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Integrated Development Strategies, Part 2: Reformulating for clinical and commercial success

Formulation Development , Early Development , Drug Product Optimization , Late Development , Dr. Andrew Lewis

Integrated Development Strategies, Part 2: Reformulating for clinical and commercial success

Dr. Andrew Lewis

In its broadest sense, the need to reformulate can occur at any stage in the product development lifecycle. This could range from small changes to the formulation, to improve processability for example, to more significant changes, such as changes to the dosage strength. Furthermore, the need for an entirely different formulation may be identified. Examples could include switching to a different drug product to ensure suitability for the development phase of a new drug, generation of age-appropriate formulations for patients, or as part of the lifecycle management strategy for a product, such as the development of a modified-release (MR) formulation to reduce dosing frequency.

However, the success of a reformulation is dependent on scientific expertise, the right technology, availability of appropriate models for formulation testing, and a lot of strategic planning.  

The general industry trend towards outsourcing to specialist contract organizations has further complicated this challenge. These specialist organizations are invariably reflective of the functional silos that exist in traditional pharma, offering the strong capability, experience, and infrastructure required in their field. However, their specialism also means that multiple providers are required to deliver each drug development activity, each of whom must play their part in total alignment with all other contributors. Naturally, issues occur along the way and development timelines are impacted. This all points to a need for an integrated service provider with all these capabilities in-house who can streamline the outsourcing model and improve the likelihood of success for a reformulated product.

What sort of reformulation might be required and when?

Early development

In early development, relatively simple, fit-for-purpose formulations are frequently employed to expedite entry into clinical development, and the efficacious dose may not be known until after dosing to healthy volunteers and the pharmacokinetics (PK) in humans is known. Such early formulations may therefore be designed to provide some dose flexibility and may also require dosing of multiple dosage units in the first-in-human (FIH) studies to define the target dose for later-stage studies. Once all of this is known, the product may need to be reformulated in order to deliver the required dose in as few dosage units as possible for proof-of-concept (POC) studies.

Furthermore, at this stage of development, relatively little will be known about the relationship between the formulation and the critical quality attributes (CQAs) of the drug product. As more is learned as the product advances through development, optimization of the formulation may be required. For example, incompatibilities with or degradation of the active pharmaceutical ingredient (API) during long-term storage might be identified, requiring modification of the levels of particular excipients or their substitution. This might also be required for product launches in different territories due to differing regulatory requirements or stability challenges in different climatic zones. Whatever the reason, an in-depth understanding of the issue at hand is required to justify the need to reformulate and the appropriate strategy to employ. Depending on the extent of the changes to the formulation, bridging clinical studies may be required to understand the impact, if any, on the bioavailability and PK of the API. 

At Quotient Sciences, we take an integrated approach to reformulation projects in the early development stage. Our unique platform, Translational Pharmaceutics®, enables us to fully integrate drug substance, drug product, and clinical testing, all under one organization and a single program manager, breaking down traditional industry silos to accelerate molecules through development. Real human data is used to drive formulation decision-making and technology selection, which greatly increases the likelihood of downstream clinical success. This seamless integration of activities allows for closely aligned workflows that efficiently conserve API consumption, reduce overall development risk and costs, and fast-track molecules from candidate development to FIH and onward to Good Manufacturing Practice (GMP) drug products for POC studies.  

Late development

In late-stage development, a complete reformulation of an API is usually only justified if there are significant issues with the formulation’s performance in manufacturing (e.g. on scale-up), prior to use (e.g. stability), or in use (e.g. performance). An exception to this, however, might be where there have been significant changes to the target product profile (TPP). This could occur, for example, following end-user feedback on the current drug product, the targeting of a new indication with a different patient demographic (e.g. pediatric population or 505(b)(2)), or as part of the product lifecycle management strategy. In this situation, there could be a switch to a totally different product format or route of delivery and/or require the use of an alternative formulation technology. While the changes made to the formulation could be significant, learnings from the previous formulation development program are invaluable in informing development and key performance targets (e.g. PK parameter targets) to give a head start to the development program.

