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BIOPHARMACEUTICSCLASSIFICATION SYSTEM: A
BASIS FOR REGULATORYWAIVER OF IN VIVO BA/BE
STUDIES
Ajaz | Insight
7/11/2013 1Ajaz | Insight
Graduate lecture at University of Maryland: on 17 August 2012
Update: 11 July 2013
http://www.ajazhussain.com
Update
ViroPharma Suit Against FDA Over Generic Vancocin Tossed
[Bloomberg. By Andrew Zajac & Tom Schoenberg - Jan 9, 2013]
The company failed to produce new evidence following rejection in April of its request
for a court order to block FDA approval of three generic versions of Vancocin
• U.S. District Judge Ellen Segal Huvelle in Washington said today in her ruling.
• The case is ViroPharma Inc. v. Hamburg, 12-cv-00584, U.S. District Court, District of Columbia(Washington)
7/11/2013 Ajaz | Insight 2
Storyofa SeminalScientificContribution&ItsRegulatory
Applications(1995-2000)
7/11/2013 3Ajaz | Insight
WhatisBCS?
A
paradigm
shift
• 𝑀 𝑡 = 0
𝑡
𝑃𝐶(
𝑑𝐴
𝑑𝑡
)
• 𝐾 𝑎 = (
𝑆
𝑉
)𝑃𝑒𝑓𝑓
• 𝐴𝑏𝑠𝑜𝑟𝑝𝑡𝑖𝑜𝑛 𝑛𝑢𝑚𝑏𝑒𝑟 𝐴 𝑛 =
𝑃𝑒𝑓𝑓
𝑅
.< 𝑇𝑠𝑖 >
• 𝐷𝑖𝑠𝑠𝑜𝑙𝑢𝑡𝑖𝑜𝑛 𝑛𝑢𝑚𝑏𝑒𝑟𝐷 𝑛 =
3𝐷
𝑟2
𝐶 𝑠
 . < 𝑇𝑠𝑖>
• If the Peff of a drug is less than2•10–4 cm/s, then
drug absorption will be incomplete
• Class I—high solubility, high permeability:
generallyvery well-absorbedcompounds
• Class II—low solubility, high permeability:exhibit
dissolution rate-limitedabsorption
• Class III—high solubility, low permeability:exhibit
permeabilityrate-limitedabsorption
• Class IV—low solubility, low permeability:very
poor oral bioavailability
7/11/2013 4
http://www.fda.gov/ohr
ms/dockets/ac/04/slides
/2004-
4078S2_10_Amidon_files/
frame.htm
Journal of Clinical Pharmacology, 2002;42:620-643
Ajaz | Insight
RegulatoryApplications?
• Types of dissolution test comparisons for
manufacturing and formulation changes
Initial applicationin
SUPAC-IR (1995)
• Methods to classify per BCS and criteria
for biowaiver
Waiver of In vivo BA/BE
…BCS Guidance (2000)
• Several workshops and reportsEfforts to extend
biowaivers (beyond 2000)
• Debate and court case
A relativelyrecent
applicationto a ‘locally
acting’ drug
• BCS a foundational element of QbDOpportunities for Quality
by Design
7/11/2013 5Ajaz | Insight
Learningobjectives
(1). Considerations
for developing the
FDA guidance
“Waiver of In Vivo
Bioavailability and
Bioequivalence
Studies for
Immediate-Release
Solid Oral Dosage
Forms Based on a
Biopharmaceutics
ClassificationSystem”
(August 2000)
Broadly, gain an
understandingof
considerationsfor
translating
scientific
knowledgeinto
regulatorypolicy
(2) What questions
should you ask?
(3) What
assumptions
should you accept?
(4) How precise
should your
answers be?
Develop a basis to
critically evaluate
considerations
utilized for
developmentof
the FDA guidance
document
(5) How should you
‘connect the dots’:
CMC – BA/BE?
Can you justify new
applications of BCS
(i.e., beyond the
2000 guidance)?
Identify and
explain how
future regulatory
applicationsof
BCS may be
realized in the
context of ‘Quality
by Design’
7/11/2013 Ajaz | Insight 6
Presentationoutline
Application
of BCS
beyond the
2000
Guidance?
54321
7/11/2013 Ajaz | Insight 7
VIROPHARMA INCORPORATED, Plaintiff,
Vs.
MARGARET A. HAMBURG, M.D., et al., Defendants.
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA
Civil Action No. 12-cv-00584-ESH
Filed 04/17/12
VIROPHARMAINC., PLAINTIFF, VS.
(FDA) MARGARETA. HAMBURG,M.D., ET AL.,
DEFENDANTS.
IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA
Civil Action No. 12-cv-00584-ESH
Filed 04/17/12
7/11/2013 Ajaz | Insight 8
13April2012PlaintiffssuedFDA
Issue
• Agency’s 9 April 9 2012 approval of three
ANDAs of the company’s Vancocin®
(vancomycin hydrochloride).
They alleged
that:
• FDA impermissiblyinterpretedthe Food, Drug, and
CosmeticAct when it denied the company three-year
exclusivity for its NDA supplement (“sNDA”)
(“exclusivityclaim”);and
• FDA violated its own regulations—andchanged
established policy withoutthe procedure requiredby
law—whenit chose to accept in vitro bioequivalence
data for oral vancomycin (“bioequivalenceclaim”).
7/11/2013 Ajaz | Insight 9
http://www.fdalawblog.net/fda_law_blog_hyman_phelps/2012/04/court-denies-viropharmas-motion-for-tropi-in-
vancomycin-caseleaves-generics-on-the-market.html
23 April2012Memorandumof Opinion
7/11/2013 Ajaz | Insight 10
http://en.wiki
pedia.org/wiki
/Ellen_Segal_H
uvelle#Early_li
fe_and_career
Memorandum Opinion issued on April 23, 2012
The Judge
TITLE 21--FOOD AND DRUGS
CHAPTER I--FOODAND DRUGADMINISTRATION
SUBCHAPTER D--DRUGS FORHUMAN USE
• PART 320 BIOAVAILABILITY AND BIOEQUIVALENCE REQUIREMENTS
• Subpart A--General Provisions
§ 320.1 - Definitions.
• Subpart B--Procedures for Determining the Bioavailability or Bioequivalence of Drug Products
§ 320.21 - Requirements for submission of bioavailability and bioequivalence data.
§ 320.22 - Criteria for waiver of evidence of in vivo bioavailability or bioequivalence.
§ 320.23 - Basis for measuring in vivobioavailability or demonstrating bioequivalence.
§ 320.24 - Types of evidence to measure bioavailability or establish bioequivalence.
§ 320.25 - Guidelines for the conduct of an in vivobioavailability study.
§ 320.26 - Guidelines on the design of a single-dose in vivobioavailability or bioequivalence study.
§ 320.27 - Guidelines on the design of a multiple-dose in vivo bioavailability study.
§ 320.28 - Correlation of bioavailability with an acute pharmacological effect or clinical evidence.
§ 320.29 - Analytical methods for an in vivobioavailability or bioequivalence study.
§ 320.30 - Inquiries regarding bioavailability and bioequivalence requirements and review of protocols by the Food and Drug Administration.
§ 320.31 - Applicability of requirements regarding an "Investigational New Drug Application."
§ 320.32 - Procedures for establishing or amending a bioequivalence requirement.
§ 320.33 - Criteria and evidence to assess actual or potential bioequivalence problems.
§ 320.34 - Requirements for batch testing and certification by the Food and Drug Administration.
§ 320.35 - Requirements for in vitro testing of each batch.
§ 320.36 - Requirements for maintenance of records of bioequivalence testing.
§ 320.38 - Retention of bioavailability samples.
§ 320.63 - Retention of bioequivalence samples
7/11/2013 Ajaz | Insight 11
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=320.22
DraftGuidance onVancomycin Hydrochloride(2008)
• Vancomycin acts locally in the lower GI tract
• The dosage form is expected to be in contact with a
relatively large fluid volume, vancomycin is
expected to be in solution long (e.g., hours) before it
reaches the site of action in the lower GI tract.
VancomycinHCl Capsules
are administeredorally for
treatmentof enterocolitis
• Equivalent release of vancomycin,
• The high solubility of vancomycin drug substance,
• The effect of inactive ingredients on the transport of
vancomycin drug through the GI tract and/or the
effectiveness of drug at the site of action
The BE of two capsule
formulationsof oral
vancomycin HCl is
determinedby?
