Application of diffusion-edited and solvent suppression 1H NMR to the direct analysis of markers in valerian-hop liquid herbal products

This is the peer reviewed version of the following article: Jose M. Prieto, Maria Mellinas-Gomez, Mire Zloh, ‘Application of diffusion-edited and solvent suppression 1H-NMR to the direct analysis of markers in valerian-hop liquid herbal products’, Phytochemical Analysis, Vol 27(2): 100-106, first published online January 13, 2016, which has been published in final form at doi: 10.1002/pca.2603 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving Copyright © 2016 John Wiley & Sons, Ltd.The rising trend to consume herbal products for the treatment and/or prevention of minor ailments together with their chemical and pharmacological complexity means there is an urgent need to develop new approaches to their quality and stability. This work looks at the application of one-dimensional diffusion-edited ¹H NMR spectroscopy (1D DOSY) and ¹H NMR with suppression of the ethanol and water signals to the characterization of quality and stability markers in multicomponent herbal medicines/food supplements. The experiments were performed with commercial tinctures of Valeriana officinalis L. (valerian), expired and non-expired, as well as its combination with Hummulus lupulus L. (hops), which is one of the most popular blends of relaxant herbs. These techniques did not require purification or evaporation of components for the qualitative analysis of the mixture, but only the addition of D2O and TSP. The best diagnostic signals were found at 7 ppm (H-11, valerenic acid), 4.2 ppm (H-1, hydroxyvalerenic acid) and 1.5-1.8 ppm (methyl groups in prenylated moieties, α-acids/prenylated flavones). This work concludes on the potential value of 1D DOSY ¹H NMR to provide additional assurance of quality in complex natural mixtures.Peer reviewe

Medicines informal market in Congo, Burundi and Angola: counterfeit and sub-standard antimalarials

BACKGROUND: The presence of counterfeits and sub-standards in African medicines market is a dramatic problem that causes many deaths each year. The increase of the phenomenon of pharmaceutical counterfeiting is due to the rise of the illegal market and to the impossibility to purchase branded high cost medicines. METHODS: In this paper the results of a quality control on antimalarial tablet samples purchased in the informal market in Congo, Burundi and Angola are reported. The quality control consisted in the assay of active substance by means of validated liquid chromatographic methods, uniformity of mass determination, disintegration and dissolution tests. Moreover, a general evaluation on label and packaging characteristics was performed. RESULTS: The results obtained on thirty antimalarial tablet samples containing chloroquine, quinine, mefloquine, sulphadoxine and pyrimethamine showed the presence of different kinds of problems: a general problem concerning the packaging (loose tablets, packaging without Producer name, Producer Country and sometimes without expiry date); low content of active substance (in one sample); different, non-declared, active substance (in one sample); sub-standard technological properties and very low dissolution profiles (in about 50% of samples). This last property could affect the bioavailability and bioequivalence in comparison with branded products and could be related to the use of different excipients in formulation or bad storage conditions. CONCLUSION: This paper evidences that the most common quality problem in the analysed samples appears to be the low dissolution profile. Here it is remarked that the presence of the right active substance in the right quantity is not a sufficient condition for a good quality drug. Dissolution test is not less important in a quality control and often evidences in vitro possible differences in therapeutic efficacy among drugs with the same active content. Dissolution profile can be dramatically affected by the choice of excipients in the oral solid formulation and, in many cases, is out of specifications due to the absence of formulation studies by producers of developing countries

Role of the list of standard terms in the European Pharmacopoeia for the establishment of the different existing pharmaceutical forms

