Assessment of Interchangeable Multisource Medicines BCS-Biowaivers Dr. Henrike Potthast...

Assessment of Interchangeable Multisource Medicines

BCS-Biowaivers

Dr. Henrike Potthast ([email protected])

Training workshop: Assessment of Interchangeable Multisource Medicines, Kenya, August 2009

Assessment of Interchangeable Multisource Medicines, Kenya, August 20092 |

Basis for BCS-based Biowaiver Applications/Decisions

Basis for BCS-based Biowaiver Applications/Decisions

WHO – Technical Report Series No. 937, May 2006

Annex 7: Multisource (generic) pharmaceutical products: guidelines on registration requirements to establish interchangeability

Annex 8: Proposal to waive in vivo bioequivalence requirements for WHO Model List of Essential Medicines immediate release, solid oral dosage forms

FDA - Guidance for Industry: “Waiver of in vivo bio-equivalence studies for immediate release solid oral dosage forms containing certain active moieties/active ingredients based on a Biopharmaceutics Classification System” (2000)

EU-guidance:“Note for Guidance on the Investigation of Bioavailability andBioequivalence” CPMP/EWP/QWP/1401/98; paragraph 5.1


Definitions Definitions

BCS-based ‘Biowaiver’.....

.....is defined as

in vitro instead of in vivo ‘bioequivalence’ testing

comparison of test and reference

....is not defined as no equivalence test



acc. to the FDA guidance:

”BCS-based biowaivers are intended only for

bioequivalence studies. They do not apply to

food effect bioavailability studies or other

pharmacokinetic studies.”

(e.g., rel. bioavailability)



Bioavailability – rate and extent at which a drug substance... becomes available in the general system (product characteristic!)

Bioequivalence – equivalent bioavailability within pre-set acceptance ranges

Pharmaceutical equivalence Bioequivalence

Bioequivalence Therapeutic equivalence


BCS-based biowaiver

In vivo bioequivalence testing is generally required

but

” Such studies may be exempted if the absence of differences in the in vivo performance can be justified by satisfactory in vitro data.”

for oral immediate release dosage forms with systemic action!


BCS-based biowaiverBCS-based biowaiver

Evaluation of drug substance and

drug product

Drug substance

pharmacodynamic/therapeutic aspects

physicochemical aspects

Drug product

in vitro dissolution



RISK assessment

(see e.g. WHO guidance; sect. 9.2 and 5.1.(a))

♦ “critical use medicines”

♦ “narrow therapeutic index drugs”

♦ “documented evidence for BA or BE problems

♦ “scientific evidence that API polymorphs, excipients or the manufacturing process affects BE”



Biowaiver justification

based on

”………criteria derived from the concepts underlying

the Biopharmaceutics Classification System ......”



Biopharmaceutics Classification System (BCS)

dissolution

drug product drug substance in solution

membrane transport

drug substance in the system

simplified mechanistic view of bioavailability


Fig.1: Physicochemical properties that affect absorption (after oral administration) [H. van de Waterbeemd/ Eur J Pharm Sci 7 (1998), 1-3]

Melting point

Charge

Ionisa-tion

H-bonding

Lipophilicity

Size Shape

ChargeDistribution

Amphiphilicity

Solubility



Solubility Permeability Dissolution

Pillars of the BCS



High solubility

the highest single unit dose is completely soluble in 250 ml or less of aqueous solution at pH 1 - 6.8 (37 °C)

generate a pH-solubility profile

cave: possible stability problems have to be considered

Discussion on ‘intermediate solubility’, i.e., pH-dependent (high) solubility

Definition of low solubility?



High permeability

♦ EU guidance: ”Linear and complete absorption reduces the possibility of an IR dosage form influencing the bioavailability”

♦ FDA guidance: absolute BA >90 %

♦ WHO guidance: at least 85 % absorption in humans

Human data are preferred;

in vitro data may be submitted if sufficiently justified and valid

Definition of low permeability?


BCS-based biowaiver



♦ „….if the fraction of the dose absorbed is the same, the human body should always do the same with the absorbed compound …Even in a disease state, this argument is still a valid statement.“

[Faassen et al. Clin Pharmacokinet 43 (2004)1117]

what does the product do to the drug substance?



When are in vitro results sufficient for bioequivalence evaluation?

When is in vitro instead of in vivo bioequivalence testing scientifically justified (or even more restrictive)?

Minimizing risk by means of ‘worst case’ investigation?

Which in vitro investigations may be sufficient?



in vitro dissolution objectives

quality control

justification of minor variations

iviv-correlation (e.g. major variations; bridging)

additional to BE studies

proportionality based biowaiver

BCS based biowaiver

….



in vitro dissolution prerequisites

reasonable, stability-indicating, validated methods

discriminative methods

reproducible methods

biorelevant methods (?)

