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A PEN INJECTOR FOR SELF-ADMINISTRATION OF FOLLITROPIN ALPHA SOLUTION WITH A MINIMAL DOSE INCREMENT OF 5 IU

https://doi.org/10.17749/2313-7347.2017.11.4.035-042

Abstract

To date, self administrations of recombinant human follicle-stimulating hormone (rhFSH) are carried out using pen injectors with minimal dose increments of 8.33 IU or 12.5 IU (IU – international units of activity). To ensure the accuracy of dose titration and to minimize the dose adjustments during the treatment, new pen injectors are needed. Those would provide for the self administration of rhFSH in a wide range of doses and with a dose increment less than the existing fractional values. Aim: to develop a pre-filled, multi-dose pen injector for rhFSH solution with a 5 IU dose increment and a dose setting from 0 to 300 IU.

Materials and methods. Dispensed volumes containing the minimal dose of 5 IU were measured gravimetrically.

Results. After testing 48 pen injectors the estimated minimal dose of 5 IU (0.0083 ml of the solution) produced the following results: the mean value of the dispensed volume was 0.0081 ml, the mean deviation was ± 0.0006 ml (or ± 0.36 IU). The results are in consistence with the ISO 11608-1:2014(E) requirements of dose accuracy for the minimal dose setting in commercial injectors.

Conclusion. We have developed a pen injector for rhFSH administration with a dose setting from 0 to 300 IU and with a minimal increment of dose adjustment of 5 IU. The individual approach to the dose selection/adjustment with a minimal increment of 5 IU may help achieving a highly accurate administration of rhFSH for the controlled ovarian hyperstimulation and for the induced-ovulation protocols with growth activation of 1-2 follicles. 

About the Authors

A. B. Podkorytov
Zavod Medsintez LLC.
Russian Federation

Alexey Borisovich Podkorytov – General Director of Zavod Medsintez LLC. 

ul. 8 Marta, 90a, Yekaterinburg,  620144.



O. V. Zhilyaev
Zavod Medsintez LLC.
Russian Federation

Oleg Vladimirovich Zhilyaev – Head of the Department of Genetically Engineered Human Insulin, Zavod Medsintez LLC.

ul. 8 Marta, 90a, Yekaterinburg,  620144.



M. A. Polzikov
IVFarma LLC.
Russian Federation

Mikhail Alexandrovich Polzikov – PhD, General Director of IVFarma LLC.

Nauchnyi proezd, 20, str. 2, Moscow, Russia, 117246.



References

1. Van Wely M., Kwan I., Burt A.L., Thomas J., Vail A., van der Veen F., Al-Inany H.G. Recombinant versus urinary gonadotrophin for ovarian stimulation in assisted reproductive technology cycles. Cochrane Database Syst Rev. 2011; 2: CD005354.

2. Van Wely M., Kwan I., Burt A.L., Thomas J., Vail A., van der Veen F., Al-Inany H.G. Recombinant versus urinary gