WO2013133702A1 - Methods and compositions for stabilizing dried biological materials - Google Patents
Methods and compositions for stabilizing dried biological materials Download PDFInfo
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- WO2013133702A1 WO2013133702A1 PCT/NL2013/050139 NL2013050139W WO2013133702A1 WO 2013133702 A1 WO2013133702 A1 WO 2013133702A1 NL 2013050139 W NL2013050139 W NL 2013050139W WO 2013133702 A1 WO2013133702 A1 WO 2013133702A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K39/12—Viral antigens
- A61K39/125—Picornaviridae, e.g. calicivirus
- A61K39/13—Poliovirus
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K39/12—Viral antigens
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/02—Inorganic compounds
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
- A61K47/16—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing nitrogen, e.g. nitro-, nitroso-, azo-compounds, nitriles, cyanates
- A61K47/18—Amines; Amides; Ureas; Quaternary ammonium compounds; Amino acids; Oligopeptides having up to five amino acids
- A61K47/183—Amino acids, e.g. glycine, EDTA or aspartame
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
- A61K47/26—Carbohydrates, e.g. sugar alcohols, amino sugars, nucleic acids, mono-, di- or oligo-saccharides; Derivatives thereof, e.g. polysorbates, sorbitan fatty acid esters or glycyrrhizin
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
- A61K9/19—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles lyophilised, i.e. freeze-dried, solutions or dispersions
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- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
- C12N7/00—Viruses; Bacteriophages; Compositions thereof; Preparation or purification thereof
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- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
- C12N2770/00—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA ssRNA viruses positive-sense
- C12N2770/00011—Details
- C12N2770/32011—Picornaviridae
- C12N2770/32611—Poliovirus
- C12N2770/32634—Use of virus or viral component as vaccine, e.g. live-attenuated or inactivated virus, VLP, viral protein
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Definitions
- the present invention relates the methods and compositions for stabilizing and preserving dried biological materials.
- biological materials include lyophilized or vacuum-dried preparations of biopharmaceuticals such as vaccines, in particular viral vaccines.
- the invention therefore relates to the field of production and formulation of biopharmaceuticals and to the field of vaccinology. Background of the invention
- This process consists of a freezing step followed by two drying steps, the primary drying where frozen water is removed by sublimation and the secondary drying where the non-frozen 'bound' water is removed.
- Either freezing or drying stresses can modify the thermodynamic stability of biopharmaceuticals and can induce or facilitate protein unfolding. Unfolding can lead to irreversible denaturation of the biopharmaceutical, but may also reduce the storage stability in the dry state [19].
- excipients serving as stabilizer and/or bulking agents are used. Different compounds, such as sugars, polymers, amino acids and surfactants, have been shown to improve the stability of biopharmaceuticals during lyophilization and subsequent storage [18, 20].
- the initial relative composition and pH of the formulation can circumvent detonation of the biopharmaceutical by freezing stresses. For example, it has been found with many biopharmaceuticals that increasing the biopharmaceutical concentration in the formulation relatively to other excipients before freezing will increase the stability of the biopharmaceutical during freeze-thawing [24]. Similarly, an initial pH that is optimal for the biopharmaceutical in solution will give the highest recovery of intact biopharmaceutical after freeze-thawing [20].
- cryoprotectants have been shown to preferentially not to be in contact with the surface of biopharmaceuticals in aqueous solutions [24].
- the thermodynamic phenomenon of solute exclusion in the presence of various biopharmaceuticals has been determined for various excipients, such as salts, amino acids, methylamines, polyethylene glycols, polyols, surfactants and sugars [19, 21, 24, 25].
- the 'vitrification hypothesis' is a widely known kinetic mechanism. According to this mechanism, both freeze-concentration and a temperature drop increase viscosity, reduce mobility and slow all dynamic processes. When the system reaches a glassy state, all molecules in the glass become physically (e.g. denaturation, aggregation) and chemically (e.g. oxidation, hydrolysis, deamidation) immobile and the rate constant of biopharmaceutical degradation is reduced [19, 26].
- Ice-water interfaces formed during freezing may cause surface denaturation. Addition of surfactants may drop surface tension of the biopharmaceutical solution and thus reduce biopharmaceutical adsorption and aggregation [25, 27].
- Polymers could stabilize biopharmaceuticals by raising the glass transition temperature of the formulation and by inhibiting crystallization of small stabilizing additives, like disaccharides [18, 22].
- Amino acids may protect biopharmaceuticals as well from freezing denaturation by reducing the rate and extend of buffer salt crystallization and thus suppressing the pH shift [18].
- biopharmaceuticals are fully hydrated, which means that the biopharmaceutical has a monolayer of water covering and interacting (by hydrogen bonds) with the biopharmaceutical surface [28]. Drying removes part of the hydration shell and this may disrupt the native state of the biopharmaceutical leading to denaturation.
- protectants are required.
- An important stabilization mechanism of such protectants is called the 'water substitution hypothesis' [18-20, 29].
- Sugars, such as sucrose and trehalose, polyols [20, 30] and amino acids [31] are able to form hydrogen bonds with the dried biopharmaceutical. As such they can act as a water substitute, when the hydration shell is removed.
- the formation of an amorphous glass explained above as the 'vitrification hypothesis', is also a major protection mechanism.
- Tg glass transition temperature
- the higher the T g the lower the molecular mobility in the glass (e.g. movement of the biopharmaceutical, stabilizing compounds, oxygen and water) and the more stable the biopharmaceutical formulation during drying and subsequent storage [18, 22].
- Another mechanism involved in the stabilization of biopharmaceuticals during drying and that is applicable for polysaccharides and other polymers, is the inhibition of crystallization during solute concentration of small excipients that stabilize the biopharmaceutical during drying.