• Formulations are Q1 and Q2 the same as the RLD
• Dissolution: Basket, 100 rpm, 0.1N HCl (or 0.1N
HCl with NaCl at pH 1.2), pH 4.5 Acetate buffer, and
pH 6.8 Phosphate buffer; 900 mL; 37ºC
• An f2 test of similarity
In Vitro BE
7/11/2013 Ajaz | Insight 12
http://www.fda.gov/OHRMS/DOCKETS/98fr/FDA-2008-D-0626-gdl.pdf
Plaintiffs’ArgumentPriorto theCourtCase
30 June 2009,
Plaintiffs’
briefing
document FDA
Advisory
Committee for
Pharmaceutical
Science and
Clinical
Pharmacology
“Is essentially the
Biopharmaceutics
Classification System
(BCS)-based biowaiver,
which was developed
using healthy GI
parameters to predict the
absorption of
systemically acting drugs
from the healthy gut and
was not intended for use
in predicting the in vivo
performance of locally
acting GI drugs”
Healthy GI physiological parameters may not
be an appropriate in vitro model for assessing
BE with locally acting GI drugs used to treat
serious GI disease
Oral Vancomycin is Systemically Absorbed in
Some Patients and has Been Linked with
Systemic Toxicity. Does a Biowaiver Ensure
Safety or Should In VivoTesting be Considered
for this Drug?
Extension of a Biowaiver to a New Class of
Drug Should be Evidence-Based and Data-
Driven.
Evaluation of Inactive Ingredients
http://www.fda.gov/downloads/AdvisoryCom
mittees/CommitteesMeetingMaterials/Drugs/
AdvisoryCommitteeforPharmaceuticalSciencea
ndClinicalPharmacology/UCM173159.pdf
7/11/2013 Ajaz | Insight 13
www.fda.gov/downloads/AdvisoryCommittees/.../UCM179424.pdf (FDA ACPS Transcripts)
Plaintiffs, In-Part,BasedtheirArgumentsona PreviousACPS
Discussion(October20,2004)
Bioequivalence
Testing for Locally
Acting
Gastrointestinal
ACPS presentations:
Prof. Amidon
http://www.fda.gov/ohrms/docke
ts/ac/04/slides/2004-
4078S2_10_Amidon_files/frame.ht
m
and OGD
(Lionberger)
http://www.fda.gov/ohrms/docke
ts/ac/04/slides/2004-
4078S2_11_Lionberger_files/frame
.htm
As the Deputy Director of FDA’s
Office of Pharmaceutical
Science Dr. Ajaz Hussain
summarized in his concluding
remarks, “I don’t want to sort of
jump in and say all right” and
simply apply the BCS approach
to locally acting GI drugs, in
part because issues relating to
“volume” and “hydrodynamics”
merited close attention.
Consequently, he said, “we have
to give some thought to how we
would approach that, so it is
not a trivial matter.”
(http://www.fda.gov/downloads/AdvisoryCommittees
/CommitteesMeetingMaterials/Drugs/AdvisoryCommit
teeforPharmaceuticalScienceandClinicalPharmacology/
UCM173159.pdf)
My comments (cited) related to broad
policy decision; not relevant to specific
case example as in this case.
FDA ‘point-to-point’ response to the
Citizen Petition addressed the questions
posed
http://www.regulations.gov/#!documentDetail;D=FDA-2006-P-
0007-0051
Congressional Record - Senate (S5649-
5650), May 7, 2007 - [D. Robertson -
Comment]
http://www.regulations.gov/#!documentDetail;D=FDA-2006-P-0007-
0014
7/11/2013 Ajaz | Insight 14
http://www.fda.gov/ohrms/dockets/ac/04/transcripts/2004-4078T2.pdf (ACPS 2004 transcripts)
http://www.regulations.gov/#!documentDetail;D=FDA-2006-P-0007-0051 (FDA CP response)
Re-capandNextSteps
Application
of BCS
beyond the
2000
Guidance?
54321
7/11/2013 Ajaz | Insight 15
A successful application of BCS principles to a
particular “locally acting” drugs (low to no
permeability). FDA willing to make ‘case-by-case’
decision. Broad policy recommendation yet to be
formulated.
(5) How should
you ‘connect the
dots’: CMC –
BA/BE? (QbD)
(2) What
questions should
you ask?
(4) How precise
should your
answers be?
(3) What
assumptions
should you
accept?
(1). Considerations
for developing the
FDA guidance
CONSIDERATIONSFOR DEVELOPING THE FDA
GUIDANCE:QUESTIONS, ASSUMPTIONS, AND NEEDED
PRECISION
Reflecting back to 1995-2000
Note: A number of data slides to follow have been taken from a
previous presentation available at:
www.fda.gov/ohrms/dockets/ac/05/.../2005-4137S2_02_Hussain.ppt
7/11/2013 Ajaz | Insight 16
NeedtoReduceOurRelianceon In VivoBEStudies:Why?
7/11/2013 Ajaz | Insight 17
• 21 CFR 320.25(a)“… no unnecessary human
researchshould be done.”Ethical reasons
• “building quality into products”
• “right first time”
Focus on
prevention
• Sciencecontinuesto provide new methodsto
identifyand eliminateunnecessary in vivo BE
studies; reduce time and cost of drug
developmentand review
Efficiency
TherapeuticEquivalence
7/11/2013 Ajaz | Insight 18
Reference Test
PharmaceuticalEquivalent
Products
Possible Differences
Drug particlesize, ..
Excipients
Manufacturingprocess
Equipment
Site of manufacture
Batch size ….
Documented Bioequivalence
= Therapeutic Equivalence
(Note: Generally, same dissolution spec.)
Normalhealthy subjects
Crossover design
Overnight fast
Glass of water
90% CI within 80-125%
of Ref. (Cmax& AUC)
RegulatoryBioequivalence:A Summary
7/11/2013 Ajaz | Insight 19
In Vivo BE
Pre-1962 DESI Drugs: In Vivo
evaluation for “bio-problem”
drugs (TI, PK, P-Chem)
Post-1962 Drugs: Generally
In Vivo - some exceptions
(IVIVC..)
SUPAC-IR
(1995)
Dissolution-IR
BCS
(pre-/post
approval
“Self-evident” - Biowaivers granted
Condition- excipients do not alter absorption
(historical data)
Solutions
Suspensions
Chewable, etc.
Conventional
Tablets
Capsules
MR Products SUPAC – MR;
IVIVC
Quality by Design & Design Space
IVIVC = In vitro to in vivo correlation
DissolutionTestMethods
7/11/2013 Ajaz | Insight 20
> 900 ml, 37oC
> Water, 0.1 N HCl, pH 6.8 buffer,or…
> 50 rpm (paddle),100 rpm (basket),…
> Vessel geometry
> Location of dosage unit
Dissolutiontests:Debates
Dissolution tests are “over
discriminating”
Products that dissolve about
70% in 45 minutes have no
medically relevant
bioequivalence problems
Dissolution tests are not sufficientto
assure bioequivalence
Demonstrationof IVIVC is necessary
IVIVC’s are “Product Specific”
7/11/2013 Ajaz | Insight 21
Failureto DiscriminateBetweenBio-in-equivalentProducts:
InappropriateAcceptanceCriteria
7/11/2013 Ajaz | Insight 22
0 10 20 30 40 50
%DrugDissolved
0
10
20
30
40
50
60
70
80
90
100
110
USP Specification
Product A
Product B
Time in Minutes
Product B was not
bioequivalent to
Product A
Log(AUCinf): CI 94.6 - 123.6
Log(AUC): CI 89.1 - 130.0
Cmax: CI 105.3 - 164.2
(weak acid, rapid dissolution inSIF)
Time in Hours
0 1 2 3 4 5 6
DrugConcentrationinPlasma(ng/ml)
0
200
400
600
800
1000
1200
1400
1600
1800
Capsule (Ref.)
Tablet 1
(wet-granulation - starch)
Tablet 2
(direct compression -
calcium phosphate)
USP Paddle 50rpm, Q 70% in 30 min
Failureto DiscriminateBetweenBio-in-equivalentProducts:
InappropriateTestMethod?
7/11/2013 Ajaz | Insight 23
DissolutionTestProblems:False+ivesand -ives
7/11/2013
Ajaz | Insight
24
15 min 30 min 45 min AUC Cmax
Ref 95 96 98 100 100
B 96 97 97 104 95
C 62 84 92 84 55
D 82 94 95 88 87
E 103 103 103 112 120
F 13 35 53 100 102
Test/Ref.Mean
I. J. MacGilvery. Bioequivalence: A Canadian Regulatory
Perspective. In, Pharmaceutical Bioequivalence
. Eds. Welling, Tse, and Dighe. Marcel Dekker, Inc., New York, (1992)).
24
“FormulationSpecific”IVIVC
7/11/2013 Ajaz | Insight 25
Peak Concentration Vs. % Dissolved in vitro
Clarke et al. J. Pharm. Sci. 66: 1429, 1977
% Dissolved in 40 minutes
20 40 60 80 100
PeakConcentration(ug/100ml)
12
14
16
18
20
22
24
26
28
30
A
B
H
I
D
F
J
C
G
E
DissolutionTest&Bioequivalence:RiskAssessment
7/11/2013 Ajaz | Insight 26
Dissolution
generally
“over-
discriminating”
Dissolution fails
to signal
bio-in-equi
~ 30% (?)
NO YES
NOYES
Bioequivalent
Dissolution Specification
Why?
