Formulation Screening
Formulations for the screening studies were selected based on previous experience with biologics stabilization utilizing these drying technologies. The formulations were generated by modest perturbation from a few base formulations (all containing at least one sugar and a buffer) that have worked successfully in the past, with the excipient contents of the wet blend within the ranges provided in Table III.
Screening of Foam Dried Formulations
In the initial screening of 39 excipient combinations, plasticizer technology using foam drying was applied to stabilize the LAIV formulations. These formulations were screened based on their ability to maintain viral potency through the drying process and during storage under accelerated conditions at 37°C for 12 weeks. Three lead foam dried formulations were selected and tested for long-term storage stability at 4, 25, and 37°C in a 74 week study.
Foam drying transformed all 39 liquid formulations into glassy, closed-cell foams with residual moisture contents between 2 and 5%wt. In general, a modest process-related reduction in viral titer was observed after foam drying <1 TCID50/mL. The majority of the foam dried formulations appeared to be relatively stable at 37°C with viral titer slowly declining over a 12 week study at an average rate of 0.15 ± 0.24 log TCID50/mL/wk, and 9 formulations (24%) less than 0.05 log TCID50/mL/wk. This rate of titer loss was significantly slower than observed with formulations prepared by spray drying or freeze drying. There was no discernible correlation between the residual moisture content in the foams and process or storage stability. Hence, changes in stability were assumed to be related to changes in formulation composition.
Formulation screening identified gelatin and arginine as key stabilizers for foam dried LAIV (Fig. 1). The rate of viral titer loss during storage at 37°C was 0.06 ± 0.03 log TCID50/mL/wk for formulations containing gelatin, as compared to 0.28 ± 0.16 log TCID50/mL/wk for formulations without gelatin. The high percent relative standard deviation for these quantities (50–57%) is the result of the variability in stability of the different formulations, coupled with the fact that the rates of titer loss overall were rather low. In the absence of gelatin, arginine proved to be an important stabilizer. The mean rate of titer loss for gelatin-free formulations with and without arginine was 0.13 ± 0.08 and 0.39 ± 0.09 log TCID50/mL/wk, respectively. In gelatin-containing formulations, the addition of arginine did not further improve storage stability. While both gelatin and arginine improved storage stability, neither appeared to impact process stability (data not shown).
Sucrose and trehalose were comparable stabilizing / bulking agents. Plasticizers, which are believed to dampen molecular vibrations and thus enhance protection from degradation mechanisms, seemed to improve LAIV stability in certain formulations, but a more robust factorial formulation study design would be needed to determine with greater confidence the relative benefit of the plasticizers. There was not an obvious advantage of one buffer system over another. LAIV stability was comparable in formulations with and without Pluronic F68. Similarly, inclusion of methionine, EDTA, or metal ions did not notably improve LAIV stability. Due to the limited formulation space evaluated, it is possible that some of these excipients may in fact enhance LAIV stability in foam dried formulations, but their impact was too small to be clearly identified in this study.
Lead formulations were selected based primarily on process loss and the rate of titer loss during storage at 37°C, weighing storage stability higher than process stability. The number of excipients was also considered, giving preference to formulations with fewer components if stability profiles were similar. While several foam dried formulations demonstrated exceptional stability, FM3, FM18, and FM23x were selected as the lead formulations. In addition to sucrose and gelatin, the plasticizer sorbitol (which was used in selected formulations FM18 and FM23x) appeared to have a benefit. FM3 and FM18 had the best overall combination of process and storage stability with the fewest components. Although a process loss of less than 0.5 log TCID50/ml is generally desirable, FM23x had the best combined stability of the gelatin-free formulations with a process loss of 0.5 log TCID50/ml in the screening study.
Screening of Freeze Dried LAIV Formulations
Five freeze-dried analogs of the foam dried LAIV formulations were manufactured to evaluate whether the drying process itself impacted LAIV stability in the solid-state. The lyophilized versions were designed to have an initial total solids content of approximately 10% (i.e., three-fold lower than the foam formulation), while maintaining similar weight ratios of the excipients. The lower solids content in these formulations is typical for freeze drying as it provides for a more porous solid product, which improves drying efficiency as well as reconstitution time. Subsequently, the process loss and storage stability of the freeze dried formulations were evaluated under accelerated conditions (37°C) for up to 8 weeks. Process loss and storage stability in one select lyophilized analog formulation and in the commercially available freeze-dried LAIV product (NASOVAC™, Serum Institute of India) were similarly studied for comparison with the foam dried formulations in the long-term storage stability study.