- biopharmaceutical is stable during the drying process, then long-term storage in the dried state is often feasible. Although in general the drying process itself is most detrimental to the biopharmaceutical, dried biopharmaceuticals may still loss their structure or potency during storage if not properly formulated. Aggregation is a major physical instability for biopharmaceuticals during storage. Different chemical degradations, like deamidation, oxidation and hydrolysis, may occur as well during storage, but these alterations may not necessarily affect the activity of biopharmaceutical, depending on the location of the transformed residue(s).
- Reducing sugars such as glucose and sucrose can react with lysine and arginine residues in biopharmaceuticals to form carbohydrate adduct via the Maillard reaction, a browning reaction, which can lead to a significant loss of activity of the lyophilized biopharmaceutical during storage.
- Storage temperature is one of the most important factors affecting the stability of biopharmaceuticals in the solid state. Other factors that affect long-term storage stability are the glass transition temperature (T g ) of the formulation, formulation pH and the residual moisture content after drying. The moisture content of a dried formulation may change significantly during storage due to several factors, including stopper moisture release, crystallization of an amorphous excipients or moisture release from an excipient hydrate.
- Excipients that are used to stabilize biopharmaceuticals during drying may destabilize biopharmaceuticals in the solid state if their quantities are not appropriately used in the formulation. Also the risk of crystallization of amorphous excipients exist during storage, because the crystalline state is thermodynamically more stable than the glassy state [39]. Many sugars and polyols have the tendency to crystallize, but this is strongly affected by their relative amount in the formulation, storage temperature and relative humidity [18, 40]. In addition, the relative composition of several excipients and the presence of non-crystallizing stabilizers, such as polymers, may inhibit crystallization of excipients.
- Stabilization mechanisms for biopharmaceuticals in the dry state during long- term storage are similar to those for lyoprotection, including formation of an amorphous glassy state, water substitution, and hydrogen bonding between excipients and the biopharmaceutical [41]. A combination of these mechanisms is required for maximum biopharmaceutical stabilization in the solid state [18, 42].
- the final quality of a lyophilized product is determined by the choice of excipients, including buffering, bulking and stabilizing agents, and the lyophilization process.
- Poliomyelitis is a highly infectious disease which mainly affects young children. The disease, caused by any one of three serotypes of poliovirus (type 1, type 2 or type 3) has no specific treatment, but can be prevented through vaccination.
- the oral poliomyelitis vaccine (Sabin OPV) is the vaccine of choice to strive for global eradication of poliomyelitis.
- OPV oral poliomyelitis vaccine
- VAPP vaccine associated paralytic poliomyelitis
- Another risk of permanent use of live attenuated poliovirus is the reversion to vaccine-derived polioviruses (VDPV) [1].
- IPV inactivated Salk polio vaccine
- the new vaccine will be based on the OPV strain, Sabin (sIPV), for which the production costs is also expected to be less expensive
- RIVM is developing sIPV formulations that show dose sparing by using an adjuvant and/or other immunization routes [6].
- IPV IPV as stand-alone vaccine is stable for 4 years at 4°C and one month at 25°C [10].
- At 37°C there is a significant loss of potency of type 1 after 1-2 days and of types 2 and 3 after two weeks [11, 12]. Also freezing has a negative effect on the potency of IPV, which is related to loss of the D-antigen structure [12].
- the invention relates to a method for producing a dried formulation of a biopharmaceutical agent, wherein the method comprises drying a solution comprising a biopharmaceutical agent, an amino acid, a polyol, a metal salt and water.
- the solution consists essentially of 1 pg - 10 g per ml of the biopharmaceutical agent, 0.01 - 20 % (w/v) of the amino acid, 0.5 - 20 % (w/v) of the polyol, 0.005 - 10 % (w/v) of the metal salt and water.
- the amino acid is glutamate, arginine, histidine, asparagine, glycine or a mixture thereof;
- the polyol is sorbitol, mannitol, mannose, maltitol or a mixture thereof; and
- the metal salt is a salt of Mg ++ , Ca ++ or Li + or a mixture thereof, of which CI " or S0 4 2" salts or mixtures thereof are preferred.
- the glutamate is preferably dissolved in the solution in the form of monosodium glutamate.
- the solution consists essentially of 1 pg - 10 g per ml of the biopharmaceutical agent, 5 - 20 % (w/v) sorbitol, 5 - 20 % (w/v) monosodium glutamate, 2 - 10 % (w/v) of a magnesium salt, preferably MgCl 2 and/or MgS0 4 , and optionally 5 - 20 % (w/v) mannitol.
- the solution preferably comprises a pharmaceutically acceptable buffer and is buffered at a neutral pH. It is also preferred that the solution is dried by vacuum drying or by lyophilization.
- the biopharmaceutical agent preferably is an agent comprising proteinaceous material. More preferably the biopharmaceutical agent is a virus, preferably an Enterovirus or a Pneumovirus. Most preferably, the biopharmaceutical agent comprises poliovirus of serotypes 1, 2 and 3, preferable inactivated poliovirus of serotypes 1, 2 and 3, or wherein the biopharmaceutical agent is a human or bovine RSV.
- the dried formulation upon reconstitution after drying, retains at least 50% of the activity of the biopharmaceutical agent present in the solution prior to drying.
- the solution to be dried comprises more than one different biopharmaceutical agents and wherein the difference in loss of activities for the different agents preferably is less than 50%, whereby the retained activity of the agent with the most loss in activity is expressed as percent of the retained activity of the agent with the least loss, which is set at 100%.
- the dried formulation upon reconstitution after storage for at least one week at 45 °C retains at least 50% of the activity of the biopharmaceutical agent present in the solution prior to drying.
- the dried formulation comprises more than one different biopharmaceutical agents and wherein the difference in loss of activities for the different agents preferably is less than 50%, whereby the retained activity of the agent with the most loss in activity is expressed as percent of the retained activity of the agent with the least loss, which is set at 100%.
