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At least 37 records · Page 2

Failure Mode Identification of Insulin Drug Products – Impact of Relevant Stress Conditions on the Quality of the Drug

Fast-acting insulin drug products (DPs) are carried and administered by diabetic patients to maintain their blood glucose level throughout the day, exposing the DPs to stress conditions. Apidra, Novolog, and Humalog insulin DPs were tested under various stress conditions. Dynamic light scattering (DLS), and size exclusion chromatography (SEC) were used to monitor the stability and aggregation. Thermal stress alone did not influence the stability. However, 24 hr exposure to vigorous mechanical stress shifted the DLS size peaks of Novolog and Humalog from 5 ± 1 nm to > 50.9 ± 25.6 nm, and the SEC native protein peak areas decreased 52% for Novolog and 18.4% for Humalog. Combined stress accelerated protein aggregation more drastically. Novolog and Humalog size shifted (>75 nm) after 3 hr and the peak area decreased > 97.9% after 6 hr exposure, indicating that high temperature accelerated the aggregation triggered by agitation. Soluble aggregates were captured by DLS early on compared to SEC. Apidra was comparably stable indicating DP formulation plays a critical role in stability. Here this study provides a greater understanding of potential failure modes patients and care givers may encounter while handling insulin DPs.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

The use of ion mobility spectrometry and gas chromatography/mass spectrometry for the detection of illicit drugs on clandestine records

Illicit drug distribution has over the past decade grown tremendously from simple 'drug pushing' where drugs were distributed from poorly organized individuals to today's well organized and well financed drug cartels. This change to a more 'corporate-like' atmosphere has resulted in a greater use of record keeping to monitor the profits generated. The use of record keeping by drug distributors is not restricted to high level drug smugglers but is used at all levels within the distribution network. Dealers at all levels including street dealers are generally 'fronted', given on consignment quantities of drugs that they in turn sell to customers, thereby requiring the need for records to keep track of drug sales versus liabilities. These records because of their illicit nature are often encrypted to hide the fact that they are indeed records of drug transactions. The creation of a handwritten notation concerning a drug transaction is normally brought on because of a purchase or sale. In a sale, this is commonly accomplished through a consignment, or the designation of a quantity to a customer to whom that amount has been 'fronted'. Because this activity generates a debt, it follows that an accounting for payments made, as well as new transactions completed, is only logical. One of the most common means of representing these is through an 'accounting flow', in which payments are subtracted from a running balance while new sales are added to it. The examination of illicit drug records has been the key to the prosecution of numerous federal, state, and local drug cases for a number of years. The Document Section of the FBI Laboratory, through its Racketeering Records Analysis Unit (RRAU), has been involved in such analytical efforts since 1983. Detailed analytical research brought about an evolution in the systematic approach utilized in the RRAU since that time. The close proximity of the drugs to the records often results in trace drug evidence being transferred to the records. The detection of trace drug residue on surfaces by ion mobility spectrometry (IMS) is well documented in literature. The following procedure will deal primarily with the newer techniques of trace drug analysis and drug record analysis developed by the Chemistry/Toxicology Unit of the FBI Laboratory since the more traditional techniques of latent finger print analysis and document analysis are well known.

Donnelly, Brian↗

International Benchmarking: A Global Perspective of Workplace Drug and Alcohol Testing

Workplace drug and alcohol testing has been widely implemented in diverse industries and is designed to detect the use of and deter the influence of legal and illegal substances that would impair the ability to perform work that has significant security and safety implications. Across the globe, patterns of drug and alcohol use and abuse and the regulations controlling drug and alcohol use vary by location (e.g., regions, countries, etc.). The prevalence of workplace drug and alcohol testing and protection of individuals’ rights in the workplace similarly tend to exhibit contextual differences. With the advancements in drug-testing technologies and the recent issuance of guidance for additional testing matrices (e.g., oral fluid, hair, etc.) by the U.S. Department of Health and Human Services, gaining a global perspective on the current state of drug and alcohol testing practices and regulations is important for leveraging such advancements to improve the effectiveness of drug and alcohol testing. The U.S. Nuclear Regulatory Commission (NRC) tasked the Pacific Northwest National Laboratory (PNNL) fitness for duty (FFD) team to conduct a benchmarking analysis of international drug and alcohol testing regulations and programs to identify similarities and differences in workplace testing programs and the basis for any differences. The benchmarking study focuses on a policy analysis and benchmarking metrics comparison among different countries and regions. The policy analysis includes the following three types of relevant international and national policies relevant to drug and alcohol testing in the nuclear industry: 1. National drug and alcohol policy 2. Workplace drug and alcohol testing 3. FFD regulations for Nuclear Power Plants The international drug and alcohol benchmarking metrics focusses on the use of blood, breath, urine, hair, and oral fluid in testing; drug and drug metabolite cutoff values; point-of-collection testing devices; roadside testing methodologies; innovations in drug testing; and the extent of availability of such data. Gaining an understanding of workplace drug and alcohol testing in other countries as well as information about new testing methods, matrices, tools, and technologies that other countries have adopted provides NRC with international comparative information regarding the technical basis for such programs and methods as it relates to the protection of worker and public health and safety.

