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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5577_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •About the Authors
- •Preface
- •Acknowledgements
- •Contents
- •1.1. Singapore as a British Colony
- •1.5.1. Levelling Up the Pharmaceutical Inspection System of Singapore
- •1.5.2. Advantages of PIC/S Membership to Singapore and Other Participating Authorities
- •1.6. Emergence of MNC Pharmaceutical Manufacturing Industry in Singapore
- •1.6.1. Why do MNC Pharmaceutical Manufacturers Set Up Facilities in Singapore?
- •2.2. Geographical Background of ASEAN vis-à-vis Asia and the Rest of the World
- •2.4. Formation of an ASEAN MRA Taskforce on GMP Inspection
- •2.5. Signing of ASEAN Sectoral MRA on GMP Inspection
- •2.6. Formation of ASEAN JSC on GMP Inspection and Establishing Register of ASEAN LIS
- •2.8. Assessment of FDA Philippines by ASEAN PoE
- •2.9. Register of ASEAN Listed Inspection Services (LIS)
- •3.1. Introduction: Urgency of Training ASEAN Inspectors
- •3.3. Collaboration with Korea Ministry of Food and Drug Safety (MFDS)
- •3.4. Collaboration with the Generics and Biosimilars Initiative (GaBI)
- •3.5. Pre-employment Training in Pharmacy and Pharmaceutical Science Schools
- •4.1. Introduction
- •4.2. Historical Context to WHO Reliance Initiative
- •4.3. The First NRAs to Achieve ML4 and WLA Status
- •4.5. Other International Reliance and Harmonization Initiatives
- •4.5.1. Access Consortium
- •4.5.2. Association of Southeast Asian Nations (ASEAN)
- •4.5.3. East African Community (EAC)
- •4.5.4. European Medicines Agency (EMA)
- •4.5.6. International Council for Harmonization (ICH)
- •4.5.6.1. Introduction
- •4.5.6.2. ICH Members and Observers
- •4.5.6.3. Future Direction
- •4.5.7.1. Introduction
- •4.5.7.2. Addressing Common Regulatory Issues
- •4.5.7.3. ICMRA Pilot Program for Collaborative Hybrid Inspection
- •4.5.8. International Pharmaceutical Regulators Program (IPRP)
- •4.5.9. Latin America
- •4.5.10. Pharmaceutical Inspection Co-operation Scheme (PIC/S)
- •4.5.10.1. Introduction
- •4.5.10.2. PIC/S Participating Authorities
- •4.5.11. WHO Collaborative Registration Procedure for Medical Products (CRP)
- •4.5.12.1. Introduction
- •4.5.12.3. WHO Inspection Report
- •4.5.13. ZaZiBoNa
- •4.6. Conclusion
- •5.1. Introduction to GMP
- •5.2. Overview of the PIC/S GMP Standard
- •5.3. How is an On-site GMP Inspection Conducted?
- •5.3.1. Why is the Warehouse Inspected?
- •5.3.3. Why are the Production Areas Inspected?
- •5.3.4. Why are the Packaging Areas Inspected?
- •5.3.5. Why are the QC Laboratories Inspected?
- •5.3.6. Why do GMP Inspectors Visit Other Miscellaneous Areas?
- •5.3.8. Why is there a Need to Conduct Documentation Audit/Review?
- •5.3.8.1. Assessing Product Quality Review
- •5.3.8.3. Assessing Self-Inspection Program
- •5.4. The 20 Annexes of PIC/S GMP Standard
- •5.5. PIC/S Inspection System: A Risk-based Approach
- •5.5.1. Whom can the GMP Inspector Interview?
- •5.5.2.1. Inspector’s Expectations of a Manufacturer
- •5.5.2.2. Manufacturer’s Expectations of an Inspector
- •5.6. Who Inspects the Inspectors?
- •6.1. Historical Development of Pharmaceutical Quality
- •6.2. What is a High-Quality Medicinal Product?