TypicalPhysiologicParameters:
SingleDoseFasting BE Study
7/11/2013 Ajaz | Insight 27
Volume = Gastric fluid + 8 oz water (~300 ml)
pH of gastric fluid = 1-3
Res. time (fasting)= variable; T50%=15 min.
Permeability - Low , compared to Small Intestine.
Surface tension lower than water, ….
Volume (fasting)= what gets emptied + SI vol.(500 ml?)
pH = 3-8, surface tension low,...
Res. time (fasting): 2-4 hours
Permeability - high compared to other parts
Hydrodynamics?
Whenyouchangethe wayyoulookata thing….
The
paradigm
shifts
• 𝑀 𝑡 = 0
𝑡
𝑃𝐶(
𝑑𝐴
𝑑𝑡
)
• 𝐾 𝑎 = (
𝑆
𝑉
)𝑃𝑒𝑓𝑓
• 𝐴𝑏𝑠𝑜𝑟𝑝𝑡𝑖𝑜𝑛 𝑛𝑢𝑚𝑏𝑒𝑟 𝐴 𝑛 =
𝑃𝑒𝑓𝑓
𝑅
.< 𝑇𝑠𝑖 >
• 𝐷𝑖𝑠𝑠𝑜𝑙𝑢𝑡𝑖𝑜𝑛 𝑛𝑢𝑚𝑏𝑒𝑟𝐷 𝑛 =
3𝐷
𝑟2
𝐶 𝑠

. < 𝑇𝑠𝑖>
• If the Peff of a drug is less than2•10–4 cm/s, then
drug absorption will be incomplete
• Class I—high solubility, high permeability:
generallyvery well-absorbedcompounds
• Class II—low solubility, high permeability:exhibit
dissolution rate-limitedabsorption
• Class III—high solubility, low permeability:exhibit
permeabilityrate-limitedabsorption
• Class IV—low solubility, low permeability:very
poor oral bioavailability
7/11/2013 Ajaz | Insight 28
http://www.fda.gov/ohr
ms/dockets/ac/04/slides
/2004-
4078S2_10_Amidon_files/
frame.htm
Journal of Clinical Pharmacology, 2002;42:620-643
SUPAC-IR/BCS:Forsome‘Level2’ Changes
7/11/2013 Ajaz | Insight 29
HS/HP LS/HP HS/LP LS/LP
Critical Process Gastric
Emptying
Dissolution Permeability D/P
IVIVC Not likely Likely Not likely (?)
Method 0.1 N HCl pH 1 - 7.4 App/Comp In Vivo BE
Acceptance
Criteria
Single point
85% in 15 min
Multiple
profiles
(f2 > or = 50)
Single profile
(f2 > or = 50)
AUC & Cmax
90% CI
80-125%
Note: NTI drugs excluded for some Level 2 Changes
CriteriaforBiowaiver,NewApplications?
Solutions
BA/BE “Self-
evident”
BCS:
Expectation of
IVIVC
IVIVC
7/11/2013 Ajaz | Insight 30
Biowaiver?
“Rapid Dissolution”
“High Solubility”
& “High
Permeability”
If two drug products, containing the same drug, have the same concentration time
profile at the intestinal membrane surface then they will have the same rate and
extent of availability at the site of action.
BCS:ClassMembership
7/11/2013 Ajaz | Insight 31
• the highestdose strength is soluble in <250 mL
aqueous buffersover 1- 7.4 pH range of at 37oC.High Solubility
• extentof absorptionin humansis determinedto
be  90%
High
Permeability
•  85% dissolves within 30 minutesin 0.1 HCl (or
SGF), pH 4.5, and pH 6.8 buffers(or SIF) using
ApparatusI at 100 rpm or ApparatusII at 50 rpm.
Rapid
Dissolution
MetoprololIRTablets:In Vitro- InVivoRelationship
7/11/2013 Ajaz | Insight 32
TIME IN MINUTES
0 5 10 15 20 25 30 35
%DRUGRELEASED
0
10
20
30
40
50
60
70
80
90
100
110
Rapid
Slow
FDA-UMAB
(931011)
RATIO (T/R) OF % DISSOLVED AT
10 MINUTES
0.2 0.4 0.6 0.8 1.0 1.2
AUC,ANDCmaxRATIOS(T/R)
0.5
0.6
0.7
0.8
0.9
1.0
1.1
1.2
SOLUTION
FDA-UMAB
(931011)
AUC
Cmax
MetoprololIRTablets:Experimental&SimulationData
7/11/2013 Ajaz | Insight 33
RATIO (T/R) OF % DISSOLVED AT 10 MINUTES
0.2 0.4 0.6 0.8 1.0 1.2
0.5
0.6
0.7
0.8
0.9
1.0
1.1
1.2
AUC
Cmax
Plot 1 Regr
SOLUTION
T85%
~30min
invitro
0.1 0.2 0.3 0.4 0.5
0.0
0.5
1.0
1.5
2.0
0.0
0.5
1.0
1.5
2.0
0.75
0.80
0.85
0.90
0.95
0.70
0.75
0.80 0.85
0.90
0.95
Mean Intestinal Transit Time = 3.33 h
Mean Intestinal Transit Time = 1.67 h
85%
D
I
S
S
O
L
U
T
I
O
N
T
I
M
E
(h)
Gastric Emptying Half-Time (h)
Kaus LC, Gillespie WR, Hussain AS, Amidon GL. The effect of in
vivo dissolution, gastric emptying rate and intestinal transit time
on the peak concentrationand area-under-the-curve of drugs with
different gastrointestinal permeabilities. Pharm. Res. ,16, 272
(1999)
BCSClassMembership:RiskManagement
7/11/2013 Ajaz | Insight 34
Volume (ml) of water required to dissolve the highestdose
strength at the lowest solubility on the pH 1-7.5 range
JejunalPermeability
Peff(x10-4)cm/sec
1 10 100 1000 10000 100000
0.01
0.1
1
10
I
III
II
IV
Rapid Dissolution (in vivo & in vitro)
Likely Unlikely
Dissolution likely
to be “rate determining.”
Complex in vivo disso. and
solubilization process.
Dissolution in vivo
not likely to be rate
limiting - well
characterized excipients
Some hesitation with
the use of current
dissolution test
and concerns
with respect to
excipients.
Generally “problem” drugs
in vitro dissolution may
not be reliable
Re-capandNextSteps
Application
of BCS
beyond the
2000
Guidance?
54321
7/11/2013 Ajaz | Insight 35
A successful application of BCS principles to a
specific “locally acting” drugs (low to no
permeability). FDA willing to make ‘case-by-case’
decision. Broad policy recommendation yet to be
formulated.
(5) How should
you ‘connect the
dots’: CMC –
BA/BE? (QbD)
(2) What
questions should
you ask?
(4) How precise
should your
answers be?
(3) What
assumptions
should you
accept?
(1). Class
boundaries, rapid
dissolution
AssumptionsAcceptableto theSociety?
Therapeutic
Equivalence =
• Pharmaceutical
equivalence +
Bioequivalence
BE Self-evident
for solutions
• For solutions a
review of
historical use
of excipients
How precise is
this approach in
ensuring
therapeutic
equivalence?
Under the
umbrella of this
assumption, does
the FDA review
process focuses
on the ‘right
questions’?
7/11/2013 Ajaz | Insight 36
Question:Whya tabletcanexhibithigherbioavailability
thana solution?
7/11/2013 Ajaz | Insight 37
www.fda.gov/ohrms/dockets/ac/05/.../2005-4137S2_02_Hussain.ppt
Note: Atenolol is a
low permeability
drug
ExperimentalFormulation
Reference TEST formulation
Sucrose*
(high permeability)
5 g 0 g
Sorbitol
(low permeability)
0 g 5 g
Water 15 ml 15 ml
Drug 1 Ranitidine (low permeability)
Drug 2 Metoprolol (highpermeability)
7/11/2013 Ajaz | Insight 38
A Modern View of Excipient Effects on Bioequivalence: Case Study of Sorbitol
M.-L. Chen, A. B. Straughn, N. Sadrieh, M. Meyer, P. J. Faustino,A. B. Ciavarella,B. Meibohm, C. R. Yates and A. S. Hussain
Pharmaceutical Research, Volume 24, Number 1 (2007),73-80, DOI: 10.1007/s11095-006-9120-4
* Rapidly metabolized at/in the intestinal wall to glucose and fructose, both exhibit complete
absorption
Lowpermeabilityexcipientcanreducebioavailabilityofa low
permeabilitydrug!
7/11/2013 Ajaz | Insight 39
Ranitidine: 150 mg
Sucrose: 5 g
Sorbitol: 5 g
A Modern View of Excipient Effects on Bioequivalence: Case Study of Sorbitol
M.-L. Chen, A. B. Straughn, N. Sadrieh, M. Meyer, P. J. Faustino,A. B. Ciavarella, B. Meibohm, C. R. Yates and A. S. Hussain
Pharmaceutical Research,Volume 24, Number 1 (2007),73-80, DOI: 10.1007/s11095-006-9120-4
Question:Howdo we selectandevaluatethe impactofexcipients
onBA/BE?
