Drug safety Africa: An overview of safety pharmacology & toxicology in South Africa.

This meeting report is based on presentations given at the first Drug Safety Africa Meeting in Potchefstroom, South Africa from November 20-22, 2018 at the North-West University campus. There were 134 attendees (including 26 speakers and 34 students) from the pharmaceutical industry, academia, regulatory agencies as well as 6 exhibitors. These meeting proceedings are designed to inform the content that was presented in terms of Safety Pharmacology (SP) and Toxicology methods and models that are used by the pharmaceutical industry to characterize the safety profile of novel small chemical or biological molecules. The first part of this report includes an overview of the core battery studies defined by cardiovascular, central nervous system (CNS) and respiratory studies. Approaches to evaluating drug effects on the renal and gastrointestinal systems and murine phenotyping were also discussed. Subsequently, toxicological approaches were presented including standard strategies and options for early identification and characterization of risks associated with a novel therapeutic, the types of toxicology studies conducted and relevance to risk assessment supporting first-in-human (FIH) clinical trials and target organ toxicity. Biopharmaceutical development and principles of immunotoxicology were discussed as well as emerging technologies. An additional poster session was held that included 18 posters on advanced studies and topics by South African researchers, postgraduate students and postdoctoral fellows

Nonclinical development of novel biologics, biosimilars, vaccines and specialty biologics /

Nonclinical Development of Novel Biologics, Biosimilars, Vaccines and Specialty Biologics is a complete reference devoted to the nonclinical safety assessment of novel biopharmaceuticals, biosimilars, vaccines, cell and gene therapies and blood products. This book compares and contrasts these types of biologics with one another and with small molecule drugs, while incorporating the most current and essential international regulatory documents. Each section discusses a different type of biologic, as well as early characterization strategies, principles of study design, preclinical pha.Print version record.Front Cover; Nonclinical Development of Novel Biologics, Biosimilars, Vaccines and Specialty Biologics; Copyright; Dedication; Contents; Preface; Contributors; Acknowledgments; Section I Development of Biopharmaceuticals Defined as Novel Biologics; Chapter 1 -- Overview of Biopharmaceuticals and Comparison with Small-molecule Drug Development; INTRODUCTION; HISTORY AND EVOLUTION OF BIOPHARMACEUTICALS; DEVELOPMENT OF DIVERSE BIOPHARMACEUTICAL MODALITIES; COMPARISON OF SMALL-MOLECULE DRUGS TO BIOPHARMACEUTICALS; SUMMARY; References.Chapter 2 -- Regulatory Guidelines and their Application in the Nonclinical Evaluation of Biological MedicinesINTRODUCTION; SPECIES SELECTION; STUDY DESIGN CONSIDERATIONS FOR REPEAT-DOSE STUDIES; IMMUNOGENICITY; REPRODUCTIVE AND DEVELOPMENTAL TOXICITY; GENOTOXICITY AND CARCINOGENICITY; SPECIAL CONSIDERATIONS FOR ANTICANCER DRUGS; FIRST-IN-HUMAN (FIH) CLINICAL TRIAL; SUMMARY; References; Chapter 3 -- Early De-risking Strategy for Novel Biotherapeutics; INTRODUCTION; ESTABLISHING A SAFETY PROFILE FOR BIOTHERAPEUTICS; GENERAL SAFETY CONSIDERATIONS RELATED TO BIOTHERAPEUTICS.PROGRESS IN EVALUATION OF IMMUNOTOXICITYCAN WE BETTER ADDRESS POTENTIAL OFF-TARGET TOXICITY?; SUMMARY; References; Chapter 4 -- Novel Biopharmaceuticals: Pharmacokinetics, Pharmacodynamics, and Bioanalytics; INTRODUCTION; ABSORPTION, DISTRIBUTION AND ELIMINATION OF BIOPHARMACEUTICALS; DISPOSITION OF MODIFIED MOLECULES; "METABOLISM" AND BIODISTRIBUTION FOR BIOPHARMACEUTICALS; IMMUNOGENICITY AND IMPACTS ON PK AND BIODISTRIBUTION; PHARMACOKINETICS AND PHARMACODYNAMICS; PRECLINICAL TO CLINICAL TRANSLATION; BIOANALYTICS; DRUG ASSAYS; BIOMARKERS: TARGET ENGAGEMENT ASSAYS.IMMUNOGENICITY ASSESSMENT: ADA ASSAYSSUMMARY; References; Section II Development of Biosimilars; Chapter 5 -- Overview of Biosimilar Therapeutics; INTRODUCTION; THE CONCEPT OF BIOSIMILARS; GENERAL CONSIDERATIONS FOR DEVELOPMENT OF BIOSIMILARS; BIOSIMILAR CANDIDATES BASED ON MODALITY AND THERAPEUTIC CLASS; SUMMARY; References; Chapter 6 -- Regulatory Standards for the Approval of Biosimilar Products: A Global Review; INTRODUCTION; EUROPEAN UNION-PIONEER FOR THE FIRST REGULATORY PATHWAY FOR BIOSIMILAR PRODUCTS; THE WORLD HEALTH ORGANIZATION GUIDANCE ON BIOSIMILARS.REGULATORY PATHWAY FOR BIOSIMILAR PRODUCTS IN THE UNITED STATESBIOSIMILAR PATHWAYS IN OTHER REGIONS; SUMMARY; References; Chapter 7 -- Early Characterization of Biosimilar Therapeutics; INTRODUCTION; RECOMBINANT INSULINS; RECOMBINANT HUMAN GROWTH HORMONE; RECOMBINANT ERYTHROPOIETINS; RECOMBINANT GRANULOCYTE COLONY-STIMULATING FACTOR; RECOMBINANT INTERFERONS; LOW MOLECULAR WEIGHT HEPARINS; MONOCLONAL ANTIBODIES; OTHER CLASSES; SUMMARY; References; Section III Vaccines; Chapter 8 -- Introduction to Vaccines and Adjuvants; INTRODUCTION; THE HISTORY OF VACCINES.Nonclinical Development of Novel Biologics, Biosimilars, Vaccines and Specialty Biologics is a complete reference devoted to the nonclinical safety assessment of novel biopharmaceuticals, biosimilars, vaccines, cell and gene therapies and blood products. This book compares and contrasts these types of biologics with one another and with small molecule drugs, while incorporating the most current and essential international regulatory documents. Each section discusses a different type of biologic, as well as early characterization strategies, principles of study design, preclinical pha.Includes bibliographical references and index.Elsevie