After lyophilization, all five formulations appeared to have good cake structure. The residual moisture content ranged from 0.8 to 1.9%wt, which was consistent with typical lyophilized products and was lower than their foam dried counterparts. There was no measureable process loss for three of the formulations, and approximately 0.5-log loss for the other two (Fig. 2). Upon storage at 37°C, the viral titer decreased at an average rate from about 0.4 to 0.6 log TCID50/mL per week across the five formulations. This rate of titer loss is approximately ten-fold higher than observed in the corresponding foam dried formulations. The slowest rate of titer loss was observed for formulation Lyo(FM23x). However, there was also visible cake collapse within 2 weeks for this formulation, whereas no cake collapse was observed with the other formulations. The reason for cake collapse is uncertain; the elevated temperature of storage was apparently above the collapse temperature of the dried formulation, although this was not measured; average moisture content of Lyo(FM23x) was higher (1.6%) relative to other freeze dried formulations, which had less the 1% moisture. Although not superior in all aspects, Lyo(FM18) was selected as the lead formulation for real-time stability testing because of its good physical stability, limited number of excipients, and similarity to one of the lead foam dried formulations to provide a direct drying method comparison.
Screening of Spray Dried Formulations
In the initial screening of 30 excipient combinations, plasticizer technology was applied to stabilize the spray dried formulations, which were then characterized in the same manner as the foam dried formulations. Similar to freeze drying, the solids content of the liquid fed to the spray dryer was one half to one third that of the foam dried formulations. Formulations were screened based their ability to maintain viral potency through the drying process and during storage under accelerated conditions at 37°C. Two lead spray dried formulations were selected and tested for long-term storage stability at 4, 25, and 37°C in a 60 week study.
Spray drying transformed all 30 liquid formulations into fine powders with residual moisture contents between 1 and 5%wt. In general, a moderate process-related reduction in viral titer was observed after spray drying with mean process loss of 0.9 ± 0.5 log TCID50/mL, which trended higher than foam dried formulations.
Viral titer rapidly declined in all spray dried formulations upon storage at 37°C with an average rate of titer loss of 0.7 ± 0.4 log TCID50/mL/wk. For most formulations, vaccine potency dropped below the assay detection limit within 4–6 weeks. This rate of titer loss for all spray dried formulations was significantly faster than that observed with foam dried formulations. There was not a discernible correlation between the residual moisture content in the spray dried powders and process or storage stability. Hence, changes in stability were assumed to be related to changes in formulation composition or process parameters.
On average, formulations containing Pluronic F68 had lower process loss than formulations without (0.8 ± 0.4 versus 1.2 ± 0.4 log TCID50/mL, respectively), suggesting that the surfactant may shield LAIV from destabilizing stresses during the drying process. In contrast to foam dried formulations, gelatin and arginine did not appear to be strong stabilizers, although their inclusion did not reduce stability. Somewhat surprisingly, the inclusion of plasticizers also did not significantly improve LAIV stability in the formulation combinations evaluated in this study. Inclusion of methionine, EDTA, or metal ions had marginal benefit on LAIV stability. Sucrose and trehalose appeared to be comparable stabilizing / bulking agents. Similarly, there was not an obvious benefit of one buffer system over another.
Lead formulations were selected based primarily on process loss and the rate of titer loss during storage at 37°C, weighing storage stability higher than process stability. The number of excipients was also considered, giving preference to formulations with fewer components if stability profiles were similar. Two spray dried formulations, SD18 and SD30, demonstrated the best overall combination of process and storage stability during formulation screening. They differed from the lead foam and freeze dried formulations with the inclusion of trehalose, which acts to increase the glass transition temperature of the resulting solid.
