscosity of infliximab do not show a proportionally strong viscosity-reducing effect when their concentration is increased. Used individually, Arg and Orn do not reduce infliximab viscosity ­ effec­ tively. However, we will show that these two excipients can indeed be valuable when used in excipient combinations. 0 20 40 60 C o n t r o l A r g O r n P h e B S A c i d P y r T M P Viscosity [mPa·s] Infliximab Control 75 mM 150 mM A 0 20 40 80 60 C o n t r o l N a C l A r g O r n P h e B S A c i d P y r T M P Viscosity [mPa·s] Evolocumab Control 75 mM 150 mM B Figure 2. Influence of increased excipient concentrations on protein formulation viscosity.
  • 3. 3 Similarly, Figure 2B shows that many excipients lead to an improved viscosity reduction for 170 mg/mL evolocumab when used at higher concentrations. By contrast, Phe actually increases protein viscosity when its concentration is increased. Overall, for both model antibodies, it was observed that doubling the concentration of an excipient does not typically lead ­ to improved viscosity reduction. Balancing viscosity reduction and protein stability is crucial to successfully develop a stable, highly concentrated protein formulation. A forced degradation study was thus conducted to evaluate the effect of elevated excipient concentrations (125–150 mM) on protein stability. Figure 3 summarizes the monomer content of infliximab and evolocumab formulations after 28 days at 40 °C and 75% relative humidity. Infliximab was formulated at a concentration of 120 mg/mL, while evolocumab was formulated at a concentration of 170 mg/mL. The amino acids do not show an adverse effect on protein stability, with the exception of Phe, which is the most effective viscosity- reducing amino acid for infliximab. Phe’s observed destabilizing effect highlights the importance of bal­ ancing protein stability and protein viscosity. The three anionic excipients show a clear destabilizing effect on both proteins, as can be seen in Figure 3. With TMP, a substantial loss of monomer content is seen, likely due to the known instability of the vitamin derivate itself at high temperatures.6 In summary, highly efficient viscosity-reducing excipients used at concentrations between 125 mM and 150 mM can desta­ bilize a protein. In contrast, amino acids typi­ cally allow protein stability to be maintained. To conclude, while increasing the excipient concen­ tration may allow for improved viscosity reduction, some excipients can destabilize proteins when used at high concentrations. Furthermore, even these increased excipient concentrations may not be able to lower viscosity sufficiently to reach the targeted formulation viscosity. Effect of protein formulation pH on excipient performance As demonstrated, excipients’ viscosity-reducing ability can differ depending on the protein they are used for. As a next step, it is important to consider the formulation conditions. Figure 4 shows the viscosity of 170 mg/mL evolocumab formulated at pH 5 (acetate buffer) and pH 7.2 (phosphate buffer). The materials used to prepare the base buffer are listed in Table 2. Table 2: Materials used for base buffer preparation Buffer Buffer Components Acetate buffer Acetic acid (glacial) 100% EMPROVE® EXPERT Ph Eur,BP,JP,USP Sodium hydroxide solution 32% EMPROVE® EXPERT Phosphate buffer Sodium dihydrogen phosphate monohydrate EMPROVE® EXPERT BP,USP di-Sodium hydrogen phosphate heptahydrate EMPROVE® EXPERT DAC,USP Optional addition: Sodium chloride EMPROVE® EXPERT Ph Eur,BP,ChP,JP,USP 0 50 100 C o n t r o l A r g O r n P h e B S A c i d P y r T M P C o n t r o l A r g O r n P h e B S A c i d P y r T M P Infliximab Evolocumab Residual Monomer Content [%] Figure 3. Effect of single excipients at concentrations between 125–150 mM on monomer content of infliximab and evolocumab stored at 40 °C/­ 75% rH for 28 days. 0 40 20 60 80 C o n t r o l pH 7.2 pH 5.0 N a C l A r g O r n P h e B S A c i d P y r T M P Viscosity [mPa·s] pH dependent excipient performance Figure 4. pH dependency of evolocumab formulation at 170 mg/mL: Comparison using pH 5 acetate and pH 7.2 phosphate buffers. Formulated in the respective base buffers, the viscosity is much higher than 20 mPa·s. At pH 5.0, it is 59 mPa·s, and at pH 7.2, it is 72 mPa·s. Adding sodium chloride has a stronger effect at pH 7.2 than at pH 5, potentially due to the lower number of charges present on the protein at pH 7.2, which is closer to the protein’s isoelectric point of about 7.6. The Viscosity Reduction Platform excipients (see Table 1) show differing trends. The performance of Phe is stable with respect to the pH condition. The excipients Arg, Orn, BSAcid, Pyr, and TMP exhibit changes in performance at different pH levels. Computational chemistry techniques were used to calculate a selection of relevant excipient properties across a pH range of 4 to 8.9–12 These parameters were used to determine whether this difference in viscosity reduction could be explained by changes in excipient or protein properties. The underlying molecular pKa values significantly impact these properties and were confirmed experimentally by titration studies. A summary is given in Table 3.