……one fits all?!



in vitro dissolution and BCS concept

meet prerequisites

ensure risk minimization

justify absence of difference

biorelevant?!0

2

4

6

8

10

12

14

16

18

20

0 5 10 15 20

time

%



In vitro comparison of immediate release oral

drug products (T and R)

first option: very rapidly dissolving products

Not less than 85 % of labeled amount are dissolved within 15 min in each of three buffers (pH 1.2, pH 4.5 acetate buffer, pH 6.8 phosphate buffer) – no further profile comparison of T and R is required

reasonable, validated experimental conditions/methods are strongly recommended!





second option: rapidly dissolving products

Not less than 85 % of labeled amount are dissolved within 30 min in each of three buffers (pH 1.2, pH 4.5 acetate buffer, pH 6.8 phosphate buffer)

reasonable, validated experimental conditions/methods are strongly recommended!



Experimental conditions:

EU guidance – no specific information yet

US-FDA guidance – ‚USP‘-conditions 50 rpm (paddle) or 100 rpm (basket); 900 ml; USP buffer; 37 °C

WHO – 75 rpm (paddle) or 100 rpm (basket); 900 ml or less; USP buffer; 37 °C

all: no surfactants!





Proving similarity of dissolution profiles of T and R

e.g., using f2-test, unless similarity is obvious

(see e.g. WHO guidance sect. 9.2 or app. 2 of the current EU guidance; note prerequisites)



f2-test

acceptance value based on 10 % difference between profiles

„identical“ profiles: f2 =100

„similar“ profiles: f2 between 50 and 100

any other reasonable/justified test possible!



Requirement: either “very rapid” or “similar” in vitro dissolution

how similar is ‘similar’?

discussion of differences usually not appropriate



BCS-based biowaiver in-vitro dissolution

no iviv correlation

no biorelevant conditions (except pH)

concept to justify absence of difference!



Evaluation of excipients (e.g., large amounts, possible interactions....; e.g. Isoniazid J Pharm Sci 96 March 2007: “…permeability changes due to excipient interaction cannot be detected in vitro…”)

Evaluation of manufacturing processes in relation with critical physicochemical properties



BCS-based Biowaiver for immediate release drug products

containing eligible drug substances.

No BCS-based biowaiver for:

locally applied, systemically acting products

non-oral immediate release forms with systemic action

modified release products

transdermal products



Provided that ......

drug solubility is high,

permeability is limited,

excipients do not affect kinetics,

excipients do not interact ,.....



....then very rapid dissolution (at least >85% in 15 min) of test

and reference may ensure similar product characteristics

because...

....absorption process is probably independent from

dissolution and not product related…

limited absorption kinetics due to poor drug permeability and/or gastric emptying

Biowaiver for BCS class III drugs (see WHO guidance)

BCS-class III?!

Fig. 1. Mean in vitro dissolution profiles of metformin for 500mg immediate-release tablet of

Glucophage® or Glucofit® in 0.1N HCI (○,●) pH 4.6 (□,■) and pH 6.8 (∆,▲) buffer solution.


BCS-class III?!BCS-class III?!

Fig. 2. Mean in vivo plasma conentration-time profiles of metformin in 12 healthy

Chinese subjects after oral administration of a 500mg immediate-release tablet of

Glucophage (○) or Glucofit (●).

Fig. 2 Fig.



Fig. 1. Comparison of mean cimetidine released-time profiles obtained from dissolution testing of cimetidine

tablets containing methacrylate copolymer and Tagamet® tablets in different media. Each value is the mean of

six observations. Data for the Tagamet® tablet were obtained from dissolution testing in 0.01N hydrovhloric acid

(HCI) and simulated intestinal fluid without pancreatin (SIFsp): (a) 0.01N HCI, pH 2; (b) phosphate buffer, pH

4.5; (c) SIFsp, pH 6.8; and (d) fasted-state simulated intestinal fluid, pH 6.5 pancreatin. Clin Pharmacokinet. Jantratid et al 2006



Fig. 2. Comparison of mean plasma cimetidine concentration-time profiles obtained after

administration of a singel oral dose of cimetidine tablets containing methacrylyte copolymer or

Tagamet® tablets. Each point represents the mean plasma cimetidine concentration (standarderror) from 12 subjects.

Clin Pharmacokinet. Jantratid et al 2006



♦ biopharmaceutics assessment (with necessary underlying PK background!!) ≠ pure PK assessment

♦ differentiation between solubility (API) and dissolution (product performance)

♦ volume of dissolution medium (900 vs 500 ml) not relevant (no concerns regarding hydrodynamics; recent findings); sink conditions!

♦ in-vitro/in-vivo relationship rather than correlation!! ♦ slow absorption… intestinal transit about 3hs!!