- •6.3. Purity of a Medicinal Product: Elimination of Impurities and Contaminants
- •6.3.1. What is a Contaminated Medicinal Product?
- •6.3.2. Why is There a Need to Control Impurities?
- •6.3.2.1. Types of Impurities from APIs
- •6.3.2.2. Types of Impurities from Container-Closure System
- •6.3.3. Control of Intrinsic Contaminants
- •6.3.4. Control of Extrinsic Contaminants
- •6.3.5. General Assessment of Cross-Contamination Risks
- •6.4. Stability and Shelf-Life Testing of a Medicinal Product
- •6.4.1. Why is Proper Storage, Distribution and Handling of a Medicinal Product Important?
- •6.6. Summary of High-Quality Medicinal Products
- •7.1. Introduction to Stability and Quality
- •7.3.1. Why is Proper Storage Important?
- •7.3.2. Why is Proper Transportation of a Medicinal Product Important?
- •7.3.3. Why is Proper Handling of a Medicinal Product during Use Important?
- •7.4.1. Number and Size of Batches
- •7.4.2. Testing Frequency
- •7.4.3. Storage Conditions
- •7.4.4. Test Methods
- •7.4.5. Container-Closure Systems
- •7.5. Stability Study Schedule and Report
- •7.6. Temperature Excursions and Product Stability
- •7.8. Cold Chain Products and Temperature Excursions
- •7.11. Conclusion
- •8.1. Christopher Columbus versus the Vikings
- •8.4. Pharmaceutical Data Integrity and ALCOA
- •8.5. Article(s) on Pharmaceutical Data Integrity
- •Introduction
- •Current trends
- •Reasons for Data Integrity violations (inadvertent and intentional)
- •Assuring and promoting Data Integrity via legislation and guidance documents
- •Legislation
- •Guidance documents
- •Proposed Solutions to Better Promote and Assure Data Integrity
- •Culture of integrity
- •Database management systems
- •Robust quality agreements
- •Collaboration between countries
- •Computerized systems validation
- •List of abbreviations
- •Conclusion
- •Authors
- •References
- •9.1. Pharmaceuticals versus Biopharmaceuticals
- •9.2. Transcription and Translation: Central Dogma of Genetics
- •9.3. Biotechnology-derived Medicinal Products: Microbial versus Mammalian Substrates
- •9.4. Manufacture of Biotechnology-derived Medicinal Products: Key Processes
- •Introduction
- •Manufacture of biopharmaceuticals — an overview
- •Procurement and testing of biological starting materials
- •Generation and characterization of cell banks/seed lots
- •Cell culturing
- •Challenges concerning manufacture of biopharmaceuticals
- •Extensive process and product understanding required
- •Inherent variability of host cells
- •Downstream processing remains a key bottleneck
- •Review of current GMP frameworks for biopharmaceuticals
- •Challenges in the regulation of biopharmaceuticals
- •Resource-intensive evaluation of biosimilarity
- •Growing number of data integrity lapses
- •Proposed solutions to challenges of biopharmaceuticals
- •Optimizing biopharmaceutical manufacturing with Industry 4.0
- •Enhancing data integrity with a culture of quality (quality culture)
- •Conclusion
- •List of abbreviations
- •Authors
- •References
- •10.1. Introduction
- •10.2. Advantages of Nanomedicines
- •10.3. Types of Nanomedicines
- •10.3.1. Nanocarrier Systems
- •10.3.2. Nanosuspensions
- •10.4. Future of Nanomedicines
- •10.5. GMP Requirements Governing Nanomedicines and Challenges
- •10.5.1. Lack of Trained Personnel to Operate Manufacturing Processes
- •10.5.2. Lack of Safety Protocol for Manufacturing Personnel
- •10.5.3. Challenges in Controlling for Nanoparticle Contamination
- •10.6. Conclusion
- •11. Novel and Traditional Vaccines
- •11.1. Historical Development and Evolution of Traditional and Novel Vaccines
- •11.2. Traditional Vaccines Versus Novel Vaccines
- •Introduction
- •Traditional vaccines
- •Novel vaccines
- •Vaccine manufacture
- •Vaccine storage, transport and distribution
- •Regulatory controls
- •Challenges, safety and quality issues and possible solutions
- •Conclusion
- •Authors
- •References
- •12.1. Cells and Tissues
- •12.2. Gene Therapy Products
- •12.3. Published Article on CTGTPs
- •Introduction
- •CTGTPs and their principles of action
- •Manufacturing of CTGTPs
- •Premises and equipment
- •Materials and processing
- •Starting material
- •Quality control
- •Cryopreservation
- •Human resource and accreditation
- •Potential solutions to the challenges encountered in manufacturing
- •Outsourcing
- •Technology
- •Control of CTGTPs
- •Current regulatory framework
- •Risk-based approach
- •Conclusion
- •Authors
- •References
- •13. Hand Sanitizers
- •13.1. What are Hand Sanitizers?