  • 4. 4 Table 3: Physical properties of excipient molecules at pH 5 and pH 7 Charge [atomic units] Dipole moment [Debye] Solvent-accessible surface area (SASA) [Ă…2 ] MolLogP Excipient pH 5.0 pH 7.2 pH 5.0 pH 7.2 pH 5.0 pH 7.2 pH 5.0 pH 7.2 L-Ornithine hydrochloride 1.0 1.0 25.5 25.5 304 304 –5.3 –5.3 L-Phenylalanine 0.0 0.0 11.3 11.3 275 275 –1.4 –1.4 Benzenesulfonic acid –1.0 –1.0 13.7 13.7 231 231 0.6 0.6 Thiamine phosphoric acid ester chloride –0.2 –1.7 29.6 26.2 442 469 –3.7 –4.9 L-Arginine 1.0 1.0 9.0 9.1 290 289 –5.5 –5.5 Pyridoxine 0.8 0.0 3.3 3.7 276 274 –0.4 0.1 Only in the case of TMP a change in protonation state was found when the pH was reduced to 5. Accordingly, changes were observed in dipole moment, accessible surface area, and the water- octanol partition coefficient indicating the molecule’s hydrophobicity. TMP was nevertheless a highly efficient viscosity-reducing excipient for evolocumab under both formulation conditions. As there is no pH- dependent change for the other excipient molecules, the difference in viscosity-reducing performance with evolocumab likely has a protein origin. Evolocumab’s hydrophobicity is pH-independent, leading to an increased charge on the protein at a lower pH, which affects protein-excipient interactions. This case study suggests that different excipients may be required to formulate a protein under different conditions. An excipient toolbox would thus allow formulation scientists to find the right excipients for the desired formulation conditions. Using excipient combinations to reduce protein viscosity As individual excipients may not be powerful enough to reduce the viscosity of a highly concentrated protein formulation on their own, the Viscosity Reduction Platform is based on the use of excipient combinations. An amino acid – i.e. Arg, Orn or Phe – is combined with an anionic excipient. Being able to vary excipient combinations in this way gives formulation scientists a high degree of flexibility when it comes to balancing viscosity reduction against protein stability and other considerations like route of administration, which may determine the pH of the formulation that is to be developed. Figure 5A shows the formulation viscosity of infliximab at a concentration of 120 mg/mL with a variety of excipient combinations. The grey control bar is the unmodified marketed formulation concentrated to the given protein concentration. The resulting viscosity of about 40 mPa·s is too high for subQ administration. The purple bar represents arginine as the benchmark excipient, which by itself is only able to slightly reduce the viscosity. In several cases, combining Orn, Arg or Phe with an anionic excipient leads to a more substantial reduction in viscosity – including below the injectability limit, most importantly. With each amino acid, there are multiple combinations that would allow for injectability of infliximab. Orn is particularly effective with Pyr. Arg can be combined with TMP. Phe is best combined with BSAcid or TMP. In summary, different excipient combinations are efficient for infliximab. However, not all excipients may be suitable for every route of administration due to potential tissue-specific reactions, which is why using an excipient portfolio is beneficial.8 0 20 60 Viscosity [mPa·s] 120 mg/mL Infliximab 40 Injectability Limit Arg Orn Pyr Phe BSAcid TMP Control A Injectability Limit 170 mg/mL Evolocumab Control TMP 0 20 60 40 Viscosity [mPa·s] Arg NaCl BSAcid Orn Phe Pyr B Figure 5. Combinations of Viscosity Reduction Platform excipients compared to experiments without a viscosity-reducing excipient (grey bar), with sodium chloride as control (green bar) and the industry standard L-Arginine (Arg) (purple bar). The color codes of the split bars indicate the excipient combinations used. A) Model antibody infliximab. B) Model antibody evolocumab.