- the invention pertains to a dried formulation of a biopharmaceutical agent obtainable in any the method according to the invention.
- the invention pertains to the formulation according to the invention for use as a medicament, preferably for inducing an immune response (in an individual) against an infectious disease or a tumour. Description of the invention
- the invention relates to a method for producing a dried formulation of a biopharmaceutical agent.
- the methods of the invention are aimed at achieving at least two improvements: 1) minimizing the loss of activity of the biopharmaceutical agent upon drying of the formulation (and preferably subsequent reconstitution of the dried formulation); and, 2) increasing the stability, i.e. shelf-life of the dried formulation of the biopharmaceutical agent, i.e. minimizing the loss of activity of the biopharmaceutical agent upon storage of the dried formulation.
- the method preferably comprises the step comprises drying a aqueous solution comprising a biopharmaceutical agent and one or more of an amino acid, a polyol and a metal salt.
- the solution to be dried comprises, consists essentially of, or consists of: a) the biopharmaceutical agent as specified herein below and in a concentration specified herein below; b) the amino acid as specified herein below and in a concentration specified herein below; c) the polyol as specified herein below and in a concentration specified herein below; d) the metal salt as specified herein below and in a concentration specified herein below; e) water; optionally, f) a buffer as specified herein below, in a concentration specified herein below and at a pH specified herein below; and, optionally, g) further ingredients as specified herein below and in a concentration specified herein below.
- the biopharmaceutical agent is the biopharmaceutical agent
- a “biopharmaceutical agent” is herein understood to refer to a biological agent, which is physiologically active when applied to a mammal, especially when applied to a human patient, preferably in a pharmaceutically acceptable form.
- the biological agent preferably is an agent that is produced by or obtainable from a cell, although synthetic copies of agents obtainable from a cell and chemically modified agents obtainable from a cell are included in the term biological agent.
- the biological agent can be a protein-based agent, i.e. an agent comprising proteinaceous material such as proteins, polypeptides and peptides.
- the biological agent may further comprises or consist of nucleic acid, e.g. DNA, RNA or a nucleic acid analogue.
- a preferred biopharmaceutical agent is a virus or a virion, preferably a virus that infects mammals, preferably a virus that infects humans.
- the virus can be an enveloped virus but preferably is a non-enveloped virus.
- 'virus' as used herein include wild type viruses as they occur in nature (e.g. natural isolates), as well as 'man-made' attenuated, mutant and defective viruses.
- the term 'virus' also includes recombinant viruses, i.e. viruses constructed using recombinant DNA technology, such as defective viruses, e.g. lacking (parts of) one or more viral genes and gene therapy vectors wherein part of the viral genome is replaced with one or more gene(s) of interest.
- a preferred virus is Picornavirus, more preferably an Enterovirus, such as poliovirus, Coxsackievirus, echovirus and rhinovirus. Most preferably the virus is poliovirus.
- the poliovirus can be an attenuated poliovirus but preferably is inactivated poliovirus (IPV).
- IPV inactivated poliovirus
- the poliovirus can also be an inactivated attenuated poliovirus
- the biopharmaceutical agent can comprise one or more of the polio viral serotypes 1, 2 and 3 but preferably the agent comprise all three polio viral serotypes 1, 2 and 3. Suitable strains of serotype 1 poliovirus include but are not limited to one or more of the Sabin 1, Mahoney, Brunhilde, CHAT and Cox strains.
- Suitable strains of serotype 2 poliovirus include but are not limited to one or more of the Sabin 2, MEF-1 and Lansing strains.
- Suitable strains of serotype 3 poliovirus include but are not limited to one or more of the Sabin 3, Saukett H and G, and Leon strains.
- the biopharmaceutical agent is a trivalent inactivated polio vaccine such as e.g. the Salk-IPV, containing the inactivated polio viral Mahoney strain for type 1, the inactivated polio viral MEF-1 strain for type 2 and the inactivated polio viral Saukett strain for type 3, or sIPV, containing the inactivated polio viral Sabin- 1, -2 and -3 strains.
- biopharmaceutical agent is a virus or a virion of a pneumovirus.
- the pneumovirus preferably is a Respiratory Syncytial Virus (RSV), more preferably a human or bovine RSV.
- the human RSV may either be a subgroup A or B virus, and preferably is a clinical isolate, more preferably an isolate that has not been extensively passaged in vitro (preferably passaged less than 10, 8, 6 or 5 times).
- the (human or bovine) RSV virus is a virus comprising a viral genome having a deleted or inactivated G attachment protein gene, e.g. having a mutation in its viral genome whereby the viral genome does not encode a functional G attachment protein, such as e.g. the RSV AG and RSV AG+G virions as described in WO 2005/061698 and in Widjojoatmodjo et al. (2010, Virol. J., 7: 114).
- the biopharmaceutical agent is preferably present in the solution to be dried in an amount ranging between 1 x 10° and 1 x 10 25 live and/or dead or inactivated particles per ml.
- the number of live particles may be determined by e.g. plaque forming units, cell culture or tissue culture 50% infectious dose (CCID 50 or TCID 50 ) and other suitable virological assays for determining the titer of the agent.
- the number of dead or inactivated particles may be determined using an assay that quantifies the amount of antigen, such e.g. protein assays, or assays that determine haemagglutination units or polio D-antigen units.
- the biopharmaceutical agent is present in the solution in an amount of at least 1 x 10 1 , 1 x 10 2 , 1 x 10 3 , 1 x 10 3 , 1 x 10 4 , 1 x 10 5 , 1 x 10 6 , 1 x 10 7 , 1 x 10 8 , 1 x 10 9 or 1 x 10 10 live and/or dead or inactivated particles per ml and/or in an amount of up to 1 x 10 24 , 1 x 10 23 , 1 x 10 22 , 1 x 10 21 , 1 x 10 20 , 1 x 10 19 , 1 x 10 18 , 1 x 10 17 , 1 x 10 16 , 1 x 10 15 or 1 x 10 14 live and/or dead or inactivated particles per ml.
