Evan A. Thackaberry

Non-clinical toxicological considerations for pharmaceutical salt selection

Introduction: Over half of all active pharmaceutical ingredients currently approved for use in the USA are pharmaceutical salts. The safety assessment of a pharmaceutical salt provides additional challenges in addition to those encountered when assessing the safety of the free acid or base form of a new chemical entity (NCE). The addition of a counter ion may have an impact on pharmacokinetics, toxicity, impurity profile and potential route of administration. Areas covered: In this review, the toxicologic profiles of commonly used counter ions and strategies for supporting the development of novel or alternate pharmaceutical salt forms are summarized. Furthermore, the article highlights the major concerns that may be encountered by the non-clinical toxicologist when considering a novel pharmaceutical salt. Expert opinion: Given the large numbers of pharmaceutical salts approved for use in the USA, relatively little non-clinical toxicologic data are available for commonly used counter ions. This information gap leaves the non-clinical toxicologist with limited resources to assess the impact of a counter ion on the toxicologic program for an NCE. The data summarized in this review provide a starting point toward a more detailed understanding of counter ion-related effects on the toxicity of pharmaceutical salts.

Vehicle selection for nonclinical oral safety studies

Introduction: The development of poorly soluble or permeable new chemical entities within the pharmaceutical industry often requires the use of nonstandard enabling nonclinical oral formulations. Despite this, the toxicity profile of many commonly used nonclinical vehicles is poorly understood. This lack of data can lead to unexpected formulation-related effects being observed in critical oral safety studies. Areas covered: This article summarizes the key considerations for formulation selection for oral nonclinical safety studies, and provides a strategy for appropriate development-phase formulation selection. The industrys use of oral nonclinical vehicles is reviewed, based on data from the FDAs Orange Book. Finally, a summary of the repeat dose oral toxicity of commonly used vehicles is presented. Expert opinion: The rapid identification of a suitable nonclinical oral formulation is a critical step in small-molecule drug development. In order to maintain flexibility and address the needs of a diverse set of new chemical entities (NCEs) with widely varying physiochemical properties, a “tool belt” of multiple oral formulations is recommended. The appropriate formulation is identified based on the goals of the study, as well as exposure required, species, duration and therapeutic indication of the NCE.

Inflammation and immunogenicity limit the utility of the rabbit as a nonclinical species for ocular biologic therapeutics

&NA; The nonclinical safety evaluation of therapeutic drug candidates is commonly conducted in two species (rodent and non‐rodent) in keeping with international health authority guidance. Biologic drugs typically have restricted species cross‐reactivity, necessitating the evaluation of safety in non‐human primates and thus limiting the utility of lower order species. Safety studies of cross‐reactive ocular biologic drug candidates have been conducted in rabbits as a second toxicology species, despite the fact that rabbits are not a rodent species. Such studies are often confounded by the development of anti‐drug antibodies and severe ocular inflammation, the latter requiring studies to be terminated prematurely for animal welfare reasons. Notably, these confounding factors preclude the interpretation of safety. Nonclinical toxicology programs should be designed with consideration of ethical animal use and 3Rs principles (Replacement, Reduction and Refinement). The experience of several pharmaceutical sponsors, demonstrating that toxicology studies of ocular (intravitreal and topical ocular) biologic drug candidates in the rabbit are of limited interpretive value, calls into question the utility of such studies in this species and indicates that such studies should not be conducted. HighlightsToxicology studies of novel medicines are typically conducted in both rodents and non‐rodents.Rabbits are often used as a second species for the safety evaluation of ocular biologic drugs.Confounding factors preclude the interpretation of safety in these rabbit toxicology studies.Support for Phase I clinical trials is thus based primarily on non‐human primate toxicology data.Toxicology studies of ocular biologic drug candidates in rabbits should not be conducted.

Characterization of the pH and Temperature in the Rabbit, Pig, and Monkey Eye: Key Parameters for the Development of Long-Acting Delivery Ocular Strategies.