  • 5. 5 Figure 5B shows the same approach using evolo­ cumab as a model protein. Here, 150 mM of sodium chloride was included as a control to monitor ionic effects. In contrast to infliximab, evolocumab is marketed in a low-salt formulation. Evolocumab’s viscosity can be managed well with arginine. However, there are conditions where arginine is not desirable because of the route of administration or a local reaction to the excipient. The Viscosity Reduction Platform presented here provides a range of alternatives. In summary, the data with these two model antibodies shows that using excipient combinations can reduce viscosity more effectively than the leading industry standard. Combined excipients are also more efficient than highly concentrated single excipients and can even perform synergistically. Moreover, an excipient portfolio gives formulation scientists greater flexibility. Depending on the nature of the antibody, the desired pH, or the route of administration, having a variety of options at hand can be beneficial when developing the final formulation. The most suitable choice of excipients will depend on the type of protein and the formulation conditions. Impact of reduced protein viscosity on syringeability To highlight the impact of viscosity and the Viscosity Reduction Platform on syringeability, the following case study investigates two relevant factors: aspiration time and extraction force. First, the aspiration time of infliximab and evolocumab was tested at high concentrations (120 mg/mL and 170 mg/mL) with and without the most effective viscosity-reducing excipients (Figure 6A). Aspirating infliximab into a 1 mL syringe through a 27-gauge needle takes 75 s. With Orn/TMP this time can be reduced by 19%, and with Phe/TMP by 44%. For evolocumab, it takes 116 s to aspirate a highly concentrated solution into the same syringe. With Orn/Pyr this time can be reduced to 46 s, and with Arg/TMP to 37 s. Figure 6B shows the syringe extraction force required for different formulations of infliximab and evolocumab using a 1 mL syringe through a 27-gauge needle (BD Plastipak™ 1 mL syringe, 27G, 13 mm needle). The syringe extraction force is very sensitive to the type of syringe used, its dimension, the needle length, and the inner needle diameter. In the present study a flow rate of 0.2 mL/s is used to showcase the impact of the Viscosity Reduction Platform on the injection force. Flow rates of 0.15 mL/s and 0.45 mL/s are described in literature.7 Evolocumab is supplied by the manufacturer in a pen to self-inject using a flow rate of 0.2 mL/s. Therefore this flow rate was chosen as an example. An extraction force of about 20 N was observed for 120 mg/mL infliximab in its marketed formulation. Viscosity-reducing excipients can reduce this to about 15 N. For 170 mg/mL evolocumab, the difference is even more pronounced. In the standard buffer, an extraction force of 30 N was measured. Both excipient combinations are able to reduce the extraction force by about 50%. These examples highlight the practical impact that reduced formulation viscosity has on the syringeability of highly concentrated protein solutions. Control 0 60 30 90 120 O r n / T M P P h e / T M P Time [s] Aspiration time A r g / T M P O r n / P y r Control Infliximab Evolocumab A 0 20 10 30 40 O r n / T M P P h e / T M P Force [N] Extraction force A r g / T M P O r n / P y r Control Control Infliximab Evolocumab B Figure 6. A) The aspiration time of infliximab and evolocumab in their reference buffers versus formulated with the best-performing viscosity-reducing excipient combinations, and B) the extraction force of the two molecules in the same formulation.
