Skip to main content

Regulatory Aspects and Approval of Biopharmaceuticals for Mucosal Delivery: Quality, Toxicology, and Clinical Aspects

  • Chapter
  • First Online:
Mucosal Delivery of Biopharmaceuticals

Abstract

Regulation of products for mucosal application has many points in common with products for other routes but also some that are unique. Identifying regulatory pitfalls is of tremendous importance early in development as this saves time, money, and nerves. There is a huge amount of regulatory advice available from the different players in the field (governments and related organizations) that is partly very general or exceptionally specific. This chapter is meant to provide guidance on what to find, where and who to ask if certain questions arise. It also provides a description of common and known problems differentiated by the three major parts: quality, preclinical, and clinical development. Finally, special key points focusing on pediatric use, use of genetically modified organisms or products classified as advanced therapy medicinal products are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Abbreviations

BA:

Bioavailability

BE:

Bioequivalence

EMA:

European Medical Agency

ERA:

Environmental risk assessment

FDA/CBER:

Food and Drug Agency/Center for Biologics Evaluation and Research

FBS:

Fetal bovine serum

GMO:

Genetically modified organism

ICH:

International Conference of Harmonization

IMP:

Investigational medicinal product

MABEL:

Minimal anticipated biological effect level

NOAEL:

No observed adverse effect level

PCR:

Polymerase Chain Reaction

PD:

Pharmacodynamics

PDCO:

Pediatric Committee

Ph. Eur.:

European Pharmacopoeia

PIP:

Pediatric investigation plan

PK:

Pharmacokinetics

USP:

United States Pharmacopoeia

References

  1. Holmgren J, Czerkinsky C. Mucosal immunity and vaccines. Nat Med. 2005;11(4):45–53.

    Article  Google Scholar 

  2. Ryan EJ, Daly LM, Mills KHG. Immunomodulators and delivery systems for vaccination by mucosal routes. Ternds Biotech. 2001;19(8):293–304.

    Article  CAS  Google Scholar 

  3. ICH Topic S6 (R1) Preclinical safety evaluation of biotechnology-derived pharmaceuticals. 1997. Addendum to the Parent Guideline (2009).

    Google Scholar 

  4. WHO guidelines on nonclinical evaluation of vaccines. 2003. www.who.int/biologicals/publications/nonclinical_evaluation_vaccines_nov_2003.pdf.

  5. Guidelines for assuring the quality and nonclinical safety evaluation of DNA vaccines. WHO Technical Report Series No 941. 2007.

    Google Scholar 

  6. Guideline on adjuvants in vaccines for human use. 2005. EMEA. EMEA/CHMP/VEG/134716/2004.

    Google Scholar 

  7. Guideline on the non-clinical studies required before first clinical use of gene therapy medicinal products. 2008. EMEA. EMEA/CHMP/GTWP/125459/2006.

    Google Scholar 

  8. Note for guidance on the quality, preclinical and clinical aspects of gene transfer medicinal products. 2001. EMEA. CPMP/BWP/3088/99.

    Google Scholar 

  9. Guideline on quality, non-clinical and clinical aspects of live recombinant viral vectored vaccines. 2010. EMA. EMA/CHMP/VWP/141697/2009.

    Google Scholar 

  10. Note for guidance on preclinical pharmacological and toxicological testing of vaccines. 1997. EMEA. CPMP/SWP/465/95.

    Google Scholar 

  11. Guidance for industry and review staff. “Nonclinical safety evaluation of reformulated drug products and products intended for administration by an alternative route”. 2008.

    Google Scholar 

  12. Guidance for Industry:“Considerations for plasmid DNA vaccines for infectious disease indications”. 2007. http://www.fda.gov/biologicsbloodvaccines/guidancecomplianceregulatoryinformation/guidances/vaccines/ucm074770.htm.

  13. Guidance for Industry: “ Consideration for developmental toxicity studies for preventive and therapeutic vaccines for infectious disease indications”. 2006. http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Vaccines/ucm074827.htm.

  14. Pires A, Fortuna A, Alves G, et al. Intranasal drug delivery: how, why and what for? J Pharm Pharm Sci. 2009;12(3):288–311.

    CAS  PubMed  Google Scholar 

  15. Makidon PE, Nigavekar SS, Bielinska AU, et al. Characterization of stability and nasal delivery systems for immunization with nanoemulsion-based vaccines. J Aerosol Med Pulm Drug Deliv. 2010;23(2):77–89.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Illum L. Nasal drug delivery—recent developments and future pro-spects. J Control Release. 2012;161(2):254–63.