• Has it been used previously?
• Many other issues
• http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProc
ess/HowDrugsareDevelopedandApproved/ApprovalApplications/A
bbreviatedNewDrugApplicationANDAGenerics/UCM291010.pdf
FDA’s Inactive
Ingredient Guide
• A case example of micro-emulsion
A logical extension –
What gaps exist in the
current definition of
‘Pharmaceutical
Equivalence”?
7/11/2013 Ajaz | Insight 40
Prescriptionfor trouble*
How flaw in FDA safety net may pose
risk to public with generic drugs
• Tom Abate, Todd Wallack, Chronicle Staff Writers
• San Francisco Chronicle. Sunday, December 22,
2002
The issues
• “[Company X] had tested its generic with chocolate
milk. [Ref.product] was chased with apple juice.”
• “Did that matter?”
7/11/2013 Ajaz | Insight 41
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2002/12/22/MN35888.DTL&ao=all
Howpreciseshouldouranswerbe?
In parallelto development of BCS
guidance the FDA had proposed
replacing the “average bioequivalence”
criterionwith population and
individual bioequivalencecriteria
• To consider variances in additionto
the difference of averages.
• One of these variancesin the
individual bioequivalencecriterion
measuressubject-by-formulation
interaction, the extent to which the
test-reference differencevaries from
person to person.
7/11/2013 Ajaz | Insight 42
http://www.fda.gov/ohrms/dockets/ac/00/slides/3657s2_07.pdf
Ranitidine AUC in individuals as a function of
sucrose or sorbitol
PolicyRecommendation:Waiverofin vivoBE studiesbasedonBCS
(8/30/2000)
7/11/2013 Ajaz | Insight 43
Recommended for a solid oral Test product that exhibit
rapid (85% in 30 min) and similar in vitro dissolution
under specified conditions to an approved Reference
product when the following conditions are satisfied:
Products are
pharmaceutical
equivalent
Drug substanceis
highly soluble and
highly permeable
and is not considered
have a narrow
therapeuticrange
Excipientsused are
not likely to effect
drug absorption
BCSa toolforriskmanagement(2000)
7/11/2013 Ajaz | Insight 44
• What is the risk of bio-in-equivalence between two
pharmaceutical equivalent products when in vitro dissolution
test comparisons are used for regulatory decisions?
• Likelihood of occurrence and the severity of the
consequences?
Assessment of
risk
• whetheror not the risks are such that the
project can be persued with or without
additional arrangementsto mitigatethe risk
Regulatory
Decision
• is the decision acceptableto society?
Acceptability
of the Decision
Relianceoncurrentdissolutionpracticecanposesan
unacceptablelevelofrisk(2000)
Compared to high
solubility drugs Risk is higher for low solubility drugs
Products with slow or
extended dissolution
profiles pose a higher
risk (dissolution rate
limiting)
Need for a rapid dissolution criteria
Potential for
differences between
in vivo and in vitro
“sink” conditions and
impact of excipients
Higher for low permeability drugs
7/11/2013 Ajaz | Insight 45
Re-cap(2000)&Update(Currentstate)
At the time the BCS guidance
was being developed
Focus on the “right question”
during FDA review needed
improvement
Understanding of excipient*drug
interactions was evolving
Improved criteria for
pharmaceutical equivalence
assessment was needed
Debate on “average
bioequivalence”, population and
individual bioequivalence criteria
Following issuance of the
BCS guidance
FDA maintained “avg. BE” &
launched the PAT/QbD program
FDA-OGD adopted a “Question
based Review” process to focus on
the “right questions”
OGD is now actively seeking to link
QbD to Pharmaceutical Equivalence
Assessment
“Pharmaceutical equivalence by
design for generic drugs: modified-
release product” Pharm Res. 2011
Jul;28(7):1445-53
7/11/2013 Ajaz | Insight 46
Re-capandNextSteps
Application
of BCS
beyond the
2000
Guidance?
54321
7/11/2013 Ajaz | Insight 47
A successful application of BCS principles to a
specific “locally acting” drugs (low to no
permeability). FDA willing to make ‘case-by-case’
decision. Broad policy recommendation yet to be
formulated.
(5) How should
you ‘connect the
dots’: CMC –
BA/BE? (QbD)
(2) What
questions should
you ask?
(4) How precise
should your
answers be?
(3) What
assumptions
should you
accept?
(1). Class
boundaries, rapid
dissolution
DrugRelease&QualitybyDesign
• Christopher Sinko, Ph.D., at the Advisory Committee for Pharmaceutical Science meeting,
on October 25, 2005
• www.fda.gov/ohrms/dockets/ac/05/.../2005-4187S1_05_Sinko.ppt
• Clinical relevanceof releaseand stability specifications
• Correlationbetweenprocess parametersand ability to achieve specifications(and thereforeremain
clinically relevant
• Once a formulation scientist understands the patient’s requirements, they can
design a formulation using either or both approaches:
• Prior knowledge: choose API form, excipients and processes that will achieve the expected
release profile
• QBD: select API form, excipients and processes that have greatest impact on quality attributes
that affect release of drug
• Selectionsbased on theoretical/fundamentalunderstanding,alternativemeasurementsand heuristic
development
7/11/2013 Ajaz | Insight 48
Drug
Release
Rate
Disintegration,
Erosion and
Granule
Dissolution
API Solubilization
(rate/extent)Porosity
API Form Selection
(Salt, Polymorph, Particle Size)
Hardness Wetting
Swelling/
Water
Penetration
DP Excipient Selection, DP Process Selection
API Form Selection, API Process Selection
Quality Attributes
Of Drug Product
Features of “Quality by Design”: doing thingsconsciously*
*A Quality by Design Approachto Dissolution Based on the
Biopharmaceutical Classification System, R. Reed
www.fda.gov/ohrms/dockets/a
c/05/.../2005-
4187S1_05_Sinko.ppt
7/11/2013 Ajaz | Insight 49
DesignSpace:API Particle Size
7/11/2013 Ajaz | Insight 50
Granulation Time
Temperature
Agitation Rate
Seeding
Cool down rate
Solvent quality
Filter heel
Blow down time
Cake thickness
Slurry thickness
Filter cloth/mesh
Cake smoothing procedure
Wash temperature
Wash solvent quality
Hold time
Transfer procedures
Agitation rate
Inlet temperature
Nitrogen blanketing
Drying time
Agitation blade
Particle shape
Drying vacuum
Heel
Transfer procedures
Set up procedures
Feed rate
Screen size
Mill speed
Particle size
Agglomeration
Operator training
Size measurement
Particle shape
Shape measurement
Mill temperature
Crystallization/
Filtration Wash/Drying Milling
Represents a known interaction
www.fda.gov/ohrms/do
ckets/ac/05/.../2005-
4187S1_05_Sinko.ppt
Chemometrics,PharmacometricsandEconometrics:Three
DimensionsofQbD
Pre-formulation
Pre-Phase I
Phase I
Phase II
Phase III
Commercial
product
Continual
Improvement
7/11/2013 Ajaz | Insight 51
Initial QTTP
Final QTTP,
End of Phase II Meeting
Chemometrics
Pharmacometrics
Econometrics
Opportunities;onlywhenthedisciplinarydividesarebridged
• Estimate of variance in PK/PD &
outcomes (e.g., intra- and inter-
individual variability)
Pharmacometrics
• Estimate of variance in critical to quality
attributes (in the context of PK/PD
variability)
Chemometrics
• Estimate of variance in cGMP compliance
(in the context of acceptable variance in
critical to quality attributes)
Econometrics
7/11/2013 Ajaz | Insight 52
A visionbecoming reality….
“I can see clearly now”
Vision 2020
• Perspectives on Regulation:
Law, Discretion, and
Bureaucratic Behavior
(Kagan and Scholz, May
1980)
• ‘Good citizens’Vs. {‘political
citizens,‘incompetent’,
and/or ‘amoral’}
• For FDA to be science and
risk-based it needs scientific
data & information,
capability, ..
“Scientific explanation yields
understanding”
7/11/2013
Ajaz | Insight 53
http://www.fda.gov/ohrms/dockets/ac/04/briefing/2004-4052B1_09_Hussain-Arden-UK-Presentation.ppt
Learningobjectives
(1). Considerations
for developing the
FDA guidance
“Waiver of In Vivo
Bioavailability and
Bioequivalence
Studies for
Immediate-Release
Solid Oral Dosage
Forms Based on a
Biopharmaceutics
ClassificationSystem”
(August 2000)
Broadly, gain an
understandingof
considerationsin
translating
scientific
knowledgeinto
regulatorypolicy
(2) What questions
should you ask?
(3) What
assumptions
should you accept?
(4) How precise
should your
answers be?
Develop a basis to
critically evaluate
considerations
utilized for
developmentof
the FDA guidance
document
(5) How should you
‘connect the dots’:
CMC – BA/BE?