  • 6. 6 Addressing protein stability with the Viscosity Reduction Platform As previously discussed, the balance between protein viscosity and protein stability is rather delicate. Focusing on protein stability, a forced degradation study was performed using combinations of excipients with varying concentrations of the individual compo­ nents. As shown in Figure 7, excipient combinations can overcome the adverse effect of using an anionic excipient alone. The formulations used were not optimized further after addition of the viscosity- reducing excipients. Instead, the stability of the two model proteins was investigated over a longer period at 2–8 °C and 25 °C/60% relative humidity. Figure 8A shows for all selected excipient combinations that infliximab and evolocumab were able to retain a high monomer content after 24 weeks at 2–8 °C. This high stability was achieved without further optimization of the formulation and could thus be potentially improved even more if the antibody were to undergo thorough formulation development. It is particularly noteworthy that the combination of Phe and TMP is able to maintain a high monomer content at 2–8 °C. At 25 °C, formulations containing TMP showed a strong destabilizing effect up to a total loss of monomer. This further supports the hypothesis that the decrease in protein stability is due to the decomposition of the excipient molecule. When stored under accelerated conditions, i.e. 25 °C/60% rH, a high monomer content (even above 95% in some cases) was observed for selected excipient combinations. Overall, it was shown that using viscosity-reducing excipients in combination with each other can maintain formulation stability under relevant storage conditions. 0 25 100 125 Monomer Content [%] Monomer content of infliximab stabilized by excipient combinations 75 50 Control Orn Phe BSAcid Pyr TMP Arg A Monomer Content [%] Monomer content of evolocumab stabilized by using combinations Control Orn Phe BSAcid Pyr TMP Arg 0 25 100 125 75 50 B Figure 7. Monomer content of A) infliximab and B) evolocumab formulations after a forced degradation study of 28 days at 40 °C/75% rH. Solid bars represent data with only one excipient, split bars represent excipient combinations, where the color code indicates which excipients were used. 0 50 100 150 Monomer Content [%] Stability when stored at 25 °C/60% rH Infliximab Evolocumab C o n t r o l O r n / B S A c i d A r g / B S A c i d P h e / T M P C o n t r o l O r n / B S A c i d A r g / B S A c i d A r g / P y r Start 8 weeks 16 weeks 24 weeks 52 weeks B Figure 8. Long-term stability of selected formulations with excipient combinations that successfully reduced viscosity. A) Stability at 2–8 °C and B) stability at 25 °C/60% rH. Stability when stored at 2–8°C 0 50 100 150 Infliximab Evolocumab Start 8 weeks 16 weeks 24 weeks 52 weeks C o n t r o l O r n / B S A c i d A r g / B S A c i d P h e / T M P C o n t r o l O r n / B S A c i d A r g / B S A c i d A r g / P y r Monomer Content [%] A
  • 7. 7 Use of Viscosity Reduction Platform on plasma-derived protein therapeutics Plasma-derived proteins (PDPs) are effective thera­ peutics for various forms of diseases. Applications can range from viral infections such as cytomegalovirus and rabies, over treating chronic diseases affecting the immune or nervous system, to antibody deficiency syndrome.13–15 For therapy induction, i.v. administration is beneficial due to the rapid rise in IgG levels in the blood stream. For subsequent maintenance doses, subQ formulations of plasma IgGs can have ­ a profoundly positive effect on the patient’s treatment, since higher and more stable IgG plasma levels can be reached.16,17 Additionally, highly concentrated subQ PDP products could lower the total medication volume required or reduce the number of required administrations per week. Alternatively, viscosity-reducing excipients could help to deliver a higher amount of protein per volume or enabling a faster delivery by reducing the force required to inject. These could be important factors to reduce the burden of treatment, which should not be greater than the burden of the disease itself. Hence, the Viscosity Reduction Platform was utilized to overcome application limitations of highly concentrated PDPs related to viscosity. The results are presented in this section. Viscosity of PDPs is driven by molecular crowding Octagam® , Pentaglobin® and Berirab® were used as model drug products to highlight the impact that viscosity-reducing excipients can have on PDP formulations. These three drug products represent different classes of PDP therapeutics (for base buffer compositions, see Table 4). Octagam® is an IgG formulation that is used to treat congenital and acquired immunodeficiencies.18,19 It comprises of different types