Depending on the formulation technology employed, “critical-to-performance” formulation variables may be identified, such as the levels of a functional excipient. As the precise level of such a formulation variable required to achieve the desired performance may not be known, to maximize the chances of success of the program, formulators can employ a “formulation design space”. This involves bracketing formulations within the design space by generating supportive batch analysis and stability data at the extremes of the design space. Obtaining regulatory approval for the design space enables the development team to dose any formulation within the design space and make formulation modifications in response to the arising clinical data until the performance targets are met. This approach requires tight integration of the chemistry, manufacturing, and controls (CMC) teams with their counterparts in drug metabolism and pharmacokinetics (DMPK), regulatory, quality assurance (QA), and clinical to align around the formulation to be dosed once in the clinic, but it can save significant time by maximizing the chances that the new formulation hits the required targets.

In the later stages of development, our Translational Pharmaceutics platform can be applied to integrate formulation development, real-time adaptive GMP manufacturing, and clinical testing activities. Flexible study protocols and rapid “make-test” cycles enable the development and optimization of formulations in real time based on clinical data. This approach can be used to evaluate and select solubilization technologies, optimize MR systems, develop pediatric dosage forms, and change routes of delivery. As part of regulatory submissions, we obtain approval to make formulation adjustments within a mapped design space. This means that any formulation within certain defined parameters can be rapidly made and tested to determine the impact on the drug release rate and PK profile, enabling us to efficiently identify the optimal formulation without the need for regulatory amendments. This greatly reduces development risks, maximizes the probability of commercial success, and saves time and costs.

Case study 1: Enhancing drug solubility before Phase II

BOS172767, a Biopharmaceutics Classification System (BCS) class II molecule, was being developed by Boston Pharmaceuticals for the treatment of autoimmune diseases. The FIH study showed poor oral bioavailability and a significant food effect, which prevented the project from advancing into patient studies. An enhanced formulation was required to help overcome these challenges and to identify a formulation suitable for long-term clinical development.

At Quotient Sciences, using Translational Pharmaceutics, three solubility-enhancement platforms were developed and rapidly screened in the clinic, including a micronized form of the API, a self-emulsified lipid delivery system, and a spray-dried dispersion. The drug products were produced at a small scale for quick POC assessment without the need to conduct larger-scale, cost-prohibitive process development and lengthy stability programs for multiple technologies. The human PK study used a five-period cross-over design in 16 healthy volunteers.

The micronized formulation delivered the best human PK outcome, which enabled the sponsor to advance with a simpler and cheaper technology into larger-scale clinical development. The overall timeline from initiating formulation laboratory work to receiving clinical PK data was 6 months.

Case study 2: Development of an optimized MR tablet formulation for initial POC trials

SLx-2101, a novel phosphodiesterase-5 (PDE-5) inhibitor, was being developed by Surface Logix as an antihypertensive agent. Data from early development studies with an immediate-release tablet formulation determined that an MR formulation was needed to reduce Cmax-related adverse events and ensure the 24-hour PK profile remained within the therapeutic window to achieve a once-daily treatment regime.

At Quotient Sciences, using Translational Pharmaceutics, hydroxypropyl methylcellulose (HPMC)-based matrix MR tablets were developed for assessment in an adaptive relative bioavailability Phase I study to optimize the MR tablet formulation based on human clinical data. A two-dimensional formulation design space was established, covering dose strengths between 10 and 20 mg and sustained drug release durations between approximately 12 and 20 hours. Representative formulations at the extremes and mid-points of the design space were manufactured and characterized to demonstrate that the performance of the formulation can be controlled by varying the drug loading and HPMC content in the formulation. The formulation design space was submitted as part of a Clinical Trial Application (CTA) and approved for clinical investigation.

The clinical study was a five-period sequential design with interim data reviews between each dosing period to allow iterative investigation of the design space and identification of the optimal drug product composition. The formulation design space allowed a wide range of formulation compositions to be evaluated in response to emerging clinical data, with the optimal MR formulation identified in 7 months.