The type and content of pharmacopoeias have changed many times over the years, until in 1964 the first European Pharmacopoeia was introduced under the jurisdiction of the Council of Europe as part of the implementation of the Convention on the Development of a European Pharmacopoeia.An important section of the European Pharmacopoeia is the list of standard terms. It is drawn up by the Commission of the European Pharmacopoeia, which is part of the European Directorate for the Quality of Medicines and Healthcare (EDQM), at the request of the European Commission, to be used in applications and marketing authorizations and packaging information, in the package leaflet, in the summary of product characteristics and in electronic communications.The main purpose of the study is to make a detailed analysis of the List of Standard Terms available in Bulgarian, as well as the database of standard terms maintained by the European Directorate for the Quality of Medicines in order to make a comparison between them and to identify the most the common dosage forms in them as well as the most common routes of administration.The results of the study show that the largest number are the standard terms referring to medicinal products intended for oral administration and injection. And the most common terms for dosage forms are those for solutions and powders. We also found that the most complete and up-to-date source of information on standard terms for medical devices is the database of standard terms maintained by the European Directorate for the Quality of Medicines, as it is constantly updated. Based on these facts, we can say that the European database is the gold standard for compiling lists of standard terms in each Member State of the Commission of the European Pharmacopoeia. The Bulgarian list of standard terms, on the other hand, is not updated often enough, it is recommended that this be done at shorter intervals, as new terms are constantly appearing. This is best done with each release of an updated version of the pharmacopoeia

Kreuth V initiative: European consensus proposals for treatment of hemophilia using standard products, extended half-life coagulation factor concentrates and non-replacement therapies

This report contains the updated consensus recommendations for optimal hemophilia care produced in 2019 by three Working Groups (WG) on behalf of the European Directorate for Quality of Medicines and Healthcare in the frame of the Kreuth V Initiative. WG1 recommended access to prophylaxis for all patients, the achievement of plasma factor trough levels of at least 3-5% when extended half-life factor VIII (FVIII) and FIX products are used, a personalized treatment regimen, and a choice of chromogenic assays for treatment monitoring. It was also emphasized that innovative therapies should be supervised by hemophilia comprehensive care centers. WG2 recommended mandatory collection of postmarketing data to assure the long-term safety and efficacy of new hemophilia therapies, the establishment of national patient registries including the core data recommended by the European Medicines Agency and the International Society on Thrombosis and Haemostasis, with adequate support under public control, and greater collaboration to facilitate a comprehensive data evaluation throughout Europe. WG3 discussed methodological aspects of hemophilia care in the context of access decisions, particularly for innovative therapies, and recommended that clinical studies should be designed to provide the quality of evidence needed by regulatory authorities, HTA bodies and healthcare providers. The dialogue between all stakeholders in hemophilia care and patient organizations should be fostered to implement these recommendations

Lasalocid awareness and sampling in Scotland

Lasalocid is an ionophore antibiotic extensively used as a coccidiostat in poultry production. Lasalocid should not be fed to egg-laying hens as it accumulates in the eggs, and residues have often been found in eggs. Other ionophores are toxic to humans, but the exact level of lasalocid toxicity to humans has not been established. Approximately 250 egg samples were analysed for lasalocid each year from the 10 billion eggs consumed annually in the UK. A census of the 32 Scottish Local Authority Environmental Health Departments assessed awareness of lasalocid residues in eggs, and the results indicated that awareness of lasalocid was very low and no local authorities tested for lasalocid. The example of lasalocid revealed weaknesses in the current sampling regime surrounding foods of animal origin. Conclusions are drawn that central government should raise awareness within local authorities and provide financial support on local authority sampling to achieve proper representation

Counterfeiting and Public Health

*** This material is copyrighted and any download is for personal use only *** The original article is published in Criminal Enforcement of Intellectual Property: A Handbook of Contemporary Research edited by Christophe Geiger © 2012 Edward Elgar

