Presentation on theme: "Evolving Science in Bioavailability and Bioequivalence"— Presentation transcript:
1Evolving Science in Bioavailability and Bioequivalence Jim Wei, MD, PhDACPU, Cincinnati, OH, October 18-20, 2010
2Agenda Bioavailability/Bioequivalence Highly variable drugs (HVD) Study Design of BioequivalenceAverage BEReplicate BE- Full replicate- Partial replicateRegulatory requirements for BE supplies, sample storage and data analysis
3Bioavailability – defined “Bioavailability is the fraction (F) of an administered dose that actually reaches systemic circulation when compared to a solution (SLN), suspension (SUSP), or intravenous (IV) dosage form.”-- 21 CFR (d)(2)&(3) --absolute: test drug vs. IV reference -BA of an IV drug is assumed to be 100%, or F = 1.00amount reaching circulation = F x Doserelative: test drug vs. SLN or SUSP reference
4Points to Consider – BAFor bioavailability studies, our primary “metric” of interest is:area under the concentration-time curve (AUC)AUC is a derived parameter, it is not observedTypes:AUCt = to the last detectable concentrationAUC = from zero to infinity (single dose)AUC = between dosing intervals at steady-state
5Approaches to Determining Bioequivalence (21 CFR 320.24) In vivo measurement of active moiety or moieties in biologic fluidIn vivo pharmacodynamic comparisonIn vivo limited clinical comparisonIn vitro comparisonAny other approach deemed appropriate by FDAFeV1 AlbuterolGlucagonTopicalsNasal SuspensionsQuestran - Binding StudiesNasal Solutions-Sprayer EvaluationPropofol - Droplet Size
7BE Statistical Analysis Bioequivalence criteriaTwo one-sided tests procedureTest (T) is not significantly less than referenceReference (R) is not significantly less than testSignificant difference is 20% ( = 0.05 significance level)T/R = 80/100 = 80%R/T = 80% (all data expressed as T/R so this becomes 100/80 = 125%)
8Highly Variable Drugs (HVD) DefinitionUse ANOVA Root Mean Square Error (RMSE) to estimate within-subject or intra-subject variability:Drug is classified as highly variable if RMSE ≥ 0.3 or 30%Two main types or sources of variabilityHighly variable PK (inherent drug characteristic)Highly variable formulation• Standard BE study approach may need more than 100 subjects
9CmaxAUClastRef-1Ref-26132771620This plot is the actual data from the studyHigh lighted are some subjects with the greatest variability between doses. The same subjects contribute to the high WSV of Cmax and AUCThe next slide shows these 6 subjects only
10BE Studies in Highly Variable Drugs (HVD) FDA Study to Characterize Highly Variable Drugs in BE Studies:Collected data from 1127 acceptable BE studies, submitted524 ANDAs from (3 years)Most sponsors used 2-way crossover studiesUsed ANOVA Root Mean Square Error to estimate within-subject varianceDrug was classified as highly variable if RMSE ≥ 0.3 or 30%BE studies of HVD enrolled more study subjects than studies of drugs with low variabilityAverage N in studies of HVD = 47Average N in studies of drugs with lower variability = 33Range 18 – 73 subjects10% of studies evaluated were HVD
11Reasons for Inconsistent Variability in BE Studies Differences in formulationsImproperly handling of Bioanalytical assaysSubjects with irregular plasma concentrationsNumber of study subjectsUncontrolled food status
1290%CIs & BE Limits Green Low WSV (~15%) Narrow 90%CI Passes Red High WSV (~35%)Wide 90%CILower bound <80%Fails125%100%80%GMR & the # of subjectsare the same in both cases
13Replicate BE Study Design Full replicate crossover design:Partial replicate crossover design:Period1234SequenceTRPeriod123SequenceTR
14Scaled Average BE for HVD Three-period, partial replicate designReference product (R) is administered twiceTest product (T) is administered onceSequences = RTR, TRR, RRTSample size: Determined by sponsor (adequate power)minimum is 24 subjectsBE criteria scaled to reference variability (Cmax & AUC)The point estimate (test/reference geometric mean ratio) must fall within [ ]Both conditions must be passed by the test product to conclude BE to the reference product
16Advantages of Scaled BE (Reference Scaled) Test product will benefit if:T variability < R variabilityThe test product will not benefit if:T variability > R variabilityWhat if high variability results from formulations problems or poor study conduct?If T variability > R variability, no benefit in using scaled approachThe burden is on the applicant to convince FDA that product is a HVD
1721 CFR 320.36 Requirements for maintenance of records of bioequivalence testing All records of in vivo or in vitro tests shall be maintained by the manufacturer for at least 2 years after the expiration date of the batch and submitted to the Food and Drug Administration on request.Any person who contracts with another party to conduct a bioequivalence study from which the data are intended to be submitted to FDA as part of an application submitted under part 314 of this chapter shall obtain from the person conducting the study sufficient accurate financial information to allow the submission of complete and accurate financial certifications or disclosure statements required under part 54 of this chapter and shall maintain that information and all records relating to the compensation given for that study and all other financial interest information required under part 54 of this chapter for 2 years after the date of approval of the application. The person maintaining these records shall, upon request for any properly authorized officer or employee of the Food and Drug Administration, at reasonable time, permit such officer or employee to have access to and copy and verify these records.
1821 CFR -320.38 Retention of bioavailability samples Each reserve sample shall be stored under conditions consistent with product labeling and in an area segregated from the area where testing is conducted and with access limited to authorized personnel.Each reserve sample shall be retained for a period of at least 5 years following the date on which the application or supplemental application is approved, or, if such application or supplemental application is not approved, at least 5 years following the date of completion of the bioavailability study in which the sample from which the reserve sample was obtained was used.
19BE Sample Retention The guidance highlights how the test article and reference standard for BA and BE studies should be distributed to the testing facilitieshow testing facilities should randomly select samples for testing and material to maintain as reserve sampleshow the reserve samples should be retained.
20FDA/DSI Inspection on BE Studies A frequent finding from these inspections is the absence of reserve samples at the testing facilities where the studies are conducted:In many cases, DSI finds that testing facilities return reserve samples to the study sponsors and/or drug manufacturers,In other cases, study sponsors and/or drug manufacturers, SMOs, or contract packaging facilities designate the study test article and reference standard for each subject, and preclude the testing facilities from randomly selecting representative reserve samples from the supplies.The study sponsor and/or drug manufacturer should send to the testing facility batches of the test article and reference standard packaged in such a way that the testing facility can randomly select samples for bioequivalence testing and samples to maintain as reserve samples.
21FDA/DSI Inspection on BE Studies cont’d Quantity of Reserve SamplesSufficient to perform five times all of the release tests required in the application or supplemental applicationFor solid oral dosage forms (e.g., tablets, capsules), an upper limit of 300 units each for the test article and reference standardEach site is asked to retain a reasonable amount of test article and reference standarda minimum limit (e.g., 5 dose units) for each of the test articles and reference standardsIn-House Studies Conducted by a Study Sponsor and/or Drug ManufacturerIf a study sponsor and/or drug manufacturer conducts such a study, manufacturing reserve samples (21 CFR ) and BE study reserve samples (21 CFR and ) should be separated.