- the amount of the biopharmaceutical agent in the solution to be dried can also be expressed as weight of the biopharmaceutical agent per ml of the solution.
- the biopharmaceutical agent is present in the solution in a weight/ml ranging between 1 pg/ml and 10 g/ml. More preferably, the biopharmaceutical agent is present in the solution in an amount of at least 10 "11 , 10 "10 , 10 “9 , 10 “8 , 10 “7 , 10 “6 , 10 “5 , 10 “4 , g/ml and/or in an amount of up to 10 "3 , 10 "2 , 10 "1 , or 10° g/ml.
- the weight of the biopharmaceutical agent in the solution may be determined by means known in the art per se, including e.g. protein assays.
- the aforementioned weights of the biopharmaceutical agent may thus also be expressed as grams protein per ml to be determined in a suitable protein assay (e.g. the Bradford assay; Zor and Selinger, 1996, Anal. Biochem. 236: 302-308).
- the amount of poliovirus in the solution preferably is at least 0.01, 0.1, 1.0, or 10 DU/ml and up to 10.000, 1.000 or 100 DU/ml, wherein 1 DU is defined and determined with a QC-ELISA as described by Westdijk et al. [6].
- the biopharmaceutical agent comprises a multivalent poliovirus (vaccine)
- each polio viral serotype is present in an amount of at least 0.01, 0.1, 1.0, or 10 DU/ml and up to 10.000, 1.000 or 100 DU/ml.
- the amount of RSV in the solution preferably is at least 1 x 10 1 , 1 x 10 2 , 1 x 10 3 , 1 x 10 3 , 1 x 10 4 TCIDso/ml and up to 1 x 10 25 , 1 x 10 20 , 1 x 10 15 , 1 x 10 12 , 1 x 10 10 or 1 x 10 9 TCID 50 /ml, wherein the TCID 50 for RSV is defined and determined as described by Widjojoatmodjo et al. (2010, Virol. J., 7: 114).
- the amino acid in the solution to be dried can be any D- or L-amino acid that is pharmaceutically acceptable.
- amino acids include the 20 standard 'proteinogenic' or 'natural' amino acids (histidine, alanine, isoleucine, arginine, leucine, asparagine, lysine, aspartic acid, methionine, cysteine, phenylalanine, glutamic acid, threonine, glutamine, tryptophan, glycine, valine, proline, tyrosine and serine), as well as non- natural amino acid such as e.g. ornithine, citrulline, selenocysteine, taurine and pyrrolysine.
- the amino acid in the solution to be dried is one or more of glutamate, glutamine, arginine, histidine, asparagine, lysine, leucine and glycine, more preferably one or more of glutamate, arginine and histidine.
- the solution to be dried may thus comprise a mixture of amino acids.
- the amino acid(s) in the solution to be dried may be either optical D- or L-isomers or mixtures thereof, although preferably the amino acid(s) are L-isomers.
- the amino acid in the solution to be dried is one or more of L-glutamate, L-arginine and L-histidine.
- L-glutamate may also be in the form of Na-glutamate, peptone, non-animal peptone, vegetable peptone.
- L-arginine may also be in the form of poly-L-arginine, peptone, non-animal peptone, vegetable peptone.
- L- histidine may also be in the form of Na-histidine.
- L-lysine may also be in the form of poly-L-lysine.
- the amino acid in the solution to be dried comprises glutamate.
- the glutamate can be one or more of sodium glutamate, potassium glutamate, ammonium glutamate, calcium diglutamate, magnesium diglutamate and glutamic acid. More preferably, the glutamate is dissolved in the solution in the form of monosodium glutamate (MSG).
- MSG monosodium glutamate
- the amino acid(s) preferably are present in the solution to be dried in a concentration in the range of 0.01 - 20 % (w/v), i.e. percent weight per volume of the solution.
- the amino acid(s) are present in the solution to be dried in a concentration of at least or more than 0.01, 0.02, 0.05, 0.1, 0.2, 0.5, 1.0, 2.0, 5.0, 8.0, 9.0 or 9.5 % (w/v) and/or the amino acid(s) are present in the solution to be dried in a concentration of no more or less than 20.0, 17.5, 15.0, 12.5, 11.0 or 10.5 % (w/v).
- the amino acid(s) are present in the solution to be dried in a concentration of about 10 % (w/v).
- the polyol in the solution to be dried preferably is a sugar or sugar alcohol.
- Preferred sugars include sucrose, trehalose, mannose and dextran.
- Preferred sugar alcohols include sorbitol, mannitol and matltitol.
- the solution to be dried comprises at least one or more of sorbitol, mannose, mannitol and matltitol, more preferably, at least one or more of sorbitol, mannose, and mannitol, still more preferably at least one or both of sorbitol and mannitol.
- Most preferably the solution to be dried comprises as polyol at least sorbitol, optionally in combination with mannitol.
- the polyol(s) are preferably present in the solution to be dried in a concentration in the range of 0.1 - 20 % (w/v), i.e. percent weight per volume of the solution.
- the polyol(s) are present in the solution to be dried in a concentration of at least or more than 0.1, 0.2, 0.5, 1.0, 2.0, 5.0, 8.0, 9.0 or 9.5 % (w/v) and/or the polyol(s) are present in the solution to be dried in a concentration of no more or less than 20.0, 17.5, 15.0, 12.5, 11.0 or 10.5 % (w/v).
- the polyol(s) are present in the solution to be dried in a concentration of about 10 % (w/v).