98 NUCLEAR DISARMAMENT, SAFEGUARDS, AND PHYSICAL P↗

Dose-finding studies in drug development for rare genetic diseases

The small patient populations inherent to rare genetic diseases present many challenges to the traditional drug development paradigm. One major challenge is generating sufficient data in early phase studies to inform dose selection for later phase studies and dose optimization for clinical use of the drug. However, optimizing the benefit-risk profile of drugs through appropriate dose selection during drug development is critical for all drugs, including those being developed to treat rare diseases. Recognizing the challenges of conducting dose finding studies in rare disease populations and the importance of dose selection and optimization for successful drug development, we assessed the dose-finding studies and analyses conducted for drugs recently approved for rare genetic diseases. Of the 40 marketing applications for new molecular entity (NME) drugs and biologics approved by the United States Food and Drug Administration for rare genetic diseases from 2015 to 2020, 21 (53%) of the development programs conducted at least one dedicated dose-finding study. In addition, the majority of drug development programs conducted clinical studies in healthy subjects and included population pharmacokinetic and exposure–response analyses; some programs also conducted clinical studies in patient populations other than the disease for which the drug was initially approved. The majority of primary endpoints utilized in dedicated dose-finding studies were biomarkers, and the primary endpoint of the safety and efficacy study matched the primary endpoint used in the dose finding study in 9 of 13 (69%) drug development programs where primary study endpoints were assessed. Our study showed that NME drug development programs for rare genetic diseases utilize multiple data sources for dosing information, including studies in healthy subjects, population pharmacokinetic analyses, and exposure–response analyses. In addition, our results indicate that biomarkers play a key role in dose-finding studies for rare genetic disease drug development programs. Our findings highlight the need to develop study designs and methods to allow adequate dose-finding efforts within rare disease drug development programs that help overcome the challenges presented by low patient prevalence and other factors. Furthermore, the frequent reliance on biomarkers as endpoints for dose-finding studies underscores the importance of biomarker development in rare diseases.

60 APPLIED LIFE SCIENCES↗

Data augmentation and multimodal learning for predicting drug response in patient-derived xenografts from gene expressions and histology images

Patient-derived xenografts (PDXs) are an appealing platform for preclinical drug studies. A primary challenge in modeling drug response prediction (DRP) with PDXs and neural networks (NNs) is the limited number of drug response samples. We investigate multimodal neural network (MM-Net) and data augmentation for DRP in PDXs. The MM-Net learns to predict response using drug descriptors, gene expressions (GE), and histology whole-slide images (WSIs). We explore whether combining WSIs with GE improves predictions as compared with models that use GE alone. We propose two data augmentation methods which allow us training multimodal and unimodal NNs without changing architectures with a single larger dataset: 1) combine single-drug and drug-pair treatments by homogenizing drug representations, and 2) augment drug-pairs which doubles the sample size of all drug-pair samples. Unimodal NNs which use GE are compared to assess the contribution of data augmentation. The NN that uses the original and the augmented drug-pair treatments as well as single-drug treatments outperforms NNs that ignore either the augmented drug-pairs or the single-drug treatments. In assessing the multimodal learning based on the MCC metric, MM-Net outperforms all the baselines. Our results show that data augmentation and integration of histology images with GE can improve prediction performance of drug response in PDXs.

60 APPLIED LIFE SCIENCES↗

Clinical pharmacology information in regulatory submissions and labeling: A comparative analysis of orphan and non-orphan drugs approved by the FDA

Clinical pharmacology is an integral discipline supporting the development, regulatory evaluation, and clinical use of drugs for the treatment of both common and rare diseases. Here, we evaluated the recommendations and information available from select clinical pharmacology studies in the therapeutic product labeling of new molecular entities (NMEs) approved from 2017 to 2019 for both common and rare diseases. A total of 151 NMEs, including 72 orphan and 79 non-orphan drugs, were analyzed for recommendations and information available related to food–drug interaction, drug–drug interaction, renal impairment, hepatic impairment, QT assessment, and human radiolabeled mass balance studies using data collected from the original labeling and other regulatory documents. The analysis showed no statistically significant difference in the recommendations between orphan and non-orphan drugs except for renal impairment related recommendations in section 8 of the labeling. Although not significant, fewer hepatic impairment labeling recommendations were available for orphan drugs when compared with non-orphan drugs. At the time of initial approval, 79 postmarketing requirements (PMRs) and postmarketing commitments (PMCs) for 33 orphan drugs and 39 PMRs and PMCs for 19 non-orphan drugs were established; with most difference observed for drug–drug interaction, hepatic impairment, and QT assessment. Overall, although there was a trend for more labeling recommendations and fewer postmarketing studies and clinical trials for non-orphan drugs, there appeared to be no substantial differences in how these select clinical pharmacology studies are leveraged during the development and approval of orphan and non-orphan drugs.

60 APPLIED LIFE SCIENCES↗