Many long-acting delivery strategies for ocular indications rely on pH- and/or temperature-driven release of the therapeutic agent and degradation of the drug carrier. Yet, these physiological parameters are poorly characterized in ocular animal models. These strategies aim at reducing the frequency of dosing, which is of particular interest for the treatment of chronic disorders affecting the posterior segment of the eye, such as macular degeneration that warrants monthly or every other month intravitreal injections. We used anesthetized white New Zealand rabbits, Yucatan mini pigs, and cynomolgus monkeys to characterize pH and temperature in several vitreous locations and the central aqueous location. We also established post mortem pH changes in the vitreous. Our data showed regional and species differences, which need to be factored into strategies for developing biodegradable long-acting delivery systems.

Determination of a No-Observable Effect Level for Endotoxin Following a Single Intravitreal Administration to Dutch Belted Rabbits

Purpose The purpose of this study was to characterize the inflammatory response and determine a no-observable effect level (NOEL) in rabbit eyes after endotoxin intravitreal (ITV) injection. Methods Fifty-three naïve male Dutch Belted rabbits were treated with a single 50-μL ITV injection ranging from 0.01 to 0.75 endotoxin units/eye (EU/eye) and monitored for up to 42 days post treatment. Ophthalmic examination included slit-lamp biomicroscopy and indirect ophthalmoscopy. Laser flare photometry was performed in a subset of animals. On days 2, 8, 16, and 43, a subset of animals was necropsied and eyes processed for histopathological evaluation. Results Intravitreal injection of endotoxin at ≥0.05 EU/eye resulted in a dose-related anterior segment inflammation response. No aqueous flare or cell response was noted in the 0.01 EU/eye dose group. A more delayed posterior segment response characterized by vitreal cell response was observed beginning on day 5, peaking on day 9, and decreasing starting on day 16 that persisted at trace to a level of 1+ on day 43. Microscopy findings of infiltrates of minimal mixed inflammatory cells in the vitreous and subconjunctiva and proteinaceous fluid in the anterior chamber and/or vitreous were observed in eyes given ≥0.1 EU/eye. Conclusions We defined the NOEL for ITV endotoxin to be 0.01 EU/eye, suggesting that the vitreal cavity is more sensitive to the effects of endotoxin than the anterior segment and aqueous chamber. These data highlight the importance of assessing endotoxin level in intravitreal formulations, as levels as low as 0.05 EU/eye may confound the safety evaluations of intravitreal therapeutics in rabbits.

Evaluation of the Toxicity of Intravitreally Injected PLGA Microspheres and Rods in Monkeys and Rabbits: Effects of Depot Size on Inflammatory Response

Purpose Poly(lactic-co-glycolic) acid (PLGA) inserts have been successfully developed for the treatment of posterior eye disease as a means of reducing injection frequency of intravitreally administered therapeutics. PLGA microspheres are also of interest for the delivery of intravitreal drugs, since they offer the advantage of being easily injected without surgical procedures or large injectors. Methods In the current study, the toxicity of PLGA microspheres and rods was investigated in nonhuman primates (NHPs) and rabbits. An in vitro assessment of cytokine responses to PLGA in peripheral blood mononuclear cells (PBMCs) and macrophages was also performed. Results Intravitreal administration of 3, 10, or 12.5 mg/eye of PLGA microspheres in NHPs resulted in a severe immune response characterized by a foreign body response. Follow-up studies in the rabbit confirmed this finding for PLGA microspheres ranging in size from 20 to 100 μm. In contrast, administration of PLGA rod implants with a similar PLGA mass did not elicit a significant immune response. In vitro assays in PBMCs and macrophages confirmed proinflammatory cytokine release upon treatment with PLGA microspheres but not PLGA rods. Conclusions These data demonstrate a lack of tolerability of PLGA microspheres upon intravitreal injection, and suggest that the size, shape, and/or surface area of PLGA depots are critical attributes in determining ocular toxicity.

