Week 6 and 9 - Biologics Flashcards

1
Q

What are biologics

A

Medicines grown + purified from bacteria or yeast
- produced from living cells

  • Used for monoclonal antibodies (largest group), growth factors, vaccines
  • delivered via injection or infusion

Diff. between biologics and small molecules:
- biologics have highly specific binding (to modify / block function to target)
- less frequet dosing with biologics
- biologics have longer t1/2 = drug circulates longer
- biologics MAIN ISSUE = IMMUNOGENIC effects
- can have allergic reaction, antibodies can aggregate + trigger immune response

Have Fab region = antigen binds here
Have Fc region (Y end) = recycling of antibody

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2
Q

What is the difference between biologics, biosimilars and biobetters

A

Biosimilars:
- a biological product similiar to a reference product
- have amino acid sequence similar to refernce
- have no clinically meaningful differences to the reference
- e.g. effectiveness, safety, potency, purity

Biobetters:
- improvement of an already existing biologic to make it better
- are less likely to fail clinical testing

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3
Q

Explain the process of bioprocessing / bioprocess of mAbs

A

mAbs are proteins (made from amino acids)

  • Cells are modified to generate active substance
  • Cells are then multiplied to target density + frozen
  • Active substance is produced in a bioreactor (nutrient solution used promotes growth)
  • API is separated from cells + purified (using chromatography)
  • drug is filled into vials in a highly sterile environment
  • stored as frozen liquid, liquid in syringes (fridge)

Summary:
1. Cells are added to bioreactors containing nutrient media / solution (promotes growth / multiplication)
2. Separate the API from the by-products / other products using chromatography (purification step)
3. Purified API is stored in vials and as a frozen liquid or liquid (in sterile conditions)

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4
Q

Explain the formulation principles for specific biologics and biosimilars

A

Biologics are formulated as liquids or solids (for reconstitution) a.k.a. lyophilisation
- solids have longer shelf life

  • Biologics are administered as injections or infusions e.g. IV, IM, SC

2 Types of Injections:
1. Pre-filled syringes (liquid form)
- max volume of 1 mL (measured dose)
- this form has better accuracy, convenience, patient compliance
- chemical degradation I.e. hydrolysis = less stable + has shorter shelf life compared to solid from
- physical degradation I.e. aggregation

  1. Dual chamber system (solid form)
    - have lypholised drug near bottom and liquid near plunger (at top)
    - when press plunger mix amount of liquid with solid = reconstitution
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5
Q

What testing are used for biologics and biosimilars

A

Stability Testing:
1. Long-term Testing:
- determien shelf life (time taken to lose 10% of drug)

2. Accelerated Testing:
         - used to establish shlef life
         - generate degradation profiles

3. Stress Yesting
         - Reveals patterns of degradation
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6
Q

Explain some formulation issues with mAbs (specifcally liquid form)

A
  1. Prone to conformational changes (unfolding)
    - chemical degradation or physical stress (e.g. shaking) can expose the hydrophobic a.acids
    - when in water these a.acids try to avoid water contact = join other unfolded hydrophobic = aggregation
    - aggregates can cause immune reaction in patients

Chemical degradation:
- hydrolysis
- oxidation

Physical degradation:
- extreme pH, High or low temp.
- physical stress (shaking)
- adsoprtion to surface of vial (can unfold protein or lwoer the dose)

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7
Q

How can we limit degradation

Lypholisation (solid form)

A

by FREEZING lypholisation (stored as solid for reconstitution with a liquid) USE CRYOPROTECTION

  • this extends mABs shelf life + long term stability
  • store lypholised med. in fridge to reduce aggregation

BUT freezing issues include:
- can get cold denaturation due to low temp.
- freezing can change pH, ionisation and solubility
- repeated freezing + thawing can cause aggregation (due to conformational changes)
- freezing forms crystals which leads to unfolding + breaking of mAB