Can you justify new
applications of BCS
(i.e., beyond the
2000 guidance)?
Identify and
explain how
future regulatory
applicationsof
BCS may be
realized in the
context of ‘Quality
by Design’
7/11/2013 Ajaz | Insight 54
PresentationSummary
Application
of BCS
beyond the
2000
Guidance?
54321
7/11/2013 Ajaz | Insight 55
VIROPHARMA INCORPORATED, Plaintiff,
Vs.
MARGARET A. HAMBURG, M.D., et al., Defendants.
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA
Civil Action No. 12-cv-00584-ESH
Filed 04/17/12
(5) How should
you ‘connect the
dots’: CMC –
BA/BE? (QbD)
(2) What
questions should
you ask?
(4) How precise
should your
answers be?
(3) What
assumptions
should you
accept?
(1). Considerations
for developing the
FDA guidance

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Biopharmaceutics Classification System (BCS) & Waiver of Bioequivalence

  • 1. BIOPHARMACEUTICSCLASSIFICATION SYSTEM: A BASIS FOR REGULATORYWAIVER OF IN VIVO BA/BE STUDIES Ajaz | Insight 7/11/2013 1Ajaz | Insight Graduate lecture at University of Maryland: on 17 August 2012 Update: 11 July 2013 http://www.ajazhussain.com
  • 2. Update ViroPharma Suit Against FDA Over Generic Vancocin Tossed [Bloomberg. By Andrew Zajac & Tom Schoenberg - Jan 9, 2013] The company failed to produce new evidence following rejection in April of its request for a court order to block FDA approval of three generic versions of Vancocin • U.S. District Judge Ellen Segal Huvelle in Washington said today in her ruling. • The case is ViroPharma Inc. v. Hamburg, 12-cv-00584, U.S. District Court, District of Columbia(Washington) 7/11/2013 Ajaz | Insight 2
  • 4. WhatisBCS? A paradigm shift • 𝑀 𝑡 = 0 𝑡 𝑃𝐶( 𝑑𝐴 𝑑𝑡 ) • 𝐾 𝑎 = ( 𝑆 𝑉 )𝑃𝑒𝑓𝑓 • 𝐴𝑏𝑠𝑜𝑟𝑝𝑡𝑖𝑜𝑛 𝑛𝑢𝑚𝑏𝑒𝑟 𝐴 𝑛 = 𝑃𝑒𝑓𝑓 𝑅 .< 𝑇𝑠𝑖 > • 𝐷𝑖𝑠𝑠𝑜𝑙𝑢𝑡𝑖𝑜𝑛 𝑛𝑢𝑚𝑏𝑒𝑟𝐷 𝑛 = 3𝐷 𝑟2 𝐶 𝑠  . < 𝑇𝑠𝑖> • If the Peff of a drug is less than2•10–4 cm/s, then drug absorption will be incomplete • Class I—high solubility, high permeability: generallyvery well-absorbedcompounds • Class II—low solubility, high permeability:exhibit dissolution rate-limitedabsorption • Class III—high solubility, low permeability:exhibit permeabilityrate-limitedabsorption • Class IV—low solubility, low permeability:very poor oral bioavailability 7/11/2013 4 http://www.fda.gov/ohr ms/dockets/ac/04/slides /2004- 4078S2_10_Amidon_files/ frame.htm Journal of Clinical Pharmacology, 2002;42:620-643 Ajaz | Insight
  • 5. RegulatoryApplications? • Types of dissolution test comparisons for manufacturing and formulation changes Initial applicationin SUPAC-IR (1995) • Methods to classify per BCS and criteria for biowaiver Waiver of In vivo BA/BE …BCS Guidance (2000) • Several workshops and reportsEfforts to extend biowaivers (beyond 2000) • Debate and court case A relativelyrecent applicationto a ‘locally acting’ drug • BCS a foundational element of QbDOpportunities for Quality by Design 7/11/2013 5Ajaz | Insight
  • 6. Learningobjectives (1). Considerations for developing the FDA guidance “Waiver of In Vivo Bioavailability and Bioequivalence Studies for Immediate-Release Solid Oral Dosage Forms Based on a Biopharmaceutics ClassificationSystem” (August 2000) Broadly, gain an understandingof considerationsfor translating scientific knowledgeinto regulatorypolicy (2) What questions should you ask? (3) What assumptions should you accept? (4) How precise should your answers be? Develop a basis to critically evaluate considerations utilized for developmentof the FDA guidance document (5) How should you ‘connect the dots’: CMC – BA/BE? Can you justify new applications of BCS (i.e., beyond the 2000 guidance)? Identify and explain how future regulatory applicationsof BCS may be realized in the context of ‘Quality by Design’ 7/11/2013 Ajaz | Insight 6
  • 7. Presentationoutline Application of BCS beyond the 2000 Guidance? 54321 7/11/2013 Ajaz | Insight 7 VIROPHARMA INCORPORATED, Plaintiff, Vs. MARGARET A. HAMBURG, M.D., et al., Defendants. IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA Civil Action No. 12-cv-00584-ESH Filed 04/17/12
  • 8. VIROPHARMAINC., PLAINTIFF, VS. (FDA) MARGARETA. HAMBURG,M.D., ET AL., DEFENDANTS. IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA Civil Action No. 12-cv-00584-ESH Filed 04/17/12 7/11/2013 Ajaz | Insight 8
  • 9. 13April2012PlaintiffssuedFDA Issue • Agency’s 9 April 9 2012 approval of three ANDAs of the company’s Vancocin® (vancomycin hydrochloride). They alleged that: • FDA impermissiblyinterpretedthe Food, Drug, and CosmeticAct when it denied the company three-year exclusivity for its NDA supplement (“sNDA”) (“exclusivityclaim”);and • FDA violated its own regulations—andchanged established policy withoutthe procedure requiredby law—whenit chose to accept in vitro bioequivalence data for oral vancomycin (“bioequivalenceclaim”). 7/11/2013 Ajaz | Insight 9 http://www.fdalawblog.net/fda_law_blog_hyman_phelps/2012/04/court-denies-viropharmas-motion-for-tropi-in- vancomycin-caseleaves-generics-on-the-market.html
  • 10. 23 April2012Memorandumof Opinion 7/11/2013 Ajaz | Insight 10 http://en.wiki pedia.org/wiki /Ellen_Segal_H uvelle#Early_li fe_and_career Memorandum Opinion issued on April 23, 2012 The Judge
  • 11. TITLE 21--FOOD AND DRUGS CHAPTER I--FOODAND DRUGADMINISTRATION SUBCHAPTER D--DRUGS FORHUMAN USE • PART 320 BIOAVAILABILITY AND BIOEQUIVALENCE REQUIREMENTS • Subpart A--General Provisions § 320.1 - Definitions. • Subpart B--Procedures for Determining the Bioavailability or Bioequivalence of Drug Products § 320.21 - Requirements for submission of bioavailability and bioequivalence data. § 320.22 - Criteria for waiver of evidence of in vivo bioavailability or bioequivalence. § 320.23 - Basis for measuring in vivobioavailability or demonstrating bioequivalence. § 320.24 - Types of evidence to measure bioavailability or establish bioequivalence. § 320.25 - Guidelines for the conduct of an in vivobioavailability study. § 320.26 - Guidelines on the design of a single-dose in vivobioavailability or bioequivalence study. § 320.27 - Guidelines on the design of a multiple-dose in vivo bioavailability study. § 320.28 - Correlation of bioavailability with an acute pharmacological effect or clinical evidence. § 320.29 - Analytical methods for an in vivobioavailability or bioequivalence study. § 320.30 - Inquiries regarding bioavailability and bioequivalence requirements and review of protocols by the Food and Drug Administration. § 320.31 - Applicability of requirements regarding an "Investigational New Drug Application." § 320.32 - Procedures for establishing or amending a bioequivalence requirement. § 320.33 - Criteria and evidence to assess actual or potential bioequivalence problems. § 320.34 - Requirements for batch testing and certification by the Food and Drug Administration. § 320.35 - Requirements for in vitro testing of each batch. § 320.36 - Requirements for maintenance of records of bioequivalence testing. § 320.38 - Retention of bioavailability samples. § 320.63 - Retention of bioequivalence samples 7/11/2013 Ajaz | Insight 11 http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=320.22
  • 12. DraftGuidance onVancomycin Hydrochloride(2008) • Vancomycin acts locally in the lower GI tract • The dosage form is expected to be in contact with a relatively large fluid volume, vancomycin is expected to be in solution long (e.g., hours) before it reaches the site of action in the lower GI tract. VancomycinHCl Capsules are administeredorally for treatmentof enterocolitis • Equivalent release of vancomycin, • The high solubility of vancomycin drug substance, • The effect of inactive ingredients on the transport of vancomycin drug through the GI tract and/or the effectiveness of drug at the site of action The BE of two capsule formulationsof oral vancomycin HCl is determinedby? • Formulations are Q1 and Q2 the same as the RLD • Dissolution: Basket, 100 rpm, 0.1N HCl (or 0.1N HCl with NaCl at pH 1.2), pH 4.5 Acetate buffer, and pH 6.8 Phosphate buffer; 900 mL; 37ºC • An f2 test of similarity In Vitro BE 7/11/2013 Ajaz | Insight 12 http://www.fda.gov/OHRMS/DOCKETS/98fr/FDA-2008-D-0626-gdl.pdf