Intravitreal administration of known phototoxicants in the rabbit fails to produce phototoxicity: implications for phototoxicity testing of intravitreally administered small molecule therapeutics

Abstract Context: Intravitreal (ITV) dosing has become a clinically important route of administration for the treatment of uveitis, endophthalmitis, retinal vein occlusion, diabetic macular edema and age-related macular degeneration. Despite this, there are no validated non-clinical models of phototoxicity for ITV products. Objective: The objective of this study was to develop an ITV rabbit model of phototoxicity for use in assessing the photosafety of small molecules therapeutics. Materials and methods: Dutch Belted rabbits were intravitreally injected bilaterally with four known phototoxicants: 8-methoxypsoralen, lomefloxacin, doxycycline and stannsoporfrin. Triescence®, a non-phototoxic triamcinolone acetonide steroid formulation designed for ITV administration, was used as a negative control. One eye was then irradiated with solar-simulated ultraviolet radiation for 30 min, 1 h after dosing, while the other eye was occluded, serving as a non-irradiated control. Results: Despite the direct administration of known phototoxicants into the vitreous, no evidence of ocular phototoxicity was observed in any dose group. Direct (non-phototoxic) retinal toxicity was observed in the doxycycline dose group only. Conclusion: These data suggest that the posterior segment of the rabbit eye is protected against phototoxicity by anatomical and/or physiological mechanisms, and is not a useful model for the assessment of phototoxicity of intravitreally administered molecules.

Lens Capsule Perforation Without Inflammation in 4 Rabbits From Intravitreal Injection Studies

Historically, it was thought that lens protein was sequestered, and injury to the lens capsule causing release of lens material into the eye would always result in ocular inflammation. Currently, it is believed that lens antigens are recognized as self, subject to normal T-cell tolerance. Three different single-dose intravitreal injection/implantation studies of 4 different test materials, ranging from 4 to 6 weeks in length, were performed in New Zealand White rabbits. The test materials included polymer microspheres, polymer rods, a solvent, and a hydrogel. Intravitreal injection/implantation procedures were performed on day 1, and indirect ophthalmoscopy and slit-lamp biomicroscopy examinations were performed by board-certified veterinary ophthalmologists periodically throughout the course of each study. None of the affected animals received corticosteroids or other immunomodulatory agents during the course of the studies. Four rabbits had perforation of the posterior lens capsule during the injection/implantation procedure on day 1, visible on clinical ophthalmic examination as lens capsule alterations described as “lens hits” and/or incipient posterior cataracts. Findings on slit-lamp biomicroscopy examination were limited to vitreous cells in 2 of the animals, although not centered on the area of lens capsule disturbance. Histologically, there was no evidence of inflammation in association with extruded lens protein material in any of the affected eyes. These results indicate that iatrogenic damage to the lens capsule during aseptically performed intravitreal injections/implantations does not appear to induce inflammation in rabbits.

Corrigendum to “Inflammation and immunogenicity limit the utility of the rabbit as a nonclinical species for ocular biologic therapeutics” [Regul. Toxicol. Pharmacol. (2017) 221–230]

Corrigendum to “Inflammation and immunogenicity limit the utility of the rabbit as a nonclinical species for ocular biologic therapeutics” [Regul. Toxicol. Pharmacol. (2017) 221e230] Christina L.Zuch de Zafra a, , Vito G. Sasseville , Steven Matsumoto , Christian Freichel , Mark Milton , Timothy K. MacLachlan , Cindy Farman , Iona Raymond , Swati Gupta , Ronald Newton , Elke-Astrid Atzpodien , Evan A. Thackaberry a a Safety Assessment, Genentech, Inc., South San Francisco, CA, United States b Preclinical Safety, Novartis Institutes for BioMedical Research, Cambridge, MA, United States c Nonclinical and Translational Sciences, Allergan, Irvine, CA, United States d Pharmaceutical Sciences, Roche Innovation Center Basel, Basel, Switzerland e Drug Metabolism and Pharmacokinetics, Novartis Institutes for BioMedical Research, Cambridge, MA, United States