of IgGs that are circu­ lating in the general donor population. Berirab® is applied during post exposure prophylactics for bites of rabite animals.20 Like Octagam® , it is an IgG formulation, but it is enriched with anti-rabies antibodies. Penta­ globin® is a drug product used to treat bacterial infections in comprises of different types of immune globulins, IgG IgM and IgA antibodies.21 At first, viscosity of PDPs was measured to profile the concentration range at which PDPs adopt high viscosity levels beyond injectability (25 mPa·s). The results showed that all PDPs tested cross the threshold of injectability at protein concentrations of approx. ≥200 mg/mL (Figure 9). To compare, infliximab and cetuximab crossed this threshold already at lower concentrations (~120–150 mg/mL). To demonstrate the impact of aforementioned heterogeneity in viscosity, diffusion interaction parameters (kD) of different PDP formulations were compared to the kD of infliximab (Figure 10). kD is a measure for self-interaction of proteins and to some extent correlates with the solution viscosity. mAbs such as infliximab have a particularly strong tendency to attractive PPIs as highlighted by the strongly negative kD. Remaining formulations exhibit less negative to neutral kD changes and accordingly become viscous at higher protein concentrations compared to those of mAbs. The reason for this difference is the higher tendency of inter- and intramolecular interactions of homogeneous (mAbs) over heterogeneous (PDPs) bioformulations as well as molecular crowding.22 Compared to these mAbs, plasma proteins have a lower tendency to self-interact. As highlighted earlier, at concentrations ≥200 mg/mL, protein crowding takes the upper hand over intramo­ lecular PPIs leading to non-specific PPIs and desta­ bi­ li­ zation of protein structure as well as a rapid increase in solution viscosity. 0,00E+00 2,00E+00 1,00E+00 1,20E+00 6,00E+00 8,00E+00 4,00E+00 12 10 14 16 18 0 2 4 6 8 1,40E+00 m=7,50E-03 m=-4,10E-03 m=-3,80E-03 m=-1,89E-02 m=-2,84E-02 Diffusion Coefficient [cm 2 /s] Protein Concentration [mg/mL] Normalized kD comparison mAbs vs. plasma proteins Octagam® Pentaglobin® Berirab® Cetuximab Infliximab Figure 10. Comparison of kD mAbs and PDPs. Figure 9. Dependence of formulation viscosity on protein concentration for mAbs and PDPs. 0 20 160 180 120 140 80 100 40 60 100 200 300 0 200 Viscosity [mPa·s] Concentration [mg/mL] Viscosity profiles comparison mAbs vs. plasma proteins Octagam® Pentaglobin® Berirab® Cetuximab Infliximab Table 4: Buffer components for different PDP base buffers PDP Buffer Components Octagam® Maltose monohydrate EMPROVE® ESSENTIAL Sodium chloride EMPROVE® EXPERT Ph Eur,BP,ChP,JP,USP Pentaglobin® Sodium chloride EMPROVE® EXPERT Ph Eur,BP,ChP,JP,USP D-(+)-Glucose, anhydrous EMPROVE® EXPERT Ph Eur,BP,USP,ACS Berirab® Glycine granulated EMPROVE® EXPERT Ph Eur,BP,ChP,JP,USP
  • 8. 8 Viscosity Reduction Platform excipient combinations efficiently reduce viscosity at highly concentrated PDPs As discussed previously, the protein-protein interactions that give rise to the high viscosity of PDPs are driven by molecular crowding. Nevertheless, said protein- protein interactions can still be weakened in strength and/or reduced in number using excipients. In order to confirm this hypothesis, viscosity measurements were performed in concentrated market formulation of Octagam® as a model PDP (250 mg/mL) with the Viscosity Reduction Platform (concentration at market formulation 50 or 100 mg/mL). The concentration was selected due to the favorable concentration-viscosity correlation at 250 mg/mL as can be seen in Figure 9. The results of viscosity measurements are depicted in Figure 11 and show that single excipients Orn and BSAcid exhibit higher viscosity values compared to that of market formulation, whereas other single excipients resulted in viscosity reduction (5–15%). Interestingly, Arg did reduce solution viscosity only marginally (~5%). Using Viscosity Reduction Platform combinations, this reduction could further be increased by up to 38% (75 mM Arg + 75 mM TMP). The results with the Phe/ TMP combination are even more intriguing (40%), however the protein concentration in this formulation was approx. 