Summary

In summary, reformulation may be required at any stage in the drug development lifecycle. Successful reformulation is dependent on many factors and can be difficult to achieve within traditional industry silos. At Quotient Sciences, through our Translational Pharmaceutics platform, we possess the expertise and capabilities needed to reformulate products for clinical and commercial success. By taking a unique, integrated approach that is tailored to each program, we provide optimal results for our customers in the most efficient and cost-effective manner, getting new medicines to patients faster.

Get more information about our fully integrated Translational Pharmaceutics platform.

Scientific Poster Spotlight: Modified-release formulation development strategies

Modified Release , Formulation Development , Translational Pharmaceutics , Drug Product

Scientific Poster Spotlight: Modified-release formulation development strategies

Modified Release Formulations at Quotient Sciences

These Quotient Sciences scientific posters highlight strategies to streamline the development of modified-release formulations.

Modified-release formulations play a vital role in improving patient compliance and therapeutic outcomes for oral drug products. However, identifying the optimal formulation technology and delivery rate to achieve the desired in-vivo release profile can be challenging.                                     

Traditional modified-release development programs follow a rigid, linear process that relies on pre-clinical models to predict performance in humans. This can be risky, given the poor correlation of bioavailability between pre-clinical species and humans. As a result, repeated cycles of pre-clinical and clinical testing are required to arrive at a sufficient formulation, which can be costly and time-consuming. This points to a need for a streamlined approach.

We have over 30 years of expertise in developing and manufacturing modified-release drug products. 

Integrated drug development activities with Translational Pharmaceutics® to support modified-release formulations

Using our Translational Pharmaceutics® platform allows us to integrate drug product development and clinical testing activities to streamline the development of modified-release drugs. As part of regulatory submissions, we obtain approval to investigate a range of formulation compositions bound within a formulation design space

This means that any formulation within the formulation design space can be rapidly made and tested to determine in-vivo performance of that product via its pharmacokinetic (PK) profile. Clinical data from one dosing period determines the formulation composition that is made and tested next, enabling efficient identification of the optimal formulation in an accelerated timeframe. 

Presented at past scientific conferences and events, including AAPS PharmSci 360, these posters highlight how using a formulation design space as part of a Translational Pharmaceutics® program and choosing flexible study protocols, among other factors, help reduce development risks while maximizing the probability of clinical success for modified-release formulations.

With a strong emphasis on science and innovation, Quotient Sciences continues to research new and improved ways to streamline the development of MR programs. Continue reading for a summary of some of our modified-release programs, presented as conference posters, or contact us to discuss how we can support your next modified-release program.

 

"Pharmaceutical and clinical performance comparisons of modified-release multiparticulates and matrix tablet formulations"

Originally presented at the American Association of Pharmaceutical Scientists (AAPS) PharmSci 360 conference in October 2021. Quotient Sciences' Authors: Asma Patel, Wu Lin, Aruna Railkar, Peter Scholes.

The purpose of this study was to review practical experiences of head-to-head pharmaceutical and clinical comparisons of two commonly used modified-release formulation technologies for sustained drug release, multiparticulates, and matrix tablets, to identify an optimal modified-release formulation.

In most of the eight integrated clinical programs that were analyzed, the in-vivo performance of both technologies was similar, but a higher food effect was observed for matrix tablets in some cases. In all eight of the programs, matrix tablets were selected over multiparticulates, which suggested that the overall benefits of matrix tablets, including development and commercialization being simpler and cheaper, outweighed any slightly greater clinical benefits of multiparticulates.

This poster highlights how a formulation design space, integrated manufacturing and clinical testing, and flexible study protocols enable parallel assessment of multiple modified-release platforms. This helps efficiently identify the best technology to achieve the desired target product profile (TPP), and ultimately maximize the probability of success.

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"Development of modified-release matrix tablet formulation using solid lipid Compritol® 888 for a poorly water-soluble drug"

Originally presented at the AAPS PharmSci 360 conference in October 2021. Quotient Sciences' Authors: Dolly Jacob, Wu Lin, Kieran Crowley, Alaa Hosny, Charlotte Clay, Katie Clarke, Peter Scholes.