Evaluation of Drying Processes for Long-Term Stability
Lead Foam-Dried Formulations
The three foam dried formulations exhibited a similar level of storage stability (Fig. 3). At 37°C, vaccine potency slowly declined during the first 6 weeks, reducing viral titer by ~0.6-log TCID50/mL in all formulations. At subsequent time points, the viral titer continued to decrease, but at a much slower rate. After 20 week at 37°C, the variability in viral titer for FM23xLTS increased significantly, wherein the titer in some vials was near or below the detection limit of the TCID50 assay while other vials had similar titer to previous time points. This increase in titer variability among samples corresponded with collapsed foam structure in the vials with low titer. A similar increase in variability and collapse of foam structure in a subset of samples was also observed with FM18LTS after 25 weeks at 37°C, but was not observed with FM3LTS. The apparent change in foam structures was not observed in the 25 and 4°C stability samples for any formulation. The observed stability of these formulations at 37°C was comparable with that observed during formulation screening, demonstrating good batch-to-batch repeatability.
At 4 and 25°C, viral titer slowly decreased over the 74 week study (Fig. 3). The change in potency was more pronounced at 25 than at 4°C, as expected. At 25°C, the titer loss approached 1-log TCID50/mL for all three formulations after 48 weeks, but there was little-to-no subsequent loss in titer between the 48 and 72 weeks time points. At 4°C, viral titer declined by approximately 0.5-log after 72 weeks for all formulations.
The rate of titer change during storage was estimated by linear regression for each formulation at each storage temperature. These rates are summarized in Table V. The three foam dried formulations appeared to have similar stability profiles, and were significantly more stable than the formulations prepared by lyophilization (Table VII) or spray drying (Table IX), especially at elevated temperatures. Based on the lower 95% confidence limit for the rate of titer loss, the shelf life for the lead H1N1 foam dried formulations have exceeded the target stability specifications at 37°C (4 weeks) and 25°C (12 weeks) (Table VI). The target shelf life at 4°C (156 weeks) was within the 95% confidence interval for two of the formulations (FM18LTS and FM23xLTS), suggesting that this target could also potentially be achieved by these formulations.
Table V Process Loss and Storage Stability for Lead Foam Dried LAIV Formulations in the LTS Study. (The negative rate of titer loss for the foam dried formulations at 4°C is likely due to variability in the TCID50 assay for these samples, which have little to no reduction in viral titer. Results are the average of three measurements, except Tg measured in duplicate, and include the standard deviation.)
Table VI Forecasted Shelf Life of Lead Foam Dried LAIV Formulations. (based on the rate of titer loss)
Freeze Dried Formulations
When stored at 37°C, vaccine potency rapidly declined in both freeze dried formulations (Fig. 4). Within 4 weeks, viral titer was reduced by 2.8-log TCID50/mL in Lyo(FM18)LTS and 2.5-log TCID50/mL in NASOVAC™. After 8 weeks, both formulations at 37°C were near the detection limit of the TCID50 assay. Similarly, the potency of the freeze dried formulations at 25°C declined fairly rapidly, losing more than 1.5-log TCID50/mL within 8 weeks. Both formulations showed significantly improved stability when stored at 4°C, exhibiting a slow and steady decline in H1N1 viral titer over time. The potency of NASOVAC™ decreased by approximately 0.5-log after 60 weeks, whereas Lyo(FM18)LTS lost over 1.5-log TCID50/mL during the same period.
The rate of titer change during storage was estimated by linear regression for each formulation at each storage temperature. At 25 and 37°C, regression analysis was limited to the initial phase of rapid titer loss (8 and 4 weeks, respectively) since that region encompassed the defined storage stability limit (1-log reduction in potency). While the two freeze dried formulations had comparable rates of titer loss at 37°C, NASOVAC™ demonstrated superior stability at 4 and 25°C (Table VII). For comparison, the rates of titer loss found here were equivalent to or less than that demonstrated at 25°C by Yannarell et al. (20) for lyophilized formulations of a Type-A strain LAIV.
Table VII Process Loss and Storage Stability for Lead Freeze Dried LAIV Formulations in the LTS Study. (Results are the average of three measurements, except Tg measured in duplicate, and include the standard deviation.)
Based on the lower 95% confidence limit for the rate of titer loss (see Table VIII), neither freeze dried formulation meets the target shelf-life specification at 25 or 37°C (12 and 4 weeks, respectively). However, target specification at 4°C (156 weeks) was currently within the 95% confidence interval of NASOVAC™’s estimated shelf life. Overall, the freeze dried formulations were approximately an order of magnitude less stable than foam dried formulations (Tables V and VI).