  • 13. Plaintiffs’ArgumentPriorto theCourtCase 30 June 2009, Plaintiffs’ briefing document FDA Advisory Committee for Pharmaceutical Science and Clinical Pharmacology “Is essentially the Biopharmaceutics Classification System (BCS)-based biowaiver, which was developed using healthy GI parameters to predict the absorption of systemically acting drugs from the healthy gut and was not intended for use in predicting the in vivo performance of locally acting GI drugs” Healthy GI physiological parameters may not be an appropriate in vitro model for assessing BE with locally acting GI drugs used to treat serious GI disease Oral Vancomycin is Systemically Absorbed in Some Patients and has Been Linked with Systemic Toxicity. Does a Biowaiver Ensure Safety or Should In VivoTesting be Considered for this Drug? Extension of a Biowaiver to a New Class of Drug Should be Evidence-Based and Data- Driven. Evaluation of Inactive Ingredients http://www.fda.gov/downloads/AdvisoryCom mittees/CommitteesMeetingMaterials/Drugs/ AdvisoryCommitteeforPharmaceuticalSciencea ndClinicalPharmacology/UCM173159.pdf 7/11/2013 Ajaz | Insight 13 www.fda.gov/downloads/AdvisoryCommittees/.../UCM179424.pdf (FDA ACPS Transcripts)
  • 14. Plaintiffs, In-Part,BasedtheirArgumentsona PreviousACPS Discussion(October20,2004) Bioequivalence Testing for Locally Acting Gastrointestinal ACPS presentations: Prof. Amidon http://www.fda.gov/ohrms/docke ts/ac/04/slides/2004- 4078S2_10_Amidon_files/frame.ht m and OGD (Lionberger) http://www.fda.gov/ohrms/docke ts/ac/04/slides/2004- 4078S2_11_Lionberger_files/frame .htm As the Deputy Director of FDA’s Office of Pharmaceutical Science Dr. Ajaz Hussain summarized in his concluding remarks, “I don’t want to sort of jump in and say all right” and simply apply the BCS approach to locally acting GI drugs, in part because issues relating to “volume” and “hydrodynamics” merited close attention. Consequently, he said, “we have to give some thought to how we would approach that, so it is not a trivial matter.” (http://www.fda.gov/downloads/AdvisoryCommittees /CommitteesMeetingMaterials/Drugs/AdvisoryCommit teeforPharmaceuticalScienceandClinicalPharmacology/ UCM173159.pdf) My comments (cited) related to broad policy decision; not relevant to specific case example as in this case. FDA ‘point-to-point’ response to the Citizen Petition addressed the questions posed http://www.regulations.gov/#!documentDetail;D=FDA-2006-P- 0007-0051 Congressional Record - Senate (S5649- 5650), May 7, 2007 - [D. Robertson - Comment] http://www.regulations.gov/#!documentDetail;D=FDA-2006-P-0007- 0014 7/11/2013 Ajaz | Insight 14 http://www.fda.gov/ohrms/dockets/ac/04/transcripts/2004-4078T2.pdf (ACPS 2004 transcripts) http://www.regulations.gov/#!documentDetail;D=FDA-2006-P-0007-0051 (FDA CP response)
  • 15. Re-capandNextSteps Application of BCS beyond the 2000 Guidance? 54321 7/11/2013 Ajaz | Insight 15 A successful application of BCS principles to a particular “locally acting” drugs (low to no permeability). FDA willing to make ‘case-by-case’ decision. Broad policy recommendation yet to be formulated. (5) How should you ‘connect the dots’: CMC – BA/BE? (QbD) (2) What questions should you ask? (4) How precise should your answers be? (3) What assumptions should you accept? (1). Considerations for developing the FDA guidance
  • 16. CONSIDERATIONSFOR DEVELOPING THE FDA GUIDANCE:QUESTIONS, ASSUMPTIONS, AND NEEDED PRECISION Reflecting back to 1995-2000 Note: A number of data slides to follow have been taken from a previous presentation available at: www.fda.gov/ohrms/dockets/ac/05/.../2005-4137S2_02_Hussain.ppt 7/11/2013 Ajaz | Insight 16
  • 17. NeedtoReduceOurRelianceon In VivoBEStudies:Why? 7/11/2013 Ajaz | Insight 17 • 21 CFR 320.25(a)“… no unnecessary human researchshould be done.”Ethical reasons • “building quality into products” • “right first time” Focus on prevention • Sciencecontinuesto provide new methodsto identifyand eliminateunnecessary in vivo BE studies; reduce time and cost of drug developmentand review Efficiency
  • 18. TherapeuticEquivalence 7/11/2013 Ajaz | Insight 18 Reference Test PharmaceuticalEquivalent Products Possible Differences Drug particlesize, .. Excipients Manufacturingprocess Equipment Site of manufacture Batch size …. Documented Bioequivalence = Therapeutic Equivalence (Note: Generally, same dissolution spec.) Normalhealthy subjects Crossover design Overnight fast Glass of water 90% CI within 80-125% of Ref. (Cmax& AUC)
  • 19. RegulatoryBioequivalence:A Summary 7/11/2013 Ajaz | Insight 19 In Vivo BE Pre-1962 DESI Drugs: In Vivo evaluation for “bio-problem” drugs (TI, PK, P-Chem) Post-1962 Drugs: Generally In Vivo - some exceptions (IVIVC..) SUPAC-IR (1995) Dissolution-IR BCS (pre-/post approval “Self-evident” - Biowaivers granted Condition- excipients do not alter absorption (historical data) Solutions Suspensions Chewable, etc. Conventional Tablets Capsules MR Products SUPAC – MR; IVIVC Quality by Design & Design Space IVIVC = In vitro to in vivo correlation
  • 20. DissolutionTestMethods 7/11/2013 Ajaz | Insight 20 > 900 ml, 37oC > Water, 0.1 N HCl, pH 6.8 buffer,or… > 50 rpm (paddle),100 rpm (basket),… > Vessel geometry > Location of dosage unit
  • 21. Dissolutiontests:Debates Dissolution tests are “over discriminating” Products that dissolve about 70% in 45 minutes have no medically relevant bioequivalence problems Dissolution tests are not sufficientto assure bioequivalence Demonstrationof IVIVC is necessary IVIVC’s are “Product Specific” 7/11/2013 Ajaz | Insight 21
  • 22. Failureto DiscriminateBetweenBio-in-equivalentProducts: InappropriateAcceptanceCriteria 7/11/2013 Ajaz | Insight 22 0 10 20 30 40 50 %DrugDissolved 0 10 20 30 40 50 60 70 80 90 100 110 USP Specification Product A Product B Time in Minutes Product B was not bioequivalent to Product A Log(AUCinf): CI 94.6 - 123.6 Log(AUC): CI 89.1 - 130.0 Cmax: CI 105.3 - 164.2
  • 23. (weak acid, rapid dissolution inSIF) Time in Hours 0 1 2 3 4 5 6 DrugConcentrationinPlasma(ng/ml) 0 200 400 600 800 1000 1200 1400 1600 1800 Capsule (Ref.) Tablet 1 (wet-granulation - starch) Tablet 2 (direct compression - calcium phosphate) USP Paddle 50rpm, Q 70% in 30 min Failureto DiscriminateBetweenBio-in-equivalentProducts: InappropriateTestMethod? 7/11/2013 Ajaz | Insight 23
  • 24. DissolutionTestProblems:False+ivesand -ives 7/11/2013 Ajaz | Insight 24 15 min 30 min 45 min AUC Cmax Ref 95 96 98 100 100 B 96 97 97 104 95 C 62 84 92 84 55 D 82 94 95 88 87 E 103 103 103 112 120 F 13 35 53 100 102 Test/Ref.Mean I. J. MacGilvery. Bioequivalence: A Canadian Regulatory Perspective. In, Pharmaceutical Bioequivalence . Eds. Welling, Tse, and Dighe. Marcel Dekker, Inc., New York, (1992)). 24
  • 25. “FormulationSpecific”IVIVC 7/11/2013 Ajaz | Insight 25 Peak Concentration Vs. % Dissolved in vitro Clarke et al. J. Pharm. Sci. 66: 1429, 1977 % Dissolved in 40 minutes 20 40 60 80 100 PeakConcentration(ug/100ml) 12 14 16 18 20 22 24 26 28 30 A B H I D F J C G E
  • 26. DissolutionTest&Bioequivalence:RiskAssessment 7/11/2013 Ajaz | Insight 26 Dissolution generally “over- discriminating” Dissolution fails to signal bio-in-equi ~ 30% (?) NO YES NOYES Bioequivalent Dissolution Specification Why?