Solid lipid excipients offer a promising strategy in the development of modified-release formulations for poorly water-soluble drugs. In this study, an modified-release tablet was required to reduce Cmax-related side effects observed with the immediate-release formulation of a poorly water-soluble drug. The purpose of the study was to evaluate the use of Compritol 888, a synthetic solid lipid excipient that can be used as an insoluble matrix for sustained drug release, to achieve the required modified-release formulation profile.

The impact on the drug release rate of adjusting the following variables in the matrix modified-release tablet was assessed: the level of Compritol 888, the drug loading, the use of lactose as a soluble filler, and the use of the surfactant sodium dodecyl sulphate (SLS) as a wetting agent. 

It was found that by adjusting the level of Compritol 888, a wide range of drug release rates could be achieved. The drug release rate was also affected by the drug loading, with a faster drug release rate observed with lower drug loading. The soluble filler promoted tablet erosion and smoothed out the overall drug release profile, whereas the surfactant did not affect the drug release rate.

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"Using formulation design spaces and clinical data to optimize the development of modified-release dosage forms"

Originally presented at the Controlled Release Society (CRS) conference in July 2021. Quotient Sciences' Authors: Aruna Railkar, Asma Patel, Peter Scholes

This poster highlights how the use of a formulation design space, along with integrated drug development strategies and flexible study protocols, enables efficient evaluation of critical-to-performance variables in modified-release formulations.

The purpose of this study was to conduct a review and meta-analysis of 50 integrated modified-release formulation development, including assessing the following features: active pharmaceutical ingredient properties, formulation technologies, critical-to-performance parameters, formulation design space variables, in-vitro characterization methods, and clinical design flexibility.

It was found that at least 10 different modified-release technologies were used across the 50 programs, with diversity in physicochemical, biopharmaceutic, and drug metabolism and pharmacokinetic (DMPK) API properties influencing which technology was most suitable for achieving the target PK/product profile. 

For 12 of the programs, more than one technology platform was evaluated in a single clinical protocol to identify an optimal formulation. In total, more than eight different formulation attributes had clinical flexibility maximized by incorporation into a formulation design space, with individual programs concurrently evaluating up to three different formulation design space variables.

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Scientific Poster Spotlight: Taste Assessment Study of Belumosudil to Inform an Integrated Pediatric Formulation Development Program

Pediatrics , Formulation Development

Scientific Poster Spotlight: Taste Assessment Study of Belumosudil to Inform an Integrated Pediatric Formulation Development Program

Pediatric Formulation & Product Development at Quotient Sciences

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At the European Pediatric Formulation Initiative (EuPFI) conference in September 2021, Quotient Sciences [1] and Kadmon (a Sanofi company) [2] presented a poster describing a taste assessment study of belumosudil, a ROCK2 selective inhibitor developed by Kadmon (a Sanofi company) for the treatment of immune disorders, that was carried out by Quotient Sciences. An oral suspension was being investigated as a possible pediatric formulation for patients aged between 3 months and 12 years, and the aim of this study was to identify an optimal flavor and/or sweetener combination to improve palatability.

Twelve healthy, adult volunteers took part in a ‘sip-and-spit’ taste assessment of six different formulations, including one unflavored/unsweetened reference and five different flavor/sweetener combinations. The participants filled in a questionnaire to rate the overall acceptability and seven key taste characteristics of each formulation on a nine-point Likert scale.

The study identified multiple successful flavor and sweetener combinations that were able to improve palatability. It was determined that a formulation with either sweetener alone or in combination with a flavor would be suitable to enhance palatability and to take forward into a relative bioavailability assessment versus the reference adult tablet formulation.

 

Poster authors

1. Quotient Sciences: Ashley Willson, Mark Beville, Nand Singh, Nazim Kanji

2. Kadmon (a Sanofi company): Olivier Schueller, Galit Regev

 

To find out more about how Quotient Sciences can support your pediatric development program, click here.