- the concentrations in this embodiment are e.g. suitable when sorbitol is used as polyol.
- the polyol(s) are preferably present in the solution to be dried in a concentration in the range of 0.1 - 40 % (w/v), i.e. percent weight per volume of the solution.
- the polyol(s) are present in the solution to be dried in a concentration of at least or more than 0.1, 0.2, 0.5, 1.0, 2.0, 5.0, 10.0, 12.5, 15.0 18.0, 19.0 or 19.5 % (w/v) and/or the polyol(s) are present in the solution to be dried in a concentration of no more or less than 50.0, 40.0, 35.0, 30.0, 25.0, 22.5, 21.0 or 20.5 % (w/v).
- the polyol(s) are present in the solution to be dried in a concentration of about 40 % (w/v).
- concentrations in this embodiment are e.g. suitable when two different polyols are used such as e.g. sorbitol and mannitol.
- the weight ratio between the two polyols may range from 1 : 100 to 1 : 1 including e.g. 1 :50, 1 :20, 1 : 10, 1 :5, and 1 :2.
- the metal salt dissolved in the solution to be dried can be any pharmaceutically acceptable salt of a divalent or monovalent metal cation.
- Preferred divalent cations are Ca ++ , Mg ++ and Zn ++ , of which Ca ++ and Mg ++ are more preferred, and of which Mg ++ is most preferred.
- Preferred monovalent cations are Li + , Na + and K + , of which Li + , Na + are more preferred, and of which Li + is most preferred.
- the counter-anion in the metal salt preferably is not an amino acid, preferably not glutamate or aspartate. More preferably, the counter-anion in the metal salt an inorganic anion.
- Preferred (inorganic) anionic counterions are CI “ , S0 4 2" and C0 3 2" , of which CI “ and S0 4 2" are more preferred, and of which CI " is most preferred.
- the solution can comprise mixtures of one or more of the above metal salts.
- the metal salt(s) preferably are present in the solution to be dried in a concentration in the range of 0.005 - 10 % (w/v), i.e. percent weight per volume of the solution.
- the metal salt(s) are present in the solution to be dried in a concentration of at least or more than 0.005, 0.01, 0.02, 0.05, 0.1, 0.2, 0.5, 1.0, 2.0, 3.0, 4.0, or 4.5 % (w/v) and/or the metal salt(s) are present in the solution to be dried in a concentration of no more or less than 10.0, 8.0, 7.0, 6.0, or 5.5 % (w/v).
- the metal salt(s) are present in the solution to be dried in a concentration of about 5 % (w/v).
- the amino acid in the solution to be dried is dissolved in the form of a metal salt of the amino acid, e.g. MSG
- the amino acid metal salt is not included in the weight percentage of the metal salt(s) but in the weight percentage of the amino acid(s), whereby the weight of the metal counter cation is included in the weight of the amino acid.
- the solution to be dried preferably has a neutral pH, e.g. a pH in the range of 6.0 - 8.0, or 6.5 - 7.5 or a pH of about 7.0.
- the solution to be dried preferably comprises a buffer to maintain the pH at the indicated values.
- any pharmaceutically acceptable buffer which preferably has effective buffering capacity in the range of pH values as indicated, can be used in the solution to be dried.
- the buffer is preferably present in a concentration in the range of 0.5 - 100 mM, more preferably in the range of 1 - 50 mM and most preferably in the range of 2 - 20 mM, such as e.g. about 10 mM.
- Suitable buffers for use in the solution to be dried include Mcllvaine buffer (see
- a citrate buffer examples include a citrate buffer, a phosphate buffer, a HEPES buffer and a histidine buffer.
- the water used for preparing the solution to be dried preferably is ultrapure and preferably pyrogen-free water, like water for injections.
- concentrations of ingredients (e.g. the excipients) in the solution to be dried of the invention are generally expressed herein as percent weight per volume (w/v) of the solution. This is understood to be the relationship of a solute (e.g. the excipient) to the solvent (e.g. water) expressed as grams of solute per liter of the total solution. For example 50 g of glucose in 1 L of solution, is considered a 5% w/v solution.
- the solution to be dried consists essentially of the biopharmaceutical agent in an amount as defined herein above, 5 - 20 % (w/v) sorbitol, 5 - 20 % (w/v) monosodium glutamate, 2 - 10 % (w/v) of a magnesium salt, preferably MgCl 2 and/or MgS0 4 , optionally 5 - 20 % (w/v) mannitol, and optionally 2 - 50 mM of a pharmaceutically acceptable buffer which buffers the solution at a neutral pH as indicated herein.
- a magnesium salt preferably MgCl 2 and/or MgS0 4
- optionally 5 - 20 % (w/v) mannitol optionally 2 - 50 mM of a pharmaceutically acceptable buffer which buffers the solution at a neutral pH as indicated herein.
- the aqueous solution comprising the biopharmaceutical agent is dried.
- Any known drying method can be used.
- a drying method can e.g. be spray drying, air drying, coating, foam-drying, desiccation, vacuum drying, vacuum/freeze drying or freeze-drying, all of which are known to the person skilled in the art per se.
- the drying method is vacuum drying or freeze-drying, of which freeze-drying or lyophilization is more preferred.
- the solution to be dried preferably is first frozen to an initial freeze-drying or shelf temperature equal to or lower than of - 50°C, -40°C, -30°C, -20°C or -10°C.
- a preferred initial shelf temperature is equal to or lower than of -50°C or -40°C.
- the solution to be dried may be subjected to fast freezing by immediately placing (a container/vial comprising) the solution on the shelf having an initial shelf temperature as indicated above.
- the solution to be dried may be subjected to slow freezing by placing (a container/vial comprising) the solution on the shelf having a temperature above 0°C, e.g.
- the solution to be dried may be brought to a pressure of 100 microbar or lower.