Alveolar fluid neutrophil elastase activity in the adult respiratory distress syndrome is coinplexed to alpha-2-macroglobulin

We characterized the elastase and antielastase activity of the alveolar fluid of seven patients with the adult respiratory distress syndrome (ARDS) and thirteen normal volunteers. Alpha-l-antitrypsin (AlAT) concentrations were 60-fold higher in ARDS as compared to normal lavage fluid (2,140±498 nM; 36.1±4.2 nM, respectively). ARDS fluid antineutrophil elastase activity was also considerably higher than that of normals (979±204 nM; 31.3±2.9 nM, respectively). Despite the antineutrophil elastase excess, 5 of 7 ARDS lavage samples contained elastase activity (mean, 6.1±2.4 pM) as assayed using low-molecular-mass substrate, while only 1 of 13 normal subjects had detectable elastase activity (0.2 pM) (P < 0.01, compared with ARDS). That this activity was due to alpha-2-macroglobulin (A2MG)-complexed neutrophil elastase was evidenced by (a) the Sephadex G-75 elution profile; (b) the inactivity against insoluble VHielastin; (c) the inhibitory profile with phenylmethylsulfonyl fluoride, methoxy-succinyl-alanyl-alanyl-prolyl-valyl-chloromethylketone, ethylene diamine tetraacetic acid, and AlAT; and (d) the immobilization by A2MG antibody bound to polystyrene plates. Furthermore, in agreement with the predicted affinity of AMAT and A2MG for neutrophil elastase, the ratio of A2MG to AMAT in the fluid (0.57%) coincided with the ratio of the A2MG- to AlAT-complexed elastase (0.36%). These findings suggest that the net lung protease-antiprotease balance in ARDS is shifted largely in favor of the antiproteases (chiefly AMAT), and that the antiproteases, AMAT and A2MG, have similar affinities for neutrophil elastase in vivo

Re-evaluating the need for chronic toxicity studies with therapeutic monoclonal antibodies, using a weight of evidence approach

To support registration of monoclonal antibodies (mAbs) for chronic indications, 6-month toxicity studies have historically been conducted. Experience with mAb development has shown a relatively benign and well-understood safety profile for this class, with most toxicity findings anticipated based on pharmacology. We evaluated whether a 6-month toxicity study is optimal to assess the long-term safety of mAbs. Data on First-in-Human (FIH)-enabling and chronic toxicity studies were shared for 142 mAbs submitted by 11 companies. Opportunities to further optimize study designs to reduce animal usage were identified. For 71% of mAbs, no toxicities or no new toxicities were noted in chronic studies compared to FIH-enabling study findings. New toxicities of potential concern for human safety or that changed trial design were identified in 13.5% of cases, with 7% being considered critical and 2% leading to program termination. An iterative, weight-of-evidence model which considers factors that influence the overall risk for a mAb to cause toxicity was developed. This model enables an evidence-based justification, suggesting when 3-month toxicity studies are likely sufficient to support late-stage clinical development and registration for some mAbs