 

Scientific Poster Spotlight: Development of a Novel Pediatric Belumosudil Oral Suspension

Pediatrics , Formulation Development , Nazim Kanji

Scientific Poster Spotlight: Development of a Novel Pediatric Belumosudil Oral Suspension

Pediatric Formulation & Product Development at Quotient Sciences

Quotient Sciences [1] and Kadmon (a Sanofi company) [2] presented a poster at the European Pediatric Formulation Initiative (EuPFI) conference in September 2021, describing a program that was carried out by Quotient Sciences to develop a pediatric formulation for belumosudil, a ROCK2 selective inhibitor developed by Kadmon (a Sanofi company) for the treatment of immune disorders. The aim was to develop a new oral suspension formulation using age-appropriate excipients suitable for patients aged between 3 months and 12 years, which could be taken forward into a relative bioavailability assessment versus the reference adult tablet formulation.

Formulation design and excipient selection was based on literature reviews and regulatory guidance. Formulations with different combinations of suspending/thickening agents, preservative, sweetener, and flavors were assessed to identify the most promising systems. Lead flavor and sweetener combinations that improved palatability were identified in a taste assessment study, and the thickener/suspension system was developed and optimized. Belumosudil grades that had been jet-milled and pin-milled were assessed as part of the development studies, which confirmed that jet-milled belumosudil was preferred in achieving dose homogeneity. A lead formulation was selected following short-term stability testing. Process development studies enabled scale-up of the formulation for clinical trial manufacturing.

As a result, a belumosudil oral suspension that met the quality target product profile (QTPP) and was suitable for patients aged between 3 months and 12 years was successfully identified, enabling CTM manufacturing for a relative bioavailability assessment versus the reference adult tablet formulation.

Access the poster to continue reading insight about the program and outcomes.

Poster authors

1. Quotient Sciences: Mark Beville, Ashley Willson, Josephine Gray, Nazim Kanji

2. Kadmon (a Sanofi company): Olivier Schueller, Galit Regev

Overcoming Challenges with Poorly Soluble Molecules in Early Development

Early Development , Formulation Development , Translational Pharmaceutics , Drug Product Optimization

Overcoming Challenges with Poorly Soluble Molecules in Early Development

In early development, the main goal for a new chemical entity is to demonstrate proof of concept (POC) in patients in the most time- and cost-effective way possible. 

Typically, simple, fit-for-purpose formulations are used in first-in-human studies to minimize upfront development time and CMC costs prior to generating clinical safety and pharmacokinetic data. However, given the increasing number of poorly soluble active pharmaceutical ingredients in the industry development pipeline, this approach has limitations, especially where enabling formulation technologies may be required to ensure adequate bioavailability. 

With over 30 years of experience, Quotient Sciences' suite of technologies and formulation strategies to address solubility challenges range from particle size reduction and spray-dried dispersions, to hot melt extrusion and lipid-based formulations. Additionally, using our Translational Pharmaceutics® platform, we are able to streamline the development of poorly soluble molecules through the use of flexible study protocols and rapid cycles to make and test drug products. This enables faster, more reliable optimization of formulations based on arising human clinical data to reduce development risk and maximize the probability of clinical success.

In this article, we review some scientific posters published by Quotient Sciences that highlight innovative strategies to overcome challenges with poorly soluble molecules in early development.

"Flexible formulation assessments in FIH studies for poorly soluble drugs accelerates dosage form development, manufacturing and supply for patient POC trials"

Presented by Quotient Sciences at AAPS PharmSci 360, October 2020

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The purpose of this study was to investigate how the integration of formulation development and drug product manufacturing activities can affect FIH-to-POC programs for poorly soluble drugs. Integrated early development programs were designed for two molecules, based on their physicochemical and biopharmaceutic properties. In both programs, drug products were prepared either by pharmacy compounding of the NCE, compounding of a GMP (Good Manufacturing Practice) intermediate, or GMP manufacture of the finished drug products. All formulations were prepared in real time during the FIH clinical study, using arising safety and PK data to inform the drug product selection for the next study period as part of an adaptive clinical protocol. In both studies, an optimized solubility-enhanced formulation was efficiently identified to take forward into patient POC trials – a lipidic capsule formulation in the first study, and a micronized API capsule formulation in the second study.