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8
Q

What excipients are in protein and mAb formulations

A
  1. Buffer
    - e.g. acetate, citrate, phosphate
    - maintains required pH
  2. Surfactants
    - e.g. Polysoprbates (PS) 20 and 80 (tween 20 / tween 80)
    - cover the intrerface of mAbs preventing unfolding
    - PS degradation can contribute to aggregation, ensure they are sterile
  3. Salt and tonicity modifiers
    - e.g. NaCl
    - IV injections require isotonic preparation
    - IV, IM or SC require certain condition
  4. Antioxidants
    - e.g. EDTA (chelates metals)
    - metals catalyse oxidation reaction
  5. Protein stabilisers
    - e.g. sugars (sucrose) or amino acids (arginine)
  6. Lyophilistaion development
    - e.g. PEG
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9
Q

Describe the structure of antibodies

A

Fab region - variable region
- where antigen binds (to antigen binding site)
- each antibody has 2 Fab regions

Fc region - fixed region (Y shape of antibody the ending)
- involved in recycling of antibody

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10
Q

How are antibodies recycled

Albumin is also recycled this way

A
  1. Fc region (on antibody) binds to Fc receptor (FcRn) on surface of cell
  2. Bound antibody + receptors is engulfed into cell and an endosome is formed
  3. As pH decreases mAb will move out of acidic endosome
  4. Unbound mAb will go through lysosomal degradation
  5. Bound mAb will move towards surface of cell, as pH increases the binding between mAb + Fc receptor breaks
  6. Antibody is released into circulation
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11
Q

What is ADA and its impact

A

ADA - Anti Drug Antibodies

ADAs are formed when immune system recognises there are foreign antibodies in body (i.e. mAb prescence)
- this triggers an immune response
- response is triggered by chimeric (-xumab) or partly humanised mAbs

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12
Q

what are the 2 types of ADAs

A

Neutralising ADA:
- binds to Fab region (on mAb) and limits its ability to bind to target antigen = ↓ efficacy of mAb treatment

Non-neutralising ADA:
- bind to Fc region of mAbs
- ↑ lysosoaml degradation + ↓ recycling of mAb

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13
Q

How has the evolution antibody synthesis changed over time

A
  • Before antibodies was synthesised from mouse and human DNA = chimeric antibody
    - would add human DNA to mouse antibody forming recombinant chimeric
    - as antibody contains mouse DNA (in Fab region) when administered in body = higher chance of immunogenicity/ immune response due to it being recognised as foreign = ADA
    • suffix = -xumab
  • Humanised antibodies = majority of antibody was from human DNA but still had small section of mouse DNA (in Fab region)
  • Now have formation of fully humanised antibody = ONLY HUMAN DNA (no mouse DNA)
    - less chance of immunogenicity
    - have reduced immune reaction in patients
    - suffix = -umab

Meanings:
-ximab = chimeric
-zumab = humanised
-umab = human
-o- = mouse
-a- = rat

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14
Q

What 4 MoA does mAbs have

A
  1. Block signalling pathways assoicated with GF receptors
    - blocks ligand from binding
  2. ADCC (Antibody Dependant Cellular Cytotoxicity)
    - Antibody (Fab region) binds to antigen on target cell
    - Fc region (of antibody) binds to natural killer cells = activation of NK cells
  3. CDC (Complement Dependant Cytotoxicity)
    - anyibody binds to antigen on cell + activates macrophages
  4. ADCP (Antibody Dependnat Cellular Phagotycosis)
    - Antibody (Fab) binds to antigen on cell surface
    - Fc region binds to phagocyte = engulfs + degrades molecule = phagocytosis
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15
Q

What are the PK parameters (ADME) of mAbs

mAbs have non-linear PK

A

Absorption:
- when not adminstered via IV e.g. IM or SC = slow absorption due to bioavailability
- low molecular weight mAbs are absorbed well

Distribution:
- size + charge impact distribution (+ive charge = attach to cell surface)
mAbs get into tissue from blood via:
- diffusion / active diffusion
- paracellular (through space between cells)
- transcytosis (mAb binds to Fc receptor and is engulfed, transported through cell)

Elimination:
- Rate of elimination is influenced by dose (amount of mAb present) and expression of antigens (on cell surface)
- biologics have longer t1/2 than small molecule drugs (due to recycling)
- NO RENAL ELIMINATION (biologic size is too big, not filiteres)
- slow CL of mAb

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