Quality of fixed dose artemether/lumefantrine products in Jimma Zone, Ethiopia

Background: Malaria caused by Plasmodium vivax and Plasmodium falciparum is among the major public health problems in most endemic areas of the world. Artemisinin-based combination therapy (ACT) has been recommended as a first-line treatment for uncomplicated Plasmodium falciparum malaria almost in all endemic regions. Since ineffectively regulated medicines in resource limited settings could favour infiltration of poor quality anti-malarial medicines into pharmaceutical supply chain and jeopardize a positive treatment outcome, regular monitoring of the quality of anti-malarial medicines is critical. Thus, the aim of this study was to assess the quality of fixed dose combination (FDC) artemether (ART)/lumefantrine (LUM) tablets available in Jimma zone, Ethiopia. Methods: This study was conducted in Jimma zone, Ethiopia. A total of 74 samples of FDC ART/LUM (20mg ART/120mg LUM) tablets were collected from 27 public facilities. All samples were subjected to visual inspection and the relevant information was recorded. The samples were transported to Jimma University Laboratory of Drug Quality (JuLaDQ) and stored at ambient temperature (20 degrees C to 25 degrees C) until analysis. The Pharmacopoeial conform/non-conform methods and the risk-based Derringer's desirability function approach were employed to assess the pharmaceutical quality of the investigated products. Results: The visual inspection results revealed that there were no signs of falsified in the investigated products. Identification test results of samples indicated that all samples contained the stated active pharmaceutical ingredients (APIs). The results of uniformity of mass indicated that all samples complied with International Pharmacopoeial specification limits. The assay results, expressed as percent label claim (%lc) of ART (89.8 to 108.8%, meanSD=99.1 +/- 3.9%) and LUM (90.0 to 111.9%, mean +/- SD=98.2 +/- 3.8%) revealed that, all samples complied with International Pharmacopoeia acceptance specification limits (i.e. 90-110%lc), except one generic product (IPCA Laboratories Ltd., India) which contains excessive LUM (111.9 +/- 1.7%lc). The risk priority number (RPN) results revealed that assay (RPN=392) is relatively the most critical quality attribute followed by identity (RPN=280) and mass uniformity (40). Quality evaluation based on psycho-physical Harrington's scale revealed that more than 96% of samples were within the acceptable ranges (D >= 0.7-1.0). Conclusions: Both Pharmacopoeial and risk-based desirability function approaches to quality evaluation applied to the investigated products revealed that above 96% FDC ART/LUM tablets circulating in public settings of Jimma zone are of good quality

Quality in Non-Licensed Radiopharmaceutical Products: Are We Achieving the Goal?

Radiopharmaceutical compounds, considered a special group of medicines, can be prepared outside the marketing authorisation track. Small-scale preparations at non-commercial sites thereby represent an important segment, however a lack of harmonisation in the regulation leads to extreme differences in the application and availability of radiopharmaceuticals across Europe. A number of guidelines and guidance documents have been issued by European Association of Nuclear Medicine (EAMN), Pharmaceutical inspection convention (PICs), European Directorate for the Quality of Medicines & HealthCare (EDQM) to achieve a good radiopharmacy practice for small-scale preparation. Nevertheless, in the case of non-licensed radiopharmaceuticals their consideration as magistral formulas, in some countries, makes it possible to waive regulatory inspections aimed to ensure those good practices enforcement. Moreover, special attention should be put on the quality assurance process for non-licensed starting materials, given that the final radiopharmaceuticals quality chiefly depends on it. This paper (chapter) will provide an insight into the quality standards applicable to starting materials, such as supplier qualification control, starting material re-test period, etc. in order to raise for discussion about how best to achieve a proven quality, efficacy, and safety for our radiopharmaceuticals (licensed or non-licensed)

Assessment of efficacy and quality of two albendazole brands commonly used against soil-transmitted helminth infections in school children in Jimma Town, Ethiopia