This poster highlights how the integration of flexible compounding and GMP manufacturing within FIH-to-POC programs can streamline development, maximize the potential for clinical success, and save time and costs for poorly soluble molecules. Drug development programs using this approach have been shown to save, on average, 18 months of time when compared to traditional manufacturing practices.

"A First-in-Human (FIH) Study to Assess the Safety, Tolerability and Pharmacokinetics of Single and Multiple Doses, and Alternative Formulations of R941552 (R552): A Selective Receptor Interacting Protein 1 (RIP1) Kinase Inhibitor"

Presented by Quotient Sciences and Rigel Pharmaceuticals at the ASCPT conference, March 2022

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R552, a potent and selective RIPK1 inhibitor, is being developed by Rigel Pharmaceuticals for the treatment of autoimmune and inflammatory disorders, and pre-clinical data suggested that solubility may limit exposure. The purpose of this FIH study was to assess the safety, tolerability, and PK of R552 when administered in a lipid solution, as well as alternative SDD suspension and tablet formulations. It was found that R552 was generally safe and well tolerated at the dose levels tested, the PK of R552 was linear, and no clinically significant food effect was observed. A suitable SDD tablet formulation for R552 was identified for future patient studies.

This poster highlights how SDDs can offer an effective strategy to overcome challenges with solubility-limited exposure.

"Applications of Lipid-based Formulations and the Benefits of Integrating Manufacturing and Clinical Testing in Formulation Selection"

Presented by Quotient Sciences at the PBP conference, March 2022

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The purpose of this study was to analyze pharmaceutical and clinical data from multiple development programs conducted by Quotient Sciences over 16 years to understand the drivers for, and outcomes from, selecting and dosing different lipid formulations. Data from 34 lipid formulation programs were analyzed for the following features: formulation application, Biopharmaceutical Classification System (BCS), and in-vitro characterization methods. Various lipid-based dosage forms were developed, including solutions, suspensions, SDDs, and modified-release (MR) tablets.

This poster highlights how lipid formulations can successfully be used for solubilization, enhancing oral bioavailability, and reducing food effects for BCS Class II and IV drugs. Conventional in-vitro testing methods for different lipid formulations are poor predictors of in-vivo performance, whereas our integrated Translational Pharmaceutics platform enables the rapid identification of optimal lipid formulations based on clinical performance.

Scientific Poster Spotlight: Development of an X-ray Diffraction Method for the Quantification of API Recrystallized from Amorphous API in a Low-Dose Dry Powder Formulation Used for Inhalation

Formulation Development , Martin Wing-King

Scientific Poster Spotlight: Development of an X-ray Diffraction Method for the Quantification of API Recrystallized from Amorphous API in a Low-Dose Dry Powder Formulation Used for Inhalation

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At the Respiratory Drug Delivery (RDD) conference in April 2020, Quotient Sciences [1] presented a poster describing the development of an X-ray diffraction (XRD) method for the quantification of active pharmaceutical ingredient (API) recrystallized from amorphous API in a low-dose dry powder inhaler (DPI) formulation.

Amorphous APIs are thermodynamically unstable and prone to recrystallization over time or upon exposure to humidity, which can significantly affect the efficacy of a product. For formulations containing amorphous APIs, ICH guidelines dictate that acceptance criteria must be determined for the polymorph content of the API. While it is relatively straightforward to identify the crystalline content of an API in isolation using XRD, it is challenging when the API is in a formulation with other excipients.

In this study, a model DPI formulation was developed containing a low dose of an amorphous API that is known to recrystallize under certain conditions. To quantify the degree of crystalline API, spiked samples containing mixtures of amorphous and crystalline API in different ratios were prepared. During the method development, different sample sizes and analysis times were evaluated. XRD analysis was performed using a Panalytical X’Pert Pro instrument, with a copper radiation source and X-Celerator detector. Data analysis was performed using the HighScore software.

The data generated in this study demonstrated that a relatively simple XRD method for the detection and quantification of very low levels of recrystallized API can be developed and validated. In the future, this will be a useful tool to support the development of low-dose DPI formulations and characterize the physical form of the API.

Poster authors

1. Martin Wing-King, Jason Gray, Yuncheng Yan, Jose Ruiz, and Bildad Nyambura

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