  • 27. TypicalPhysiologicParameters: SingleDoseFasting BE Study 7/11/2013 Ajaz | Insight 27 Volume = Gastric fluid + 8 oz water (~300 ml) pH of gastric fluid = 1-3 Res. time (fasting)= variable; T50%=15 min. Permeability - Low , compared to Small Intestine. Surface tension lower than water, …. Volume (fasting)= what gets emptied + SI vol.(500 ml?) pH = 3-8, surface tension low,... Res. time (fasting): 2-4 hours Permeability - high compared to other parts Hydrodynamics?
  • 28. Whenyouchangethe wayyoulookata thing…. The paradigm shifts • 𝑀 𝑡 = 0 𝑡 𝑃𝐶( 𝑑𝐴 𝑑𝑡 ) • 𝐾 𝑎 = ( 𝑆 𝑉 )𝑃𝑒𝑓𝑓 • 𝐴𝑏𝑠𝑜𝑟𝑝𝑡𝑖𝑜𝑛 𝑛𝑢𝑚𝑏𝑒𝑟 𝐴 𝑛 = 𝑃𝑒𝑓𝑓 𝑅 .< 𝑇𝑠𝑖 > • 𝐷𝑖𝑠𝑠𝑜𝑙𝑢𝑡𝑖𝑜𝑛 𝑛𝑢𝑚𝑏𝑒𝑟𝐷 𝑛 = 3𝐷 𝑟2 𝐶 𝑠  . < 𝑇𝑠𝑖> • If the Peff of a drug is less than2•10–4 cm/s, then drug absorption will be incomplete • Class I—high solubility, high permeability: generallyvery well-absorbedcompounds • Class II—low solubility, high permeability:exhibit dissolution rate-limitedabsorption • Class III—high solubility, low permeability:exhibit permeabilityrate-limitedabsorption • Class IV—low solubility, low permeability:very poor oral bioavailability 7/11/2013 Ajaz | Insight 28 http://www.fda.gov/ohr ms/dockets/ac/04/slides /2004- 4078S2_10_Amidon_files/ frame.htm Journal of Clinical Pharmacology, 2002;42:620-643
  • 29. SUPAC-IR/BCS:Forsome‘Level2’ Changes 7/11/2013 Ajaz | Insight 29 HS/HP LS/HP HS/LP LS/LP Critical Process Gastric Emptying Dissolution Permeability D/P IVIVC Not likely Likely Not likely (?) Method 0.1 N HCl pH 1 - 7.4 App/Comp In Vivo BE Acceptance Criteria Single point 85% in 15 min Multiple profiles (f2 > or = 50) Single profile (f2 > or = 50) AUC & Cmax 90% CI 80-125% Note: NTI drugs excluded for some Level 2 Changes
  • 30. CriteriaforBiowaiver,NewApplications? Solutions BA/BE “Self- evident” BCS: Expectation of IVIVC IVIVC 7/11/2013 Ajaz | Insight 30 Biowaiver? “Rapid Dissolution” “High Solubility” & “High Permeability” If two drug products, containing the same drug, have the same concentration time profile at the intestinal membrane surface then they will have the same rate and extent of availability at the site of action.
  • 31. BCS:ClassMembership 7/11/2013 Ajaz | Insight 31 • the highestdose strength is soluble in <250 mL aqueous buffersover 1- 7.4 pH range of at 37oC.High Solubility • extentof absorptionin humansis determinedto be  90% High Permeability •  85% dissolves within 30 minutesin 0.1 HCl (or SGF), pH 4.5, and pH 6.8 buffers(or SIF) using ApparatusI at 100 rpm or ApparatusII at 50 rpm. Rapid Dissolution
  • 32. MetoprololIRTablets:In Vitro- InVivoRelationship 7/11/2013 Ajaz | Insight 32 TIME IN MINUTES 0 5 10 15 20 25 30 35 %DRUGRELEASED 0 10 20 30 40 50 60 70 80 90 100 110 Rapid Slow FDA-UMAB (931011) RATIO (T/R) OF % DISSOLVED AT 10 MINUTES 0.2 0.4 0.6 0.8 1.0 1.2 AUC,ANDCmaxRATIOS(T/R) 0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2 SOLUTION FDA-UMAB (931011) AUC Cmax
  • 33. MetoprololIRTablets:Experimental&SimulationData 7/11/2013 Ajaz | Insight 33 RATIO (T/R) OF % DISSOLVED AT 10 MINUTES 0.2 0.4 0.6 0.8 1.0 1.2 0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2 AUC Cmax Plot 1 Regr SOLUTION T85% ~30min invitro 0.1 0.2 0.3 0.4 0.5 0.0 0.5 1.0 1.5 2.0 0.0 0.5 1.0 1.5 2.0 0.75 0.80 0.85 0.90 0.95 0.70 0.75 0.80 0.85 0.90 0.95 Mean Intestinal Transit Time = 3.33 h Mean Intestinal Transit Time = 1.67 h 85% D I S S O L U T I O N T I M E (h) Gastric Emptying Half-Time (h) Kaus LC, Gillespie WR, Hussain AS, Amidon GL. The effect of in vivo dissolution, gastric emptying rate and intestinal transit time on the peak concentrationand area-under-the-curve of drugs with different gastrointestinal permeabilities. Pharm. Res. ,16, 272 (1999)
  • 34. BCSClassMembership:RiskManagement 7/11/2013 Ajaz | Insight 34 Volume (ml) of water required to dissolve the highestdose strength at the lowest solubility on the pH 1-7.5 range JejunalPermeability Peff(x10-4)cm/sec 1 10 100 1000 10000 100000 0.01 0.1 1 10 I III II IV Rapid Dissolution (in vivo & in vitro) Likely Unlikely Dissolution likely to be “rate determining.” Complex in vivo disso. and solubilization process. Dissolution in vivo not likely to be rate limiting - well characterized excipients Some hesitation with the use of current dissolution test and concerns with respect to excipients. Generally “problem” drugs in vitro dissolution may not be reliable
  • 35. Re-capandNextSteps Application of BCS beyond the 2000 Guidance? 54321 7/11/2013 Ajaz | Insight 35 A successful application of BCS principles to a specific “locally acting” drugs (low to no permeability). FDA willing to make ‘case-by-case’ decision. Broad policy recommendation yet to be formulated. (5) How should you ‘connect the dots’: CMC – BA/BE? (QbD) (2) What questions should you ask? (4) How precise should your answers be? (3) What assumptions should you accept? (1). Class boundaries, rapid dissolution
  • 36. AssumptionsAcceptableto theSociety? Therapeutic Equivalence = • Pharmaceutical equivalence + Bioequivalence BE Self-evident for solutions • For solutions a review of historical use of excipients How precise is this approach in ensuring therapeutic equivalence? Under the umbrella of this assumption, does the FDA review process focuses on the ‘right questions’? 7/11/2013 Ajaz | Insight 36
  • 37. Question:Whya tabletcanexhibithigherbioavailability thana solution? 7/11/2013 Ajaz | Insight 37 www.fda.gov/ohrms/dockets/ac/05/.../2005-4137S2_02_Hussain.ppt Note: Atenolol is a low permeability drug
  • 38. ExperimentalFormulation Reference TEST formulation Sucrose* (high permeability) 5 g 0 g Sorbitol (low permeability) 0 g 5 g Water 15 ml 15 ml Drug 1 Ranitidine (low permeability) Drug 2 Metoprolol (highpermeability) 7/11/2013 Ajaz | Insight 38 A Modern View of Excipient Effects on Bioequivalence: Case Study of Sorbitol M.-L. Chen, A. B. Straughn, N. Sadrieh, M. Meyer, P. J. Faustino,A. B. Ciavarella,B. Meibohm, C. R. Yates and A. S. Hussain Pharmaceutical Research, Volume 24, Number 1 (2007),73-80, DOI: 10.1007/s11095-006-9120-4 * Rapidly metabolized at/in the intestinal wall to glucose and fructose, both exhibit complete absorption
  • 39. Lowpermeabilityexcipientcanreducebioavailabilityofa low permeabilitydrug! 7/11/2013 Ajaz | Insight 39 Ranitidine: 150 mg Sucrose: 5 g Sorbitol: 5 g A Modern View of Excipient Effects on Bioequivalence: Case Study of Sorbitol M.-L. Chen, A. B. Straughn, N. Sadrieh, M. Meyer, P. J. Faustino,A. B. Ciavarella, B. Meibohm, C. R. Yates and A. S. Hussain Pharmaceutical Research,Volume 24, Number 1 (2007),73-80, DOI: 10.1007/s11095-006-9120-4
  • 40. Question:Howdo we selectandevaluatethe impactofexcipients onBA/BE? • Has it been used previously? • Many other issues • http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProc ess/HowDrugsareDevelopedandApproved/ApprovalApplications/A bbreviatedNewDrugApplicationANDAGenerics/UCM291010.pdf FDA’s Inactive Ingredient Guide • A case example of micro-emulsion A logical extension – What gaps exist in the current definition of ‘Pharmaceutical Equivalence”? 7/11/2013 Ajaz | Insight 40
  • 41. Prescriptionfor trouble* How flaw in FDA safety net may pose risk to public with generic drugs • Tom Abate, Todd Wallack, Chronicle Staff Writers • San Francisco Chronicle. Sunday, December 22, 2002 The issues • “[Company X] had tested its generic with chocolate milk. [Ref.product] was chased with apple juice.” • “Did that matter?” 7/11/2013 Ajaz | Insight 41 http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2002/12/22/MN35888.DTL&ao=all
  • 42. Howpreciseshouldouranswerbe? In parallelto development of BCS guidance the FDA had proposed replacing the “average bioequivalence” criterionwith population and individual bioequivalencecriteria • To consider variances in additionto the difference of averages. • One of these variancesin the individual bioequivalencecriterion measuressubject-by-formulation interaction, the extent to which the test-reference differencevaries from person to person. 7/11/2013 Ajaz | Insight 42 http://www.fda.gov/ohrms/dockets/ac/00/slides/3657s2_07.pdf Ranitidine AUC in individuals as a function of sucrose or sorbitol