- •13.4. Published Article and Commentary on Hand Sanitizers
- •Introduction
- •The microbiology of bacteria, fungi and viruses
- •Antimicrobial compounds and their applications in hand sanitizers
- •FDA policy for testing of alcohol and USP limits for methanol
- •Common myths about hand sanitizers
- •A lack of regulatory framework
- •Proposed solutions
- •Tightening the regulatory framework
- •Training pharmacists on hand sanitizer vigilance
- •Public Education
- •Conclusion
- •Authors
- •References
- •14. Pharmaceutical Dosage Forms
- •14.1. Introduction
- •14.2. What Are Pharmaceutical Dosage Forms?
- •14.4.1. Routes of Administration
- •14.4.1.1. Oral Dosage Forms — Solids
- •14.4.1.2. Oral Dosage Forms — Liquids
- •14.4.1.3. Topical Dosage Forms
- •14.4.1.5. Inhaled Dosage Forms
- •14.4.1.6. Ophthalmic Dosage Forms
- •14.4.1.7. Nasal Dosage Forms
- •14.4.1.8. Otic Dosage Forms
- •14.4.1.9. Rectal Dosage Forms
- •14.4.1.10. Vaginal Dosage Forms
- •14.4.1.11. Transdermal Patch
- •14.4.2. Physical Forms
- •14.4.2.1. Solid Dosage Forms
- •14.4.2.2. Liquid Dosage Forms
- •14.4.2.3. Semi-solid Dosage Forms
- •14.4.2.4. Gaseous or Aerosol Dosage Forms
- •14.5. Manufacture and Important Characteristics of Common Pharmaceutical Dosage Forms
- •14.5.1. Tablets
- •14.5.2. Capsules
- •14.5.3. Solutions
- •14.5.4. Suspensions
- •14.5.5. Emulsions
- •14.5.6. Creams
- •14.5.7. Ointments
- •14.5.8. Metered Dose Inhalers
- •14.6. Overall Summary of the Manufacture of a Pharmaceutical Dosage Form
- •15.1. Introduction

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Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
Structure of Lovastatin
Molecular weight: 404.5 Daltons
Structure of Immunoglobulin G
Molecular weight: 150,000 Daltons
while biopharmaceuticals have complex structures and are more
dicult to characterize (and to reproduce or to copy identically).
This is one of the reasons we do not have generics for biopharmaceuticals as we have for pharmaceuticals. For biopharmaceuticals,
we use the terms biosimilars or follow-on biologics, rather than
generic biopharmaceuticals. Another clear and important dierence between pharmaceuticals and biopharmaceuticals is that pharmaceuticals are more stable while biopharmaceuticals are generally
sensitive to heat and pH changes, as the latter is generally composed
of proteins. Biopharmaceuticals are also generally more targetspecific, and therefore less toxic to other cells and tissues.
