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Short-term storage stability of
Triple IT solution Triple IT solution Objective Stability protocol Results Discussion Conclusion Matthias D’Hondt1, Elien Vangheluwe1, Nadia Lemeire1, Tiene Bauters2, Brigitte Pelfrene2, Johan Vandenbroucke2, Hugo Robays2, and Bart De Spiegeleer1,* 1 DruQuaR (Drug Quality and Registration) group, Faculty of Pharmaceutical Sciences and 2 Ghent University Hospital, Ghent University, Harelbekestraat 72, B-9000 Ghent, Belgium b
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Triple Intrathecal (IT) chemotherapy:
Triple IT solution Objective Stability protocol Results Discussion Conclusion Triple Intrathecal (IT) chemotherapy: Cytarabine (CB): pyrimidine antitumor agent Methotrexate (MT): synthetic inhibitor of dihydrofolate reductase vomiting, fever, paraplegia, meningoencephalopathy corticosteroid: reduces complications BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Hydrocortisone: benzylalcohol (preservative)
Triple IT solution Objective Stability protocol Results Discussion Conclusion Hydrocortisone: benzylalcohol (preservative) Methylprednisolone (21)-sodium succinate (Solu-Medrol®): no preservative Yet, no in-use stability data available: logistics and cost issues BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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(0.385 %m/V CB, 0.154 %m/V MT, 0.051 %m/V MP(21)-SS)
Triple IT solution Objective Stability protocol Results Discussion Conclusion Determination of short-term (in-use) storage stability of Triple IT solution (ex tempore prepared): (0.385 %m/V CB, %m/V MT, %m/V MP(21)-SS) Evaluation of influences: - Storage temperature - Photometric conditions - Packaging - Batch to batch variability BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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1. Syringe system (PhaSeal®) 2. Brown glass vial
Triple IT solution Objective Stability protocol Results Discussion Conclusion Batch 3 different batches Packaging material 1. Syringe system (PhaSeal®) 2. Brown glass vial 3. Brown glass vial filled with needles BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Temperature (°C) Relative humidity (%)
Triple IT solution Objective Stability protocol Results Discussion Conclusion Temperature stability time points (n=6): 0, 4, 8, 24, 32, 48 hrs. 3 batches, 3 packaging materials (all protected from light) Temperature (°C) Relative humidity (%) 5 50 25 60 40 75 Controlled conditions BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Photometric stability
Triple IT solution Objective Stability protocol Results Discussion Conclusion Photometric stability - Triple IT solution quartz cuvette (25°C / 60 % R.H.) UV light – 2 days VIS light – 8 days - (Light protected) control samples 2 batches, in duplo ICH Q1B compliant (light energy) BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Fused-core HPLC method
Triple IT solution Objective Stability protocol Results Discussion Conclusion Fused-core HPLC method Column (+ guard column) Halo C18 (4.6×150 mm; 2.7 µm) Column / sample temp. 30°C / 15°C Mobile phase A: 0.1% V/V glacial acetic acid in H2O B: 0.1% V/V glacial acetic acid in ACN Gradient program Time (min) 15 %A 90 10 %B Flow rate 1 ml/min Injection volume 10 µl Detection DAD 240 nm (MP(21)-SS) @ 280 nm (MT and CB) BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
Triple IT solution Objective Stability protocol Results Discussion Conclusion T0hrs. Triple IT 240 nm 280 nm BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Triple IT Comp. Degradation Impurity formed Mass balance 1
Triple IT solution Objective Stability protocol Results Discussion Conclusion Temperature stability – Global results Triple IT Comp. Degradation Impurity formed Mass balance 1 CB - – % MT 99.43 – % MP(21)-SS 2 stat. significant RRT: 0.88 and 0.90 99.49 – % 2 Reporting threshold: 0.5% 1 relative to T0 hrs.; 95% CI 2 Including formed impurities, assuming RRF 1 BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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MP(21)-SS degradation kinetics:
Triple IT solution Objective Stability protocol Results Discussion Conclusion MP(21)-SS degradation kinetics: assuming (and confirmed) 1st order to determine k Arrhenius regression: ln k = ln A – Ea/RT Ea: 45.5 kJ/mol (95% CI: kJ/mol) A: 524×103 h-1 (95% CI: 107× ×103 h-1) BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Identification MP(21)-SS related degradants (ESI-MS)
[M+H+]+ [M+H+]+ RRT: 0.88 RRT: 0.90 Methylprednisolone Methylprednisolone (17)-succinate [2M+H+]+ [2M+H+]+ BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Batch / packaging material influence on MP(21)-SS degradation
Triple IT solution Objective Stability protocol Results Discussion Conclusion Batch / packaging material influence on MP(21)-SS degradation MLR: k batch and packaging material (Temp. constant) No stat. sign. (95%) batch / packaging influence BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Triple IT Comp. Degradation (%) 1 Impurity formed Mass balance 1
Triple IT solution Objective Stability protocol Results Discussion Conclusion Photometric stability – Global results Triple IT Comp. Degradation (%) 1 Impurity formed Mass balance 1 CB UV - 101.29 VIS 3.80 RRT 1.12 99.47 MT 32.46 66.92 100.00 RRT 0.85; 1.05 28.09 MP(21)-SS 2 RRT 0.88; 0.90 98.62 90.84 Reporting threshold: 0.5% 1 Decrease of API, relative to light protected control samples 2 Including formed impurities, assuming RRF=1 BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Photometric stability – MTdegradation
Triple IT solution Objective Stability protocol Results Discussion Conclusion Photometric stability – MTdegradation MT: single compound vs Triple IT mixture BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Related impurities specifications (Ph. Eur.) of MP(21)-SS MP: 0.5%
Triple IT solution Objective Stability protocol Results Discussion Conclusion Related impurities specifications (Ph. Eur.) of MP(21)-SS MP: 0.5% MP(17)-SS: 0.5% Risk: MP (lower solubility) precipitation Risk: min. (31% degradation) Conclusion: some consistent and controlled (MP + MP(17)-SS) degradation of MP(21)-SS is allowed in FPP (DP) Triple IT (3%). In API Solu-Medrol® FDP (Triple IT) higher, e.g. 1% ∑impurities < 1% BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Predicted MP(21)-SS degr. in function of storage condition and time
Triple IT solution Objective Stability protocol Results Discussion Conclusion Predicted MP(21)-SS degr. in function of storage condition and time BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Related impurities specifications (Ph. Eur.) of MT API
Triple IT solution Objective Stability protocol Results Discussion Conclusion Related impurities specifications (Ph. Eur.) of MT API 0.2% (= IT): H, I 0.3%: (B, E) 0.5% (= QT): C 3%: (F) 6 unspecified 0.05% ∑impurities < 0.5% (excl. imp. B, E and C) Conclusion: no significant MT degradation is allowed Triple IT: total imp. <0.5% 6 specified BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Proposed storage conditions: Storage:
Triple IT solution Objective Stability protocol Results Discussion Conclusion Proposed storage conditions: Storage: Max. 12 hour refrigerator 1.8% MP(21)-SS degradation Before administration Max. 30 min heating cycle (37°C) 0.6% MP(21)-SS degradation During administration / transport Max. 2 hours administration (25°C) 1.1% MP(21)-SS degradation All light protected no MT degradation BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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Thank you for your attention!!!
BGFW - DruQuaR, Fac. Pharm. Sciences, Ghent University
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