Table VIII Forecasted Shelf Life of Lead Freeze Dried LAIV Formulations
Long-term Stability Testing of Spray Dried Formulations
When stored at 37°C, vaccine potency rapidly declined during the first 4 weeks for both formulations, reducing viral titer by 3-log TCID50/mL (Fig. 5). After the first month, the viral titer of SD30LTS appeared to stabilize, but viral titer of SD18LTS fell below the limit of detection. A biphasic reduction in viral titer was also observed for both formulations at 25°C, wherein the viral titer of these formulations was reduced by approximately 2-log TCID50/mL within 8 weeks. The spray dried formulations were much more stable at 4°C, but a slow and steady decline in potency has been observed. After 72 weeks at 4°C, the potency of both formulations had decreased by approximately 1 log TCID50/mL. The stability of these formulations at 37°C was comparable with that observed during formulation screening, demonstrating good batch-to-batch repeatability.
The rate of titer change during storage was estimated by linear regression for each formulation at each storage temperature. At 25 and 37°C, regression analysis was limited to the initial phase of rapid titer loss (8 and 4 weeks, respectively) since that region encompassed the defined storage stability limit (1-log reduction in potency). The two spray dried formulations had comparable rates of titer loss at each storage temperature (Table IX), and were approximately an order of magnitude less stable than foam dried formulations (Table V). Based on the lower 95% confidence limit for the rate of titer loss, neither spray dried formulation achieved the target shelf-life specification at any temperature (Table X).
Table IX Process Loss and Storage Stability for Lead Spray Dried LAIV Formulations in the LTS Study. (Results are the average of three measurements, except Tg measured in duplicate, and include the standard deviation.)
Table X Forecasted Shelf Life of Lead Spray Dried LAIV Formulations
Comparison of three drying processes for stabilization of LAIV performance
Figure 6 provides a picture of representative stability samples from each drying technology, illustrating the significant differences in the physical form of the final dried product. As can be seen, the larger vial associated with foam drying is needed to provide sufficient head space for the expanded foam.
Figure 7 and Table XI summarize the stability results, which show superior stabilization properties of the foam dried formulation over the other drying approaches across all three storage temperatures, but particularly at 25 and 37°C.
Table XI Physical Properties and H1N1 LAIV Stability in Foam Dried, Freeze Dried, and Spray Dried Formulations. (Results are the average of three measurements, except Tg measured in duplicate, and include the standard deviation.)
Figure 8 shows the Arrhenius temperature dependence of the rate of titer loss. The linear dependence of the spray dried and freeze dried formulations is more evident, while the foam dried formulation could be argued to deviate from Arrhenius kinetics, possibly attributable to the closeness of the highest storage temperature (37°C) to the Tg of this formulation.
Immunogenicity
In Vivo Testing in Ferrets
All LAIV formulations exhibited good safety profile. All animals maintained a normal weight and activity level throughout the study. There were no signs of nasal or respiratory distress, or fever associated with any formulation.
All LAIV formulations elicited an immunogenic response after the priming dose. The measured HAI titer in groups receiving the foam dried, freeze dried and spray dried formulations was comparable to the group receiving the frozen LAIV control (Fig. 9). Therefore, it can be concluded that the lead formulations retain complete biological potency. Surprisingly, there was little or no increase in HAI titer after the boosting dose. While the study demonstrated that the dried formulations retained immunogenicity, the resulting HAI titer for all groups (including the control) was lower than predicted by other published studies. Additional dose ranging studies may be necessary to establish the optimum dose.
Application to LAIV Type B
The foam drying process and lead formulations were applied to the LAIV Type-B strain from SII. The TCID50 assay was qualified to measure the potency of LAIV Type-B. Two batches of foam dried LAIV Type-B were manufactured for each formulation. Virus stability through the foam drying process and during storage at 4, 25, and 37°C was assessed using the TCID50 assay. Figure 10 and Table XII show that a lead foam dried formulation applied to a Type-B LAIV strain imparts comparable stabilization to the H1N1 strain. While the addition of gelatin seemed to improve the stabilization of the H1N1 strain, no measurable improvement was observed for the Type-B strain (Table XII).
Table XII H1N1 and Type-B LAIV Stability in Foam Dried Formulations with and without Gelatin. (Results are the average of three measurements and include the standard deviation.)