Background : There is a worldwide upscale in mass drug administration (MDA) programs to control the morbidity caused by soil-transmitted helminths (STHs): Ascaris lumbricoides, Trichuris trichiura and hookworm. Although anthelminthic drugs which are used for MDA are supplied by two pharmaceutical companies through donation, there is a wide range of brands available on local markets for which the efficacy against STHs and quality remain poorly explored. In the present study, we evaluated the drug efficacy and quality of two albendazole brands (Bendex and Ovis) available on the local market in Ethiopia. Methodology/Principal Findings : A randomized clinical trial was conducted according to the World Health Organization (WHO) guidelines to assess drug efficacy, by means of egg reduction rate (ERR), of Bendex and Ovis against STH infections in school children in Jimma, Ethiopia. In addition, the chemical and physicochemical quality of the drugs was assessed according to the United States and European Pharmacopoeia, encompassing mass uniformity of the tablets, amount of active compound and dissolution profile. Both drugs were highly efficacious against A. lumbricoides (>97%), but showed poor efficacy against T. trichiura (similar to 20%). For hookworms, Ovis was significantly (p < 0.05) more efficacious compared to Bendex (98.1% vs. 88.7%). Assessment of the physicochemical quality of the drugs revealed a significant difference in dissolution profile, with Bendex having a slower dissolution than Ovis. Conclusion/Significance : The study revealed that differences in efficacy between the two brands of albendazole (ABZ) tablets against hookworm are linked to the differences in the in-vitro drug release profile. Differences in uptake and metabolism of this benzimidazole drug among different helminth species may explain that this efficacy difference was only observed in hookworms and not in the two other species. The results of the present study underscore the importance of assessing the chemical and physicochemical quality of drugs before conducting efficacy assessment in any clinical trials to ensure appropriate therapeutic efficacy and to exclude poor drug quality as a factor of reduced drug efficacy other than anthelminthic resistance. Overall, this paper demonstrates that "all medicines are not created equal"

The impact of European integration on the German system of pharmaceutical product authorization

The European Union has evolved since 1965 into an influential political player in the regulation of pharmaceutical safety standards. The objective of establishing a single European market for pharmaceuticals makes it necessary for member-states to adopt uniform safety standards and marketing authorization procedures. This article investigates the impact of the European integration process on the German marketing authorization system for pharmaceuticals. The analysis shows that the main focal points and objectives of European regulation of pharmaceutical safety have shifted since 1965. The initial phase saw the introduction of uniform European safety standards as a result of which Germany was obliged to undertake “catch-up” modernization. From the mid-1970s, these standards were extended and specified in greater detail. Since the mid-1990s, a process of reorientation has been under way. The formation of the European Agency for the Evaluation of Medicinal Products (EMEA) and the growing importance of the European authorization procedure, combined with intensified global competition on pharmaceutical markets, are exerting indirect pressure for EU member-states to adjust their medicines policies. Consequently, over the past few years Germany has been engaged in a competition-oriented reorganization of its pharmaceutical product authorization system the outcome of which will be to give higher priority to economic interests.Die Europäische Gemeinschaft ist in der Regulierung der Arzneimittelsicherheit seit 1965 zu einem einflussreichen politischen Akteur geworden. Das Ziel eines einheitlichen europäischen Marktes für Arzneimittel erfordert eine Vereinheitlichung der Sicherheitsstandards und Zulassungsverfahren in den Mitgliedstaaten. Im folgenden Beitrag wird der Frage nachgegangen, welche Auswirkungen der Prozess der Europäischen Integration auf das System der Arzneimittelzulassung in Deutschland hat. Es wird deutlich, dass sich die Schwerpunkte und Zielsetzungen der europäischen Regulierung der Arzneimittelsicherheit seit 1965 verschoben haben. Nach einer ersten Phase der Etablierung einheitlicher europäischer Sicherheitsstandards, die in Deutschland eine nachholende Modernisierung erforderlich machten, wurden diese Standards seit Mitte der 1970er Jahre ausgebaut und präzisiert. Seit Mitte der 1990er Jahre kommt es zu einer Neuausrichtung. Die Errichtung der europäischen Arzneimittelagentur EMEA und der Bedeutungsgewinn der europäischen Zulassungsverfahren erzeugen in Verbindung mit dem verschärften globalen Wettbewerb auf den Arzneimittelmärkten einen mittelbaren Anpassungsdruck auf die nationalen Arzneimittelpolitiken. In der Konsequenz wird in Deutschland seit einigen Jahren eine wettbewerbsorientierte Umgestaltung der Arzneimittelzulassung betrieben, die zu einer Aufwertung ökonomischer Interessen im Zulassungssystem führt