Safety and Pharmacokinetics of Dapivirine Delivery From Matrix and Reservoir Intravaginal Rings to HIV-Negative Women

Vaginal microbicides for the prevention of HIV transmission may be an important option for protecting women from infection. Incorporation of dapivirine, a lead candidate nonnucleoside reverse transcriptase inhibitor, into intravaginal rings (IVRs) for sustained mucosal delivery may increase microbicide product adherence and efficacy compared with conventional vaginal formulations. Twentyfour
healthy HIV-negative women 18–35 years of age were randomly assigned (1:1:1) to dapivirine matrix IVR, dapivirine reservoir IVR, or placebo IVR. Dapivirine concentrations were measured in plasma
and vaginal fluid samples collected at sequential time points over the 33-day study period (28 days of IVR use, 5 days of follow-up). Safety was assessed by pelvic/colposcopic examinations, clinical laboratory tests, and adverse events. Both IVR types were safe and well tolerated with similar adverse events observed in the placebo and dapivirine groups. Dapivirine from both IVR types was successfully distributed throughout the lower genital tract at concentrations over 4 logs greater than the EC50 against wild-type HIV-1 (LAI) in MT4 cells. Maximum concentration (Cmax) and area under the concentration–time curve (AUC) values were significantly higher with the matrix than reservoir IVR. Mean plasma concentrations of dapivirine were ,2 ng/mL. These findings suggest that IVR delivery of microbicides is a viable option meriting further study.

Trends in product recalls within the agri-food industry:Empirical evidence from the USA, UK and the Republic of Ireland

The increasing frequency of product recalls within the agri-food industry has led many to question food safety. Research studies also often focus on biological hazards without considering how past, present and emerging risks change over time. We undertake a systematic review of the different biological, operational and chemical hazards within the agri-food industry using a dataset of 2070 registered food recalls in the USA, UK and Republic of Ireland between 2004 and 2010. We show product recalls have become more frequent over time and operational hazards, rather than biological and chemical hazards, are the most frequent recall type within the agri-food industry. © 2012 Elsevier Ltd. All rights reserved.

Product standardisation as a tool to control prescribing costs a case study of alginate liquid preparations

Introduction Product standardisation involves promoting the prescribing of pre-selected products within a particular category across a healthcare region and is designed to improve patient safety by promoting continuity of medicine use across the primary/secondary care interface, in addition to cost containment without compromising clinical care (i.e. maintaining safety and efficacy). Objectives To examine the impact of product standardisation on the prescribing of compound alginate preparations within primary care in Northern Ireland. Methods Data were obtained on alginate prescribing from the Northern Ireland Central Services Agency (Prescription Pricing Branch), covering a period of 43 months. Two standardisation promotion interventions were carried out at months 18 and 33. In addition to conventional statistical analyses, a simple interrupted time series analysis approach, using graphical interpretation, was used to facilitate interpretation of the data. Results There was a significant increase in the prescribed share of the preferred alginate product in each of the four health boards in Northern Ireland and a decrease in the cost per Defined Daily Dose for alginate liquid preparations overall. Compliance with the standardisation policy was, however, incomplete and was influenced to a marked degree by the activities of the pharmaceutical industry. The overall economic impact of the prescribing changes during the study was small (3.1%). Conclusion The findings suggested that product standardisation significantly influenced the prescribing pattern for compound alginate liquid preparations within primary care across Northern Ireland. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

Hydrogel-forming microneedle arrays exhibit antimicrobial properties:potential for enhanced patient safety

We describe, for the first time, the microbial characterisation of hydrogel-forming polymeric microneedle arrays and the potential for passage of microorganisms into skin following microneedle penetration. Uniquely, we also present insights into the storage stability of these hydroscopic formulations, from physical and microbiological viewpoints, and examine clinical performance and safety in human volunteers. Experiments employing excised porcine skin and radiolabelled microorganisms showed that microorganisms can penetrate skin beyond the stratum corneum following microneedle puncture. Indeed, the numbers of microorganisms crossing the stratum corneum following microneedle puncture were greater than 105 cfu in each case. However, no microorganisms crossed the epidermal skin. When using a 21G hypodermic needle, more than 104 microorganisms penetrated into the viable tissue and 106 cfu of Candida albicans and Staphylococcus epidermidis completely crossed the epidermal skin in 24 h. The hydrogel-forming materials contained no microorganisms following de-moulding and exhibited no microbial growth during storage, while also maintaining their mechanical strength, apart from when stored at relative humidities of 86%. No microbial penetration through the swelling microneedles was detectable, while human volunteer studies confirmed that skin or systemic infection is highly unlikely when polymeric microneedles are used for transdermal drug delivery. Since no pharmacopoeial standards currently exist for microneedle-based products, the exact requirements for a proprietary product based on hydrogel-forming microneedles are at present unclear. However, we are currently working towards a comprehensive specification set for this microneedle system that may inform future developments in this regard.