Traditionally, many biological medicinal products were passively
extracted from human and animal tissues. Examples of traditional
biological medicinal products include smallpox and rabies vaccines,
heparin and antivenoms. Today, the newer biologics are produced
via biotechnology using microbial (bacteria, yeast), mammalian,
insect and plant cells. Examples of newer biologics include human
insulin and other recombinant DNA proteins, monoclonal antibodies and novel vaccines.

Manufacture and Supply, Science and Reg ulation of Biopha rmaceutical Products
263
According to a Newsweek issue published at the beginning of the
new millennium, the 21
st
century will witness the Biotech Boom
where medicinal products are concerned. In this new millennium,
biotechnology and biopharmaceuticals will prevail over synthesisand chemical-based pharmaceutical products. Today, more and
more biotechnology-derived medicinal products rather than chemical-based pharmaceutical products are coming out from manufacturing pipelines of innovator drug companies as well as startups.
Biotechnology involves the use (or exploitation) of living organisms to produce food or to obtain products to improve human and
animal health. Products from classical (traditional) biotechnology
include cheese, yoghurt, beer and penicillin, whereas products from

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Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
modern biotechnology (such as recombinant DNA technology and
hybridoma technology) include hormones, enzymes, recombinant
proteins, monoclonal antibodies and novel vaccines.
9.2. Transcription and Translation: Central Dogma of Genetics
If you have studied or read molecular biology or biochemistry, you
will be familiar with the process of transcription and translation.
Within each living cell, there is a nucleus, the cytoplasm and other
functional organelles. The messenger RNA (mRNA) transcribes
genetic information from the genes or DNA in the nucleus with
the help of DNA polymerase, and pass it on to the transfer RNA
(tRNA). The tRNA carries the transcribed DNA information to the
ribosomes (protein factories) where protein synthesis (translation)
takes place.
The transcription of DNA and its eventual translation into protein has been referred to as the Central Dogma of Genetics or Central Dogma of Molecular Biology. The genetic code in the DNA is

Manufacture and Supply, Science and Reg ulation of Biopha rmaceutical Products
transcribed with the help of mRNA (code in transit) and translated
into proteins as the final decoded product. This Central Dogma is a
fundamental concept of Molecular Biology.
9.3. Biotechnology-derived Medicinal Products: Microbial versus Mammalian Substrates
The manufacture of biotechnology-derived medicinal products
involves cell substrates such as those of microorganisms (e.g., bacteria and yeast), mammals (e.g., Chinese hamster ovary), rodents (e.g.,
rat or murine) and insects. Microbial cells and mammalian cells
are the two most common cell substrates used in biotechnology.
Appended below is a table of comparison between these two types
of cell substrates.
265
Microbial Substrate Mammalian Substrate
1. Faster cultivation, relatively
straightforward fermentation
process.
2. Proteins secreted within cells;
disruption of cell needed during
harvesting to obtain product.
3. Lower yield due to more dicult
purification process.
4. Simpler proteins which are
non-glycosylated produced.
5. Relatively safe biotechnology-
derived medicine produced.
1. Slower cultivation, more complicated
cell culture (growth) process.
2. Products secreted outside cells; no cell
disruption needed.
3. Higher yield due to less complicated
purification process.
4. More complex proteins produced with
glycosylation and post-translational
modifications involved.
5. Several safety issues, including potential presence of endogenous viruses and
residual DNA, in the final product.