    Article  CAS  PubMed  Google Scholar 

  17. Wang SH, Thompson AL, Hickey AJ, et al. Dry powder vaccines for mucosal administration: critical factors in manufacture and delivery. Curr Top Microbiol Immunol. 2012;354:121–56.

    CAS  PubMed  Google Scholar 

  18. ICH Topic Q6B: specifications: test procedures and acceptance criteria for biotechnological/biological products.

    Google Scholar 

  19. FDA guidance for industry: characterization and qualifications of cell sub-strates and other biological materials used in the production of viral vaccines for infectious disease indications.

    Google Scholar 

  20. Guideline on the pharmaceutical quality of inhalation and nasal products; EMEA/CHMP/QWP/49313/2005.

    Google Scholar 

  21. Guideline on comparability of medicinal products containing biotechnology-derived proteins as active substance: quality issues; EMEA/CPMP/BWP/3207/00/Rev1.

    Google Scholar 

  22. Towns J, Webber K. Demonstrating comparability for well-characterized biotechnology products. Bioprocess Int. 2008;2(6):32–43.

    Google Scholar 

  23. ICH Topic Q5E Comparability of biotechnological/biological products.

    Google Scholar 

  24. Guideline on similar biological medicinal products containing biotechnology-derived proteins as active substance: quality issues; EMEA/CHMP/BWP/49348/2005.

    Google Scholar 

  25. US Food and Drug Administration (FDA) Guidance for industry: bioavailability and bioequivalence studies for nasal aerosols and nasal sprays for local action; FDA Washington, DC; 2003.

    Google Scholar 

  26. ICH topic Q5C quality of biotechnological products: stability testing of bio-technological/biological products.

    Google Scholar 

  27. Guidelines on stability evaluation of vaccines; WHO/BS/06.2049.

    Google Scholar 

  28. Lovelyn C, Attama A. Current state of nanoemulsions in drug delivery. J Biomater Nanobiotechnol. 2011;2(5A):626–39.

    Article  CAS  Google Scholar 

  29. Anliker B, Longhurst S, Buchholz CJ. Bundesgesundheitsbl. 2010;53:52–7.

    Article  CAS  Google Scholar 

  30. Guideline on plastic immediate packaging materials; CPMP/QWP/4359/03.

    Google Scholar 

  31. Guideline on the suitability of the graduation of delivery devices for liquid dosage forms; EMEA/CHMP/QWP/178621/2004.

    Google Scholar 

  32. Guideline on Excipients in the dossier for application for marketing authorization of a medicinal product; EMEA/CHMP/QWP/396951/2006.

    Google Scholar 

  33. Directive 2001/83/EC of the European parliament and of the council of 6 November 2001 on the Community code relating to medicinal products for human use. Official J L. 2001;311:67–128.

    Google Scholar 

  34. Code of Federal Regulation, Title 21, Part 312, Washington, DC, US Government Printing Office. 2010. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=210&showFR=1.

  35. Guideline on non-clinical testing for inadvertent germline transmission of gene transmission of gene transfer vectors. 2005. EMEA. EMEA/273974/05.

    Google Scholar 

  36. ICH Guideline M3 (R2) on non-clinical safety studies for the conduct of human clinical trials and marketing authorization for pharmaceuticals. Step 5. 2009. EMA/CPMP/ICH/286/1995.

    Google Scholar 

  37. Guideline on repeated dose toxicity. 2010. CPMP/SWP/1042/99 Rev 1 Corr.

    Google Scholar 

  38. ICH—S5A Guideline on detection of toxicity to reproduction for medicinal products. 1994.

    Google Scholar 

  39. Guideline on the need for non-clinical testing in juvenile animals on human pharmaceuticals for paediatric indications. 2005. EMEA. Doc. Ref. EMEA/CHMP/SWP/169215/2005.

    Google Scholar 

  40. WHO Guidelines on the quality, safety and efficacy of dengue tetravalent vaccines (live, attenuated). 2011.

    Google Scholar 

  41. WHO recommendations to assure the quality, safety and efficacy of live attenuated poliomyelitis vaccine (oral). 2012.

    Google Scholar 

  42. WHO Guidelines on the quality, safety and efficacy of japanese encephalitis vaccine (live, attenuated) for human use. 2012.