For drugs showing ....

‘very’ high permeability

pH-dependent solubility within the physiologically relevant pH range

.....an ‘intermediate solubility’ class is suggested

[Polli et al. J Pharm Sci 93 (2004) 1375; see WHO guidance]



“pH-dependent soluble, highly permeable, weak

acidic, ionizable drug compounds may be handled

like BCS class I drugs” (e.g. chpt 8 in: Drug Bioavailability, van de Waterbeemd,

Lennernäs, Artursson (edts) 2003 Wiley-VCH)

in vitro dissolution requirements acc. to WHO guidance at least 85% within 30 min at pH 6.8 and

f2 testing for pH 1.2 and 4.5 profiles

but no biowaiver for weak basic drugs



meaningful literature data may be used for drug substance characteristics (and excipients)

product related data must always be actually generated for the particular product



BCS-based biowaiver are not just in-vitro dissolution, but in-vitro dissolution is meant to be an important part of BCS-based biowaiver applications



Current recommendation for TB drugs

no BCS-based biowaiver for RMP

‘regular’ BCS-based biowaiver possible for levofloxacin and ofloxacin (“rapid dissolution”)

currently a BCS-based biowaiver is possible for isoniazid (cave: excipients!), ethambutol and pyrazinamide if the same “very rapid” dissolution (T and R) is demonstrated

see specific, currently published WHO guidance documents at: http://healthtech.who.int/pq/info_applicants/info_for_applicants_BE_studies.htm


BCS-based biowaiverex.: Pyrazinamide [Dressman et al., 2008, unpubl.]



BCS-based biowaiver ex.:Pyrazinamide [Dressman et al., 2008, unpubl.]

BCS-based biowaiver ex.:Pyrazinamide [Dressman et al., 2008, unpubl.]


BCS-based biowaiver ex.: Isoniazid [Dressman et al., 2008, unpubl.]



BCS-based biowaiverex.: Ethambutol [Dressman et al., 2008, unpubl.]

BCS-based biowaiverex.: Ethambutol [Dressman et al., 2008, unpubl.]


BCS-based biowaiver ex.: Ethambutol [Dressman et al., 2008, unpubl.]




Becker C, Dressman JB, Amidon GL, Junginger HE, Kopp S, Midha KK, Shah VP, Stavchansky S, Barends DM: Biowaiver monographs for immediate release solid oral dosage forms: Pyrazinamide; J Pharm Sci. 2008 Feb 12; [Epub ahead of print]

Becker C, Dressman JB, Amidon GL, Junginger HE, Kopp S, Midha KK, Shah VP, Stavchansky S, Barends DM: Biowaiver monographs for immediate release solid oral dosage forms: ethambutol dihydrochloride; J Pharm Sci. 2008 Apr;97(4):1350-60.

Vogt M, Derendorf H, Krämer J, Junginger HE, Midha KK, Shah VP, Stavchansky S, Dressman JB, Barends DM: Biowaiver monographs for immediate release solid oral dosage forms: prednisone; J Pharm Sci. 2007 Jun;96(6):1480-9.

Becker C, Dressman JB, Amidon GL, Junginger HE, Kopp S, Midha KK, Shah VP, Stavchansky S, Barends DM; International Pharmaceutical Federation, Groupe BCS: Biowaiver monographs for immediate release solid oral dosage forms: isoniazid; J Pharm Sci. 2007 Mar;96(3):522-31.

Kalantzi L, Reppas C, Dressman JB, Amidon GL, Junginger HE, Midha KK, Shah VP, Stavchansky SA, Barends DM: Biowaiver monographs for immediate release solid oral dosage forms: acetaminophen (paracetamol); J Pharm Sci. 2006 Jan;95(1):4-14.

Potthast H, Dressman JB, Junginger HE, Midha KK, Oeser H, Shah VP, Vogelpoel H, Barends DM: Biowaiver monographs for immediate release solid oral dosage forms: ibuprofen; J Pharm Sci. 2005 Oct;94(10):2121-31.

Kortejärvi H, Yliperttula M, Dressman JB, Junginger HE, Midha KK, Shah VP, Barends DM: Biowaiver monographs for immediate release solid oral dosage forms: ranitidine hydrochloride; J Pharm Sci. 2005 Aug;94(8):1617-25.

Verbeeck RK, Junginger HE, Midha KK, Shah VP, Barends DM: Biowaiver monographs for immediate release solid oral dosage forms based on biopharmaceutics classification system (BCS) literature data: chloroquine phosphate, chloroquine sulfate, and chloroquine hydrochloride; J Pharm Sci. 2005 Jul;94(7):1389-95.

……….



THANK YOU FOR YOUR ATTENTION!

Assessment of Interchangeable Multisource Medicines BCS-Biowaivers Dr. Henrike Potthast...

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