  • 43. PolicyRecommendation:Waiverofin vivoBE studiesbasedonBCS (8/30/2000) 7/11/2013 Ajaz | Insight 43 Recommended for a solid oral Test product that exhibit rapid (85% in 30 min) and similar in vitro dissolution under specified conditions to an approved Reference product when the following conditions are satisfied: Products are pharmaceutical equivalent Drug substanceis highly soluble and highly permeable and is not considered have a narrow therapeuticrange Excipientsused are not likely to effect drug absorption
  • 44. BCSa toolforriskmanagement(2000) 7/11/2013 Ajaz | Insight 44 • What is the risk of bio-in-equivalence between two pharmaceutical equivalent products when in vitro dissolution test comparisons are used for regulatory decisions? • Likelihood of occurrence and the severity of the consequences? Assessment of risk • whetheror not the risks are such that the project can be persued with or without additional arrangementsto mitigatethe risk Regulatory Decision • is the decision acceptableto society? Acceptability of the Decision
  • 45. Relianceoncurrentdissolutionpracticecanposesan unacceptablelevelofrisk(2000) Compared to high solubility drugs Risk is higher for low solubility drugs Products with slow or extended dissolution profiles pose a higher risk (dissolution rate limiting) Need for a rapid dissolution criteria Potential for differences between in vivo and in vitro “sink” conditions and impact of excipients Higher for low permeability drugs 7/11/2013 Ajaz | Insight 45
  • 46. Re-cap(2000)&Update(Currentstate) At the time the BCS guidance was being developed Focus on the “right question” during FDA review needed improvement Understanding of excipient*drug interactions was evolving Improved criteria for pharmaceutical equivalence assessment was needed Debate on “average bioequivalence”, population and individual bioequivalence criteria Following issuance of the BCS guidance FDA maintained “avg. BE” & launched the PAT/QbD program FDA-OGD adopted a “Question based Review” process to focus on the “right questions” OGD is now actively seeking to link QbD to Pharmaceutical Equivalence Assessment “Pharmaceutical equivalence by design for generic drugs: modified- release product” Pharm Res. 2011 Jul;28(7):1445-53 7/11/2013 Ajaz | Insight 46
  • 47. Re-capandNextSteps Application of BCS beyond the 2000 Guidance? 54321 7/11/2013 Ajaz | Insight 47 A successful application of BCS principles to a specific “locally acting” drugs (low to no permeability). FDA willing to make ‘case-by-case’ decision. Broad policy recommendation yet to be formulated. (5) How should you ‘connect the dots’: CMC – BA/BE? (QbD) (2) What questions should you ask? (4) How precise should your answers be? (3) What assumptions should you accept? (1). Class boundaries, rapid dissolution
  • 48. DrugRelease&QualitybyDesign • Christopher Sinko, Ph.D., at the Advisory Committee for Pharmaceutical Science meeting, on October 25, 2005 • www.fda.gov/ohrms/dockets/ac/05/.../2005-4187S1_05_Sinko.ppt • Clinical relevanceof releaseand stability specifications • Correlationbetweenprocess parametersand ability to achieve specifications(and thereforeremain clinically relevant • Once a formulation scientist understands the patient’s requirements, they can design a formulation using either or both approaches: • Prior knowledge: choose API form, excipients and processes that will achieve the expected release profile • QBD: select API form, excipients and processes that have greatest impact on quality attributes that affect release of drug • Selectionsbased on theoretical/fundamentalunderstanding,alternativemeasurementsand heuristic development 7/11/2013 Ajaz | Insight 48
  • 49. Drug Release Rate Disintegration, Erosion and Granule Dissolution API Solubilization (rate/extent)Porosity API Form Selection (Salt, Polymorph, Particle Size) Hardness Wetting Swelling/ Water Penetration DP Excipient Selection, DP Process Selection API Form Selection, API Process Selection Quality Attributes Of Drug Product Features of “Quality by Design”: doing thingsconsciously* *A Quality by Design Approachto Dissolution Based on the Biopharmaceutical Classification System, R. Reed www.fda.gov/ohrms/dockets/a c/05/.../2005- 4187S1_05_Sinko.ppt 7/11/2013 Ajaz | Insight 49
  • 50. DesignSpace:API Particle Size 7/11/2013 Ajaz | Insight 50 Granulation Time Temperature Agitation Rate Seeding Cool down rate Solvent quality Filter heel Blow down time Cake thickness Slurry thickness Filter cloth/mesh Cake smoothing procedure Wash temperature Wash solvent quality Hold time Transfer procedures Agitation rate Inlet temperature Nitrogen blanketing Drying time Agitation blade Particle shape Drying vacuum Heel Transfer procedures Set up procedures Feed rate Screen size Mill speed Particle size Agglomeration Operator training Size measurement Particle shape Shape measurement Mill temperature Crystallization/ Filtration Wash/Drying Milling Represents a known interaction www.fda.gov/ohrms/do ckets/ac/05/.../2005- 4187S1_05_Sinko.ppt
  • 51. Chemometrics,PharmacometricsandEconometrics:Three DimensionsofQbD Pre-formulation Pre-Phase I Phase I Phase II Phase III Commercial product Continual Improvement 7/11/2013 Ajaz | Insight 51 Initial QTTP Final QTTP, End of Phase II Meeting Chemometrics Pharmacometrics Econometrics
  • 52. Opportunities;onlywhenthedisciplinarydividesarebridged • Estimate of variance in PK/PD & outcomes (e.g., intra- and inter- individual variability) Pharmacometrics • Estimate of variance in critical to quality attributes (in the context of PK/PD variability) Chemometrics • Estimate of variance in cGMP compliance (in the context of acceptable variance in critical to quality attributes) Econometrics 7/11/2013 Ajaz | Insight 52
  • 53. A visionbecoming reality…. “I can see clearly now” Vision 2020 • Perspectives on Regulation: Law, Discretion, and Bureaucratic Behavior (Kagan and Scholz, May 1980) • ‘Good citizens’Vs. {‘political citizens,‘incompetent’, and/or ‘amoral’} • For FDA to be science and risk-based it needs scientific data & information, capability, .. “Scientific explanation yields understanding” 7/11/2013 Ajaz | Insight 53 http://www.fda.gov/ohrms/dockets/ac/04/briefing/2004-4052B1_09_Hussain-Arden-UK-Presentation.ppt
  • 54. Learningobjectives (1). Considerations for developing the FDA guidance “Waiver of In Vivo Bioavailability and Bioequivalence Studies for Immediate-Release Solid Oral Dosage Forms Based on a Biopharmaceutics ClassificationSystem” (August 2000) Broadly, gain an understandingof considerationsin translating scientific knowledgeinto regulatorypolicy (2) What questions should you ask? (3) What assumptions should you accept? (4) How precise should your answers be? Develop a basis to critically evaluate considerations utilized for developmentof the FDA guidance document (5) How should you ‘connect the dots’: CMC – BA/BE? Can you justify new applications of BCS (i.e., beyond the 2000 guidance)? Identify and explain how future regulatory applicationsof BCS may be realized in the context of ‘Quality by Design’ 7/11/2013 Ajaz | Insight 54
  • 55. PresentationSummary Application of BCS beyond the 2000 Guidance? 54321 7/11/2013 Ajaz | Insight 55 VIROPHARMA INCORPORATED, Plaintiff, Vs. MARGARET A. HAMBURG, M.D., et al., Defendants. IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA Civil Action No. 12-cv-00584-ESH Filed 04/17/12 (5) How should you ‘connect the dots’: CMC – BA/BE? (QbD) (2) What questions should you ask? (4) How precise should your answers be? (3) What assumptions should you accept? (1). Considerations for developing the FDA guidance