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Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
In the early days of biopharmaceutical production, mammalian cells
were not commonly used as substrates in the manufacture of biotechnology-derived medicinal products as there were initial safety
concerns. For example, transformed mammalian cells (generated
via hybridoma technology) have unlimited capacity for continuous
population doubling. They are immortal cells and are potentially
oncogenic. Hence, there were fears of possible contamination of
the eventual biological medicinal product with residual (oncogenic)
DNA from the mammalian host cell or substrate. This fear held up
the use of mammalian cells as a substrate for many years. Fears were
allayed by a 1986 WHO Study Report (and other subsequent scientific reports) which concluded that there was no reason to exclude
continuous mammalian cell lines for biological production, if the
purification process can reduce residual DNA to 10 nanograms per
dose or lower. Today, mammalian cells, in particular Chinese hamster ovary cells, are the substrates of choice for the manufacture of
many therapeutic monoclonal antibodies and biotechnology-derived
medicinal products. They produce high yields and possess the ability
to perform post-translational modifications, including the production of therapeutic proteins which are glycosylated. There is also a
successful approval history from medicines regulatory authorities
involving therapeutic monoclonal antibodies and recombinant proteins produced using Chinese hamster ovary cells as the substrate.
9.4. Manufacture of Biotechnology-derived Medicinal Products: Key Processes
In the manufacture of biotechnology-derived medicinal products, contamination and cross-contamination control are critical

Manufacture and Supply, Science and Reg ulation of Biopha rmaceutical Products
processes which must be managed. The following are key considerations during their manufacture:
• genetic stability of cell substrate with expression construct
(vector);
• consistency of manufacturing process and product yield;
• contamination by endogenous and adventitious organisms
(including viruses);
• presence of impurities from media proteins and starting
materials; and
• presence of residual DNA.
Moreover, in the manufacture of biotechnology-derived medicinal
products, a slight change in any key manufacturing process can
have major impacts on the quality, safety, ecacy and, therefore,
the clinical performance of the final product. Thus, each biotechnology-derived medicinal product is considered as an “innovative
product”. It is dicult to make an identical copy of a biotechnology-derived product; hence, the term “biosimilar product” is used
instead of the term “generic product”, as in the case of a copy of a
chemical-based pharmaceutical product.
267
The key steps in the manufacture of a biotechnology-derived medicinal product involve:
(1) Cell Bank (Cell Storage) System
(2) Cell Culture (Fermentation)
(3) Isolation (Extraction)
(4) Purification
(5) Viral (Removal or) Inactivation

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Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
(6) Storage of Bulk Biotech/Biological Product
(7) Formulation, Packaging and Sterilization
(8) QC and Batch Release of Finished Dosage Form
The specific GMP requirements for the manufacture of biotechnology-derived medicinal products are stipulated under Annex 2B of
the PIC/S Guide to GMP for Medicinal Products (Part I) and the
PIC/S Guide to GMP for Active Pharmaceutical Ingredients (also
known as Part II).
For further reading on the subject of Manufacture and Supply, Science and Regulation of Biopharmaceutical Products, you should
read the article entitled “Global Challenges in the Manufacture,
Regulation and International Harmonization of GMP and Quality Standards for Biopharmaceuticals”, by Sia Chong Hock, Sia
Ming Kian and Chan Lai Wah, published in GaBI Journal (Volume 1
| 2020 | Issue 2). Copyright © 2020 Pro Pharma Communications
International. This article has been reproduced with permission
from the publisher of GaBI Journal, and it appears immediately after
this introduction.