    Google Scholar 

  43. Note for guidance on the development of vaccinia virus-based vaccines against smallpox. 2002. EMEA. CPMP/1100/02.

    Google Scholar 

  44. IABS scientific workshop on neurovirulence tests for live attenuated viral vaccines. 2005. WHO.

    Google Scholar 

  45. Mutsch M, Zhou W, Rhodes P, Bopp M, Chen RT, Linder T, Spyr C, Steffen R. Use of the inactivated intranasal influenza vaccine and the risk of Bell’s palsy in Switzerland. N Engl J Med. 2004;350(9):896–903.

    Article  CAS  PubMed  Google Scholar 

  46. Guideline on clinical evaluation of new vaccines, EMEA/CHMP/VWP/164653/2005; www.ema.europa.eu.

  47. ICH Topic E 1, Population exposure: the extent of population exposure to assess clinical safety, www.ich.org.

  48. Pediatric Decision Tree. US Food and Drug Administration. Specific requirements on content and format of labelling for human prescription drugs: revision of “pediatric use” subsection in the labeling: final rule. FedRegist. 1994;59. www.fda.gov.

  49. ICH E11 Clinical Investigation of medicinal products in the paediatric population, www.ich.org.

  50. Role of Pharmacokinetics in the development of medicinal products in the Paediatric Population, CHMP/EWP/147013/2004, www.ema.europa.eu.

  51. Concept paper on extrapolation of efficacy and safety in medicine development, EMA/129698/2012, www.ema.europa.eu.

  52. Guideline on clinical trials in small populations, CHMP/EWP/83561/2005, www.ema.europa.eu.

  53. Providing clinical evidence of effectiveness for human drugs and biological products, http://www.fda.gov/cder/guidance/.

  54. Ellis SJ, Baddely. Buccal midazolam and rectal diazepam for epilepsy. Lancet. 1999;353(9166):1796–7.

    Article  CAS  PubMed  Google Scholar 

  55. Clinical AR of FluMist® www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts.

  56. E Rey, JM Treluyer, G Pons, Pharmacokinetic optimization of benzodiazepine therapy for acute seizures. Focus on deliveryroutes, Clinpharmacokinet. 1999;36:409–24.

    Article  CAS  Google Scholar 

  57. Food-effect bioavailability and fed bioequivalence studies, FDA guidance for industry, www.fda.gov/cder/guidance/.

  58. Note for guidance on modified release oral and transdermal dosage forms: SECTION II (Pharmacokinetic and clinical evaluation), CPMP/EWP/280/96, www.ema.europa.eu.

  59. Guideline on the investigation of drug interactions; CPMP/EWP/560/95/Rev. 1, www.ema.europa.eu.

  60. Bioavailability and bioequivalence studies for nasal aerosols and nasal sprays for local Action, FDA Guidance for Industry, http://www.fda.gov/cder/guidance/.

  61. US Food and Drug Administration (FDA). Guidance for industry and reviewers. Estimating the safe starting dose in clinical trials for therapeutics in adult healthy volunteers (FDA, Washington, DC; 2002). www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/.

  62. Suntharalingam G, et al. N Engl J Med. 2006;355:1018–28.

    Article  CAS  PubMed  Google Scholar 

  63. Guideline on Strategies to identify and mitigate risks for first-in-human clinical trials with investigational medicinal products, CHMP/SWP/28367/07, www.ema.europa.eu.

  64. Goetz KB, Pfleiderer M, Schneider CK. First-in-human clinical trials with vaccines–what regulators want. Nat Biotechnol. 2010;28(9):910–6.

    Article  CAS  PubMed  Google Scholar 

  65. Guideline for the study of drugs likely to be used in the elderly, US Department of Health and Human Services, Food and Drug Administration, 1989. www.fda.gov/cder/guidance/.

  66. Studies in support of special populations: geriatrics, ICH Topic E7, www.ich.org.

  67. Romero-Steiner S, et al. Reduction in functional antibody activity against streptococcus pneumoniae in vaccinated elderly individuals highly correlates with decreased IgG antibody avidity. Clin Infect Dis. 1999;29(2):281–8.

    Article  CAS  PubMed  Google Scholar 

  68. General considerations for the clinical evaluation of drugs in infants and children, US Department of Health and Human Services, Food and Drug Administration, 1977. www.fda.gov/cder/guidance.

  69. Guideline on the role of pharmacokinetics in the development of medicinal products in the paediatric population, EMEA/CHMP/EWP/147013/2004, www.ema.europa.eu.