- the shelf temperature may be increased to higher temperatures.
- the shelf temperature may e.g. be increased at a rate of e.g. 0.05, 0.1 or 0.2°C per minute to a temperature of 5, 10 or 15 or °C above the initial freeze-drying temperature.
- the primary drying step is preferably ended when no pressure rise is measured in the chamber. Preferably at that moment, the shelf temperature may be increased to e.g.
- the solution to be dried preferably is at a temperature in the range of about 5 - 25°C, e.g. room temperature or more preferably at a temperature in the range of about 10 - 20°C, e.g. a temperature of about 15°C.
- the pressure is then reduced, e.g. to a pressure of less than 1, 0.5, 0.2, 0.1, 0.05 mbar.
- the temperature of the solution being dried can be decreased to a temperature that can be below 0°C but that is Gust) above the eutectic temperature of the solution to prevent freezing of the solution.
- the temperature of the solution can be increased to e.g.
- the invention relates to a dry or dried formulation of a biopharmaceutical agent obtainable or obtained in a method according to the invention as described herein above.
- the methods of the invention for producing a dried formulation of a biopharmaceutical agent are preferably aimed at minimizing the loss of activity of the biopharmaceutical agent upon drying of the formulation.
- the methods of the invention as well as the formulations themselves are also aimed at minimizing the loss of activity of the biopharmaceutical agent upon subsequent storage of the dried formulation obtainable with the methods of the invention.
- the methods of the invention are thus preferably methods for producing stable formulations of biopharmaceutical agents, i.e. formulations with a long or extended shelf-life, preferably under refrigerated conditions (e.g. 2 - 10 °C), at room temperature (e.g. 18 - 25 °C), or even at elevated temperatures (e.g. 32 - 45°C) as may occur in tropical regions.
- Loss of activity or inactivation of a biopharmaceutical agent is understood to include both loss of activity due to chemical pathways (such as oxidation, hydrolysis or enzymatic action) as well as physical pathways (such as denaturation, aggregation, gelation).
- the loss of activity of the biopharmaceutical agent does not exceed an acceptable level. In other words, at least a level of biological activity or viability and/or a level of original function or structure sufficient for the intended commercial therapeutic and/or diagnostic application of the biopharmaceutical agent is retained after drying and/or subsequent storage.
- the skilled person will know which assay is to be used for assessing an activity of said biopharmaceutical agent.
- the activity of the biopharmaceutical agent may be expressed as its viability, e.g. in the case of active live viruses, or activity may be expressed as enzymatic activity or biological activity which may be determined in suitable assays known to the skilled person. In other instances the activity of the may rather relate to the physical and chemical integrity of the agent and may be determined by assessing the structure and/or function of said biopharmaceutical agent.
- Antigen structure is preferably assessed by ELISA or Biacor analysis.
- Secondary and tertiary structure is preferably assessed by UV-, fluorescence, Fourier Transformed Infra Red (FTIR) and/or Circular Dichroism (CD) spectroscopy.
- Immunogenicity is preferably assessed by in vivo analysis using animal models (e.g. mice, rats, cotton rats, ferrets or rabbits). Rats are e.g. a preferred model for poliovirus and cotton rats are a preferred model for RSV.
- the drying of the solution causes the dried formulation upon rehydration (preferably immediately) after drying, to retain at least 50, 60, 70, 75, 80, 85, 90 or 95% of the biological activity present in the solution prior to drying,.
- the difference in loss of activities for the different agents preferably is less than 50, 60, 70, 75, 80, 85, 90 or 95%, whereby the retained activity of the agent with the most loss in activity is expressed as percent of the retained activity of the agent with the least loss, which is set at 100%.
- the dried formulation retains at least 50, 60, 70, 75, 80, 85, 90 or 95% of the biological activity present in the solution prior to drying, after storage for at least one week at 45°C and upon rehydration of the dried formulation.
- the difference in loss of activities for the different agents preferably is less than 50, 60, 70, 75, 80, 85, 90 or 95%, whereby the retained activity of the agent with the most loss in activity is expressed as percent of the retained activity of the agent with the least loss, which is set at 100%.
- the percentages of activities retained after storage as indicated above are also retained after storage two weeks, three weeks, four weeks, five weeks, six weeks, seven weeks, eight weeks, nine weeks, ten weeks or more at 37 °C or at 45 °C.
- the invention in a third aspect relates to a formulation of a biopharmaceutical agent obtainable or obtained in a method according to the invention as described herein above for use as a medicament.
- the formulation can be used as dried formulation or it can be reconstituted by dissolving the dried formulation, e.g. using water as defined above.
- the formulation is preferably reconstituted to its original volume, i.e. the volume before drying.
- the formulation is a formulation for inducing an immune response (in an individual) against an infectious disease or a tumour.
- the individual or subject to whom the formulations of the invention are administered can be a human but can also be an animal, such as a farm animal or pet, including e.g.
- the formulation is a formulation for vaccination against an infectious disease or tumour.
- the formulation is thus preferably a formulation for the prevention or treatment of an infectious disease or tumour.
- the invention relates to the use of the formulation obtainable or obtained in a method according to the invention as described herein above for the manufacture of a medicament for inducing the immune response, for vaccination and/or for the prevention or treatment of an infectious disease or tumour.
- the invention relates to a method for inducing an immune response against an infectious agent or tumour by administering an effective amount of the formulation to a subject in need thereof.
- the immune response is preferably induced against an antigen in the biopharmaceutical agent.
- the antigen preferably is an antigen of a pathogen causing the infectious disease or an antigen of the tumour, or an antigen that induces an immune response against the pathogen or the tumour.
- the pathogen preferably is a virus as herein defined above.
- the formulation of the invention can be administered with or without reconstitution via intranasal, parenteral, intramuscular, subcutaneous and/or transdermal routes.
