Formulation and delivery of monoclonal antibodies Flashcards

1
Q

what do proteins and macromolecules consist of

A

4 polypeptide chains

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2
Q

describe the stability of proteins and macromolecules

A

not very stable compared to small drug molecules

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3
Q

what is the route of administration of infliximab

A

IV infusion

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4
Q

what is the route of administration of rituximab

A

IV infusion

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5
Q

what is the route of administration of tocilizumab

A

IV infusion, sc injection

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6
Q

what is the route of administration of abatacept

A

IV infusion

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7
Q

what is the route of administration of adalimumab

A

sc injection

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8
Q

what is the route of administration of golimumab

A

sc injection

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9
Q

what is the route of administration of certolizumab pegol

A

sc injection

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10
Q

what is the route of administration of etanercept

A

sc injection

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11
Q

what are the advantages of sc route for delivery of mabs

A
  1. Can self administer treatment following training
    - better self management
  2. useful to treat chronic diseases with frequent dosing
  3. can use prefilled syringes/pens/autoinjectors
    - better patient comfort than IV infusion
    - longer dosing interval
  4. reduced healthcare costs
    - reduced hospital visits
    - increased compliance
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12
Q

what are the disadvantages of sc route for delivery of mabs

A
  1. limited volume can be delivered to sc space
  2. relatively high dose required
  3. need stable, highly concentrated antibody formulation
  4. can have high viscosity
    - can increase injection force, time and pain at injection site
    - can reduce compliance
  5. can also adversely affect bioprocessing during manufacture
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13
Q

what are the challenges of high concentration formulation development

A
  1. high concentration
    - >0.1 of solution volume is occupied by solute
    - molecular size and distance between van Der waal surfaces is of a similar magnitude to size of molecule
  2. refers to molecular proximity
  3. can result in interaction between proteins
    - reversible self association, increase in viscosity, aggregation
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14
Q

what is viscosity at a macroscopic level

A

rate of transfer of momentum in a liquid
- how readily it pours

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15
Q

what is viscosity at a microscopic level

A

resistance to solute mobility
- how solute molecules move around relative to solvent molecules

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16
Q

what needs to be considered in concentrated solutiosn

A
  1. molecular crowding
  2. intermolecular interactions
17
Q

how does dose of monoclonal antibody affect viscosity

A

a high dose of mab required leads to high viscosity solutions

18
Q

what is the pairwise intermolecular interactions

A
  • difference in viscosity due to different intermolecular interactions
  • considers behaviour of pairs of molecules
  • DVLO
19
Q

what is pairwise intermolecular interactions dependant on

A
  • overall charge on solute molecule and charge distribution
  • proximity of molecules
20
Q

what are higher order intermolecular interactions

A

considers behaviour of groups of molecules

21
Q

what are the approaches to avoid high viscosity

A
  1. predict or study concentration dependant viscosity of mab
    - could reconsider use of mab if early enough and alternatives exist
  2. understand effect of sequence and structure of mab on viscosity at high concentrations
    - optimise sequence while still retaining activity
  3. understand role of excipients in controlling viscosity
22
Q

what are buffers used for

A

regulating pH

23
Q

what are salts and charged amino acids used for in excipients

A

reduce tendency for proteins to self associate

24
Q

what is the role of surfactants in excipients

A

replace proteins at interfaces
- both are surface active

25
Q

what is the role of stabilisers In excipients

A

anti oxidant, metal chelator, cyroprotectant

26
Q

what is the isoelectric point in proteins

A

pH at which a protein has no net charge
- when ph>pl, a protein has a net negative charge

27
Q

name the 6 categories of excipients

A
  1. buffers to keep ph levels between 4.7 and 7.4
  2. most formulations use 1 of 3 surfactants
  3. sodium chloride is commonly used
  4. 2 amino acids
  5. antioxidants
  6. all lyophilised formulations used 1 or a mixture of polysaccharide/disaccharide
28
Q

give examples of buffers

A

acetate, histidine, phosphate

29
Q

give examples of surfactants

A

polysorbate 80, polysorbate 20

30
Q

give examples of amino acids used as excipients

A

glycine and arginine

31
Q

give examples of antioxidants

A

ascorbic acid, methionine and EDTA

32
Q

Give examples of disaccharides/polysaccharides

A
  • sucrose, sugars provide bulk and serve as a stabilising agent, mannitol
33
Q

what devices can be used for delivery of mabs

A
  1. conventional needle and syringe
  2. combination product- drug and device
    - drug solution (viscous)
    - device: needle technology, ergonomic design (shape, size, actuation mechanism)
  3. certolizumab pegol pre filled pen/syringe
  4. adalimumab (humira) pre filled pen/syringes, injection vials
  5. golimumab pre filled pen/syringes and pre filled disposable devices
  6. etanercept:
    - benepali: pre filled disposable injection
    - enbrel: pre filled disposable injection, powder and solvent for solution for injection vials
    - erelzi: pre filled disposable injection
34
Q

what are the requirements of using a drug and device combination product

A
  1. bolus injector- not multi use
  2. pre filled plastic syringe
  3. needle safety device