10 mg/mL lower than that of the control sample, preventing a direct comparison. Hence, Viscosity Reduction Platform combination Arg/TMP is considered as the best lead and was evaluated for a concentration-based lead profiling study as outlined below. Concentration ratios of excipient combinations do not have a critical impact on viscosity reduction of Octagam® in solution Typically, excipient concentrations are optimized using a Design of Experiments (DoE) approach. It is therefore conceivable that by changing the ratio of the two viscosity-reducing excipients, an additional improvement could be achieved. To test this hypothesis, Arg and TMP were combined in various ratios and the viscosity was measured. The respective viscosities of the concentrated market formulation (246 mg/mL) and formulations comprising one excipient, either Arg or TMP, were used as a reference. While single excipient-containing solutions delivered a moderate reduction in solution viscosity (12–15%), all Viscosity Reduction Platform combinations exhibited ≥29% viscosity reduction, with 75 mM Arg/75 mM TMP showing the highest relevant reduction in solution viscosity (~38%). Even though the viscosity for PDP formulation with Viscosity Reduction Platform combinations are still slightly beyond injectability (25 mPa·s), the objective of reducing viscosity for PDPs is not to create an injectable formulation that can otherwise not be made but to improve patient convenience. Hence, lowering the number of repetitive applications with higher protein loads is the first step to enable this. In conclusion, the Viscosity Reduction Platform is a strong viscosity reduction tool not only for utilization in highly concentrated mAb products but also for other biologics formulations. We have demonstrated that using the Viscosity Reduction Platform, a higher protein concentration for PDP formulations compared to market formulations could be achieved. Furthermore, Viscosity Reduction Platform combinations performed better than formulations containing only one Viscosity Reduction Platform excipient. 0 60 40 20 80 100 C o n t r o l 1 2 5 m M A r g 1 5 0 m M O m 1 2 5 m M P h e 1 5 0 m M B S A c i d 1 5 0 m M P y r - H C I 1 5 0 m M T M P 7 5 m M O m + 7 5 m M B S A c i d 7 5 m M O m + 7 5 m M P y r - H C I 7 5 m M O m + 7 5 m M T M P 7 5 m M A r g + 7 5 m M B S A c i d 7 5 m M A r g + 7 5 m M P y r - H C I 7 5 m M A r g + 7 5 m M T M P 7 5 m M P h e + 7 5 m M B S A c i d 7 5 m M P h e + 7 5 m M P y r - H C I 7 5 m M P h e + 7 5 m M T M P Viscosity [mPa·s] Octagam® 246 mg/mL Figure 11. Viscosity screening for Octagam® at 246 mg/mL. Combinations of Viscosity Reduction Platform excipients compared to experiments without a viscosity-reducing excipient (grey bar), with the industry standard Arg as benchmark (purple bar). The color codes of the split bars indicate the excipient combinations. Figure 12. Profiling of Viscosity Reduction Platform lead combination for Octagam® (243 mg/mL) at different excipient ratios. Samples were compared to control experiments without reducing excipient (grey bar) and to the single excipients of the lead combination Arg (purple bar) and TMP (blue bar), respectively. The color codes of the split bars indicate the excipient combinations used. 0 20 40 60 C o n t r o l 1 5 0 m M A r g 1 5 0 m M T M P Viscosity [mPa·s] Octagam® 243 mg/mL 1 5 0 m M A r g / 5 0 m M T M P 5 0 m M A r g / 1 0 0 m M T M P 7 5 m M A r g / 7 5 m M T M P
  • 9. Conclusion The Viscosity Reduction Platform contains a portfolio of excipients and is based on combining an amino acid with a second viscosity-reducing excipient. The latter excipients are ones that often adversely affect protein stability when used individually at high concentrations but combining them with an amino acid circumvents this and improves viscosity-reducing capacity. The Viscosity Reduction Platform allows for a better balance of protein stability versus protein viscosity. This platform therefore enables subcutaneous delivery while preserving long-term stability. It also makes the application through a device both more patient- friendly and more economical. The Viscosity Reduction Platform provides formulation scientists with a variety of options for formulation development that take the route of administration and the requirements of the protein into account. Beyond monoclonal antibodies, also formulations of plasma-derived proteins can be improved by the application of the platform. Please visit: sigmaaldrich.com/viscosity-reduction for a detailed user guide for the Viscosity Reduction Platform. For the technical sample kit as well as information on commercial licensing options, please reach out to your local sales representative. References 1. Viola, M. et al. Subcutaneous delivery of monoclonal antibodies: How do we get there? Journal of Controlled Release 286, 301–314, 2018. doi:10.1016/j.jconrel.2018.08.001 2. Shire, S. J., Shahrokh, Z. Liu, J. Challenges in the development of high protein concentration formulations. Journal of pharmaceutical sciences 93, 1390–1402, 2004. doi:10.1002/jps.20079 3. Xu, A. Y., Castellanos, M. M., Mattison, K., Krueger, S. Curtis, J. E. Studying Excipient Modulated Physical Stability and Viscosity of Monoclonal Antibody Formulations Using Small-Angle Scattering. 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