Manufacture and Supply, Science and Reg ulation of Biopha rmaceutical Products
Global challenges in the manufacture,
regulation and international harmoni-
zation of GMP and quality standards for
biopharmaceuticals
Adjunct Associate Professor Sia Chong Hock*1, BSc (Pharm), MSc; Sia Ming
Kian1, BSc (Pharm) (Hons); Associate Professor, Chan Lai Wah1, BSc (Pharm)
(Hons), PhD
269
Biopharmaceuticals belong to a class of medicinal products whose
active pharmaceutical ingredient (API) is manufactured using living
systems such as microbial and mammalian cells. With the patent
expiry of the originator biopharmaceuticals, a surge in the production of biopharmaceuticals in the form of biosimilars is to be
expected. However, biopharmaceuticals are inherently more complex
than conventional chemical-based pharmaceuticals, hence requiring
a more complicated manufacturing process. This paper provides a
brief overview of the biopharmaceutical manufacturing processes
and reveals that most biopharmaceuticals share similar processes
and considerations. The complex nature of biopharmaceuticals presents various manufacturing challenges such as the inherent variation in quality and demand for extensive process and product understanding. Furthermore, downstream processing bottleneck also
presents another manufacturing challenge. A brief comparison of
the good manufacturing practice (GMP) standards of various regulatory authorities (RAs) and international organizations (IOs) reveals

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Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
that the standards are largely similar and appropriate in addressing
the manufacturing challenges. This review is one of the few covering
the biopharmaceutical industry and the regulatory framework of the
Association of South East Asian Nations (ASEAN). However, GMP
alone does not address regulatory challenges such as evaluation of
biosimilarity, diering outlook on interchangeability and a growing
occurrence of data integrity lapses. Solutions such as the implementation of Industry 4.0, improved harmonization of regulatory eorts
and creating a culture of quality within the organization may help
to address the forgoing challenges.
Keywords: ASEAN, biopharmaceuticals, biopharmaceutical manufacturing, good manufacturing practice, harmonization, regulatory
guidelines
Introduction
Biopharmaceuticals belong to a class of medicinal products whose
active pharmaceutical ingredient (API) is manufactured using living systems such as microbial, mammalian, insect, plant or animal
cells. According to the Pharmaceutical Inspection Co-operation
Scheme (PIC/S), a medicinal product is defined as any medicine or
similar product intended for human use, which is subject to control
under health legislation [1]. The API in the medicinal product is
responsible for furnishing a pharmacological or other direct eect
in the diagnosis, cure, mitigation, treatment or prevention of the
disease, or alteration of the structure or function of the body [2].
Depending on the regulatory authorities (RAs), biopharmaceuticals
may be termed as ‘biologics’, ‘biological medicines’ or ‘biotherapeutics’ [3–5]. Biotechnological methods such as ex vivo expansion [6–8],

Manufacture and Supply, Science and Reg ulation of Biopha rmaceutical Products
recombinant deoxyribonucleic acid (rDNA) or hybridoma technologies are typically employed to produce biopharmaceuticals. Examples
of biopharmaceuticals are vaccines, insulins, monoclonal antibodies
(mAbs) and other therapeutic proteins [9]. Cell-based, tissue-based
or gene-based therapeutic products, also known as ‘advanced therapy medicinal products’ (ATMPs) in the European Union (EU), are
also considered biopharmaceuticals [10]. Biosimilars, also termed
‘subsequent-entry biologics’ and ‘similar biotherapeutic products’,
are biopharmaceuticals which are highly similar in terms of safety,
ecacy and quality with the innovator biopharmaceutical [11]. Such
similarities are demonstrated using comparability studies with the
reference product, which is the innovator biopharmaceutical that
has received market authorization by the relevant RAs [12].
Frost & Sullivan has estimated that US$16.83 billion worth of biopharmaceuticals in the global market would lose their patent from
2015 to 2025. The global biosimilar market is expected to grow at a
compound annual growth rate of 31.5% and reach US$66.33 billion
during the same period [13]. Given the highly promising outlook
of the biopharmaceutical market, manufacturers are motivated to
invest in the manufacturing of biopharmaceuticals. However, there
are major dierences between biopharmaceuticals and the conventional chemical-based pharmaceuticals which may necessitate the
use of dierent types of manufacturing facilities and standards.
271
Biopharmaceuticals consist of API molecules with a highly complex structure and very high molecular mass [14], ranging from
thousands to hundred-thousands of Daltons. In comparison, conventional chemical-based pharmaceuticals consist of API molecules that are significantly smaller, and possess a much simpler
molecular structure, see Figure 1. As such, the characterization
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