- Figure 1 D- Antigen recovery directly after lyophilization of serotype 1, 2 and 3 IPV- formulations (experiment A). The stabilizing effect of sucrose (SUC), trehalose (TREH), mannitol (MAN), dextran (DEX) and sodium chloride (NaCl) was tested.
- Figure 2 Response surface plots representing D-antigen recovery percentages of the three serotypes directly after lyophilization of IPV-formulations containing 10% of mannitol and 0% dextran.
- Figure 7 Accelerated stability testing of lyophilized serotype 1, 2 and 3 IPV- formulations as indicated (experiment D) as determined by D-antigen recovery after one week incubation at 45°C.
- Figure 8 D-antigen recovery directly after lyophilization of serotype 1, 2 and 3 IPV- formulations as indicated (experiment E).
- the stabilizing effects of sorbitol (SOR), sucrose (SUC), mannitol (MAN), mono-sodium glutamate (MSG), peptone (PEP) and MgCl 2 were tested by using fast (panel A) and slow (panel B) freezing rates.
- the stabilizing effect of peptone was investigated in an IP V- formulation containing 10% sorbitol, 10% MSG and 5% MgCl 2 with or without 10%) mannitol. All formulations were fast frozen prior to the drying phase of the lyophilization process.
- Figure 12 D-antigen recovery directly after lyophilization of serotype 1, 2 and 3 IPV- formulations with different buffer components as indicated (experiment G).
- Figure 13 Stability of lyophilized serotype 1, 2 and 3 IPV-formulations with different buffer components as indicated (experiment G) after lyophilization and subsequent storage at 45°C for one week.
- Figure 16 Stability of serotype 1, 2 and 3 IPV-formulations as indicated after lyophilization and subsequent storage at 45°C for one week, as determined by D- Antigen recovery.
- the trivalent inactivated polio vaccine (Salk-IPV), containing the inactivated Mahoney strain for type 1, MEF for type 2 and Saukett for type 3, was obtained from the process development department of the RIVM-Vaccinology (Bilthoven, The Netherlands).
- the Salk-IPV trivalent bulk (lOx) was formulated as a ten times concentrated 40-8-32 DU/single human dose (1 ml).
- the concentration of the IPV 05- 126B bulk that was used in this study was determined at 411-90-314 DU/ml with the QC-ELISA as described by Westdijk et al. [6].
- Peptone vegetable
- dextran (6 kDa, from Leuconostoc ssp)
- L-histidine 6 kDa, from Leuconostoc ssp
- L-alanine zinc chloride
- calcium lactobionate monohydrate were from Fluka (Buchs, Switzerland).
- Lactitol (Lacty®-M) was from Purac Biochem (Gorinchem, The Netherlands)
- L-arginine EP, non-animal origin
- Tween80 were from Merck (Darmstadt, Germany)
- polyvinylpyrrolidone 25 PVP, 29 kDa
- Sol-U-Pro a hydro lyzed porcine gelatin
- 10 mM Mcllvaine buffer 10 mM citric acid was added to 10 mM Na 2 FIP0 4 in a ratio of 1 :6 and a pH-value of 7.0.
- the 10 mM citrate buffer the components trisodiumcitrate dihydrate (10 mM) and citric acid (10 mM) were mixed together till pH 7.0 was reached.
- the 10 mM phosphate buffer of pH 7.0 consisted of 10 mM KH 2 P0 4 and 10 mM Na 2 HP0 4 .
- the 10 mM HEPES and 10 mM histidine buffers were prepared by weighing and dissolving the buffer components followed by adjustment of the pH-value at 7.0 using HC1 and/or NaOH.
- the trivalent IPV bulk material was dialyzed against 10 mM Mcllvaine buffer (pH 7.0) using a 10 kDa molecular weight cut-off, low- binding regenerated cellulose membrane dialysis cassette (Slide-A-Lyzer®, Pierce, Thermo Scientific, Rockford, IL) to replace the buffer components of the IPV bulk (Ml 99 medium).
- Polystyrene 96-well microtiter plates were coated overnight at room temperature with serotype-specific bovine anti-polio serum (RIVM, Bilthoven, The Netherlands). After washing with 0.1% Tween20 in PBS (wash buffer), twofold dilutions of an IPV reference standard and a single dilution of IPV-formulations diluted in assaybuffer (PBS with 0.5% Protifar and 0.1% Tween20) were added ( ⁇ /well, in duplicate).
- the plates were incubated at 37°C for 30 minutes under gentle shaking, extensively washed and a mixture of serotype-specific monoclonal mouse antibodies (mab 3-4-E4 (type 1), 3-14-4 (type 2), 1-12-9 (type 3), all from RIVM, Bilthoven, The Netherlands) and HRP-labeled anti-mouse IgG (GE Healthcare, Buckinghamshire, UK) was added. Subsequently, plates were incubated at 37°C for 30 minutes under gentle shaking.
- serotype-specific monoclonal mouse antibodies mab 3-4-E4 (type 1), 3-14-4 (type 2), 1-12-9 (type 3), all from RIVM, Bilthoven, The Netherlands
- HRP-labeled anti-mouse IgG GE Healthcare, Buckinghamshire, UK
- the water content was determined using a Karl Fischer coulometric titrimeter (Model CA-06 Moisture meter, Mitsubishi).
- the principle of the water residue determination by Karl Fischer method is based on the fact that iodine and sulphurdioxide only react in the presence of water.
- the samples were weighted and subsequently reconstituted in the Karl-Fischer reagent, Hydranal Coulomat A (Fluka, Buchs, Switzerland). The reconstituted sample was withdrawn into a syringe and injected into the titration vessel. Each vial was measured in triplicate.
- the empty vials were weighted and the water content was calculated based on the water content measured by the titrimeter, the weight of the lyophilized product in the vial, the reconstitution volume of the reagent, titration volume and the water content of the blank titration.