Risk assessment of neonatal excipient exposure:Lessons from food safety and other areas

Newborn babies can require significant amounts of medication containing excipients intended to improve the drug formulation. Most medicines given to neonates have been developed for adults or older children and contain excipients thought to be safe in these age groups. Many excipients have been used widely in neonates without obvious adverse effects. Some excipients may be toxic in high amounts in which case they need careful risk assessment. Alternatively, it is conceivable that ill-founded fears about excipients mean that potentially useful medicines are not made available to newborn babies. Choices about excipient exposure can occur at several stages throughout the lifecycle of a medicine, from product development through to clinical use. Making these choices requires a scalable approach to analysing the overall risk. In this contribution we examine these issues.

Changes in quality and safety attributes throughout long term storage of tomato juice processed by high pressure.

Tomato is the second most widely grown vegetable crop across the globe and it is one of widely cultivated crops in Sri Lanka. However, tomato industry in Sri Lanka facing a problem of high postharvest loss (54%) during the glut coupled with heavy revenue loss to the country by importing processed products. The aim of this work is to develop shelf-stable tomato product with maximum quality characteristics using high pressure processing (HPP). Tomato juice with altered and unaltered pH was processed using HPP at 600 MPa for 1 min after blanching (90 oC/2 min). As a control tomato juice was subjected to thermal processing (TP) at 95 oC /20 min. Processed samples were stored under 20oC and 28oC for 9 month period and analysed for total viable count (TVC) and instrumental colour (L, a, b) value at 0,1,2 3, and 4 week and 2, 3, 6 and 9 months interval. The raw juice sample had initial 6.69 log10 CFU/ml and both TP and HPP caused a more than 4.69 log10 reduction in the TVC of juice and microbial numbers remained low throughout the storage period even at 3 months after storage irrespective of the storage temperature. Both TP and HPP treated samples had the redness ⤘a value’ of 14.44-17.15 just after processing and showed non-significant reduction with storage in all the treatments after 3 months. The storage study results and discussed in relation to the end goal and compared with the literature.

Effect of high-pressure processing on the shelf life, safety and organoleptic characteristics of lasagne ready meals during storage at refrigeration and abuse temperature

The effect of different pressure levels (500 and 600. MPa for 1. min at ambient temperature) on lasagne ready meal as a means of increasing the safety and shelf life during storage at refrigeration (4. °C) and abuse temperature (8. °C) was investigated. High-pressure processing (500 and 600. MPa for 1. min) was able to significantly reduce the total aerobic and lactic acid bacteria counts and prolong the microbiological shelf life of lasagne at both refrigeration and abuse temperatures. Pressure at 600. MPa was a useful tool to reduce the safety risks associated with Staphylococcus aureus and Listeria monocytogenes. However, abuse storage temperature facilitated the recovery of L. monocytogenes towards the end of storage. Organoleptic evaluation revealed that HPP did not negatively influence the quality attributes of lasagne and prolonged its organoleptic shelf life. HPP treatment can serve as a useful additional step to enhance safety and increase the shelf life of multicomponent ready meals, such as lasagne. Industrial relevance: The ready meals sector of the food industry has been experiencing increasing growth in the past years. This comprehensive study explored the effects of HPP on a very popular multicomponent ready meal i.e., lasagne after treatment and during storage. The results showed that HPP can be successfully applied to lasagne ready meals to decrease the risk from S. aureus and L. monocytogenes and also significantly prolong its shelf life without affecting its organoleptic properties. The utilisation of HPP by the industry can significantly increase safety and also provide the opportunity for this product to reach markets further away.