  70. Clinical investigation of medicinal products in the paediatric population, ICH Topic E11, www.ich.org.

  71. Regulation (EC) No 1901/2006 of the European Parliament and of the Council of 12 December 2006 on medicinal products for paediatric use and amending Regulation (EEC) No 1768/92, Directive 2001/20/EC, Directive 2001/83/EC and Regulation (EC) No 726/2004, http://ec.europa.eu/health/documents/eudralex/.

  72. Regulation (EC) No 1902/2006 of the European Parliament and of the Council of 20 December 2006 amending Regulation 1901/2006 on medicinal products for paediatric use. http://ec.europa.eu/health/documents/eudralex/.

  73. Reflection paper: Formulations of choice for the paediatric population, EMEA/CHMP/PEG/194810/2005, www.ema.europa.eu.

  74. Guideline on environmental risk assessments for medicinal products consisting of, or containing, genetically modified organisms (GMOs), EMEA/CHMP/473191/06 Corr, www.ema.europa.eu.

  75. Committee for Advanced Therapies (CAT) Work Programme 2010–2015 (EMA/CAT/235374/2010).

    Google Scholar 

  76. European Medicines Agency, advanced-therapy-medicinal-product classification. Summaries of scientific recommendations.

    Google Scholar 

  77. Reflection paper on classification of advanced therapy medicinal products (EMA/CAT/600280/2010).

    Google Scholar 

  78. Emami CN, Chokshi N, Wang J, Hunter C, Guner Y, Goth K, Wang L, Grishin A, Ford HR. Role of interleukin-10 in the pathogenesis of necrotizing enterocolitis. Am J Surg. 2012 Apr;203(4):428–35.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  79. Braat H, Rottiers P, Hommes DW, Huyghebaert N, Remaut E, Remon JP, van Deventer SJ, Neirynck S, Peppelenbosch MP, Steidler L. A phase I trial with transgenic bacteria expressing interleukin-10 in Crohn’s disease. Clin Gastroenterol Hepatol. 2006 Jun;4(6):754–9.

    Article  CAS  PubMed  Google Scholar 

  80. Caluwaerts S, Vandenbroucke K, Steidler L, Neirynck S, Vanhoenacker P, Corveleyn S, Watkins B, Sonis S, Coulie B, Rottiers P. AG013, a mouth rinse formulation of Lactococcuslactis secreting human Trefoil Factor 1, provides a safe and efficacious therapeutic tool for treating oral mucositis. Oral Oncol. 2010 Jul;46(7):564–70.

    Article  CAS  PubMed  Google Scholar 

  81. ActoGeniX announces positive results from a Phase 1 PK study of AG013 for the prevention of oral mucositis in cancer patients. Ghent, Belgium, August 22, 2012.

    Google Scholar 

  82. Niethammer AG, Xiang R, Becker JC, Wodrich H, Pertl U, Karsten G, Eliceiri BP, Reisfeld RA. A DNA vaccine against VEGF receptor 2 prevents effective angiogenesis and inhibits tumor growth. Nat Med. 2002 Dec;8(12):1369–75.

    Article  CAS  PubMed  Google Scholar 

  83. Niethammer AG, Lubenau H, Mikus G, Knebel P, Hohmann N, Leowardi C, Beckhove P, Akhisaroglu M, Ge Y, Springer M, Grenacher L, Buchler MW, Koch M, Weitz J, Haefeli WE, Schmitz-Winnenthal FH. Double-blind, placebo-controlled first in human study to investigate an oral vaccine aimed to elicit an immune reaction against the VEGF-Receptor 2 in patients with stage IV and locally advanced pancreatic cancer. BMC Cancer. 2012;12:361.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  84. ICH considerations—general principles to address virus and vector shedding (EMEA/CHMP/ICH/449035/2009).

    Google Scholar 

  85. Guideline on scientific requirements for the environmental risk assessment of gene therapy medicinal products (EMEA/CHMP/GTWP/125491/2006).

    Google Scholar 

  86. Guideline on follow-up of patients administered with gene therapy medicinal products (CHMP/GTWP/60436/07).

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karen Brigitta Goetz .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Goetz, K., Sun, Y., Féchir, K., Kretzschmar, E., Buettel, I. (2014). Regulatory Aspects and Approval of Biopharmaceuticals for Mucosal Delivery: Quality, Toxicology, and Clinical Aspects. In: das Neves, J., Sarmento, B. (eds) Mucosal Delivery of Biopharmaceuticals. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-9524-6_25

Download citation

Publish with us

Policies and ethics