- thermodynamic behaviour of the formulations was determined by differential Scanning Calorimetry (DSC), a method which measures the temperatures and heat flow, associated with phase transitions in materials, as a function of time and temperature.
- DSC differential Scanning Calorimetry
- the freeze-dried formulations were filled in an aluminium DSC pan and subjected to a controlled temperature program in a differential scanning calorimeter (DSC Q100, TA Instruments).
- the sample was heated from 0°C to 150°C at a heating rate of 20°C/min and the sample chamber was purged with nitrogen gas (50 ml/min).
- the glass transition temperatures (Tg) were determined as the midpoint of the discontinuities in the heat flow curves using software (Universal Analysis 2000, TA Instruments).
- IPV-formulations were lyophilized as described above (section 1.2.3).
- Lyophilized cakes were reconstituted by adding an equal amount of water as the starting volume and the D-antigen recovery was determined by an ELISA (section
- Mcllvaine buffer showed recoveries ⁇ 10% for all serotypes after lyophilization (Figure 1; Al).
- Type 2 IPV showed to be the most stable serotype in all formulations with maximum D-antigen recoveries of ⁇ 80%. Dextran seemed to have a negative effect on
- Example B the stabilizing potential of a mixture of glutamate, a saccharide, and a polymer was investigated.
- Different combinations of the excipients sucrose, trehalose, monosodium glutamate (MSG), hydroxyethyl starch (HES) and NaCl were investigated. Lyophilization of trivalent IPV with formulations based on MSG together with disaccharide, sucrose and/or trehalose, showed D-antigen recoveries of 50-60%, 70-95% and 50-65%) for the three serotypes respectively (Figure 3; formulations B4, B7, B9, B12, B 13).
- Formulations containing trivalent IPV were dried by vacuum drying (a drying method without freezing), freeze drying using a fast freezing step (direct placement of the product on pre-cooled shelves of - 50°C) and freeze drying using a slow freezing step (placement of product on shelves of 4°C and freezing towards -50°C).
- standard formulations e.g. based on sucrose or trehalose, partially protect IPV upon vacuum drying. However, these formulations do not give protection upon freeze drying.
- Example D Based on these findings a new screening experiment (Experiment D) was designed. Since the most promising recoveries were obtained with formulations based on sorbitol, peptone and Mg or Li-chloride, we designed an experiment based on 10% sorbitol, 5% peptone and 125 mM NaCl. Ovalbumine was discarded since it is from animal origin, thus an undesirable excipient in a vaccine for human use.
- the MgCl 2 -containing formulation showed auspicious stabilizing capacity during lyophilization, which was similar for the calciumchloride (CaC12)- and lithium chloride (LiCl)-containing IPV formulations ( Figure 6; D17-19).
- During the screening phase accelerated stability has been evaluated to select the excipients on their ability to provide a stable lyophilized product as well, even after subsequent storage at high temperature.
- Experiment E was set up on the basis of 'Design of Experiment' using the "Modde” software from Umetrics. Besides recovery of D-antigen after lyophilization, also recoveries after lyophilization and subsequent storage at 37°C or 45°C were used as output in the design. The output as function of the formulations was modulated and put in a model using Modde. This revealed which formulation parameters affected the recovery after lyophilization and storage (data not shown).
- Serotype 2 showed already in the control formulation full maintenance of D-antigen recovery during accelerated stability. Although the exact composition of peptone is hard to determine, the amino acid quantification by reverse-phase HPLC with non- hydrolyzed versus chemical hydrolyzed peptone showed that peptone consists of both single amino acids and peptides, however >90% w/w of the peptone remains undefined. Since peptone seemed to increase glass transition temperature of the studied IPV- formulations, it might be possible to replace the peptone by an excipient with high T g , like sucrose or trehalose.
- Tg' and Tg Glass transition temperatures (Tg' and Tg) of IPV-formulations containing sorbitol, MSG and MgCl 2 with/without mannitol were determined by DSC. The effect of peptone on the glass transition of these formulations was investigated. Single measurements were shown.
- Figure 14 shows that only formulations containing sorbitol can resist stresses caused by the different drying methods. This could further be improved by inclusion of MSG and MgCl 2 (especially type 3), resulting in formulations that gave comparable or even higher recoveries than vacuum drying with trehalose or sucrose. From earlier results (Experiment E) we concluded that the formulations based on sorbitol, MSG and MgCl 2 possesses the best recovery after accelerated stability testing.
- VDPV Vaccine-derived poliovirus
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CN117482072A (en) * | 2023-11-17 | 2024-02-02 | 上海市浦东新区公利医院(第二军医大学附属公利医院) | Application of sorbitol in preparation of medicine for treating diseases caused by respiratory syncytial virus |
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Cited By (2)
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US11116955B2 (en) | 2017-02-24 | 2021-09-14 | Hisamitsu Pharmaceutical Co., Inc. | Method for producing microneedle device |
EP3615006A4 (en) * | 2017-04-28 | 2020-12-30 | Universal Stabilization Technologies, Inc. | Antigenic thermostable polio vaccines&related methods |
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US9827303B2 (en) | 2017-11-28 |
ZA201407198B (en) | 2016-02-24 |
AU2013228096A1 (en) | 2014-09-11 |
US20150030629A1 (en) | 2015-01-29 |
CN104271119A (en) | 2015-01-07 |
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US10335479B2 (en) | 2019-07-02 |
CA2865551C (en) | 2021-01-12 |
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EP2822540B1 (en) | 2020-04-08 |
JP6253161B2 (en) | 2017-12-27 |
JP2015509529A (en) | 2015-03-30 |
EP2822540A1 (en) | 2015-01-14 |
US20180055924A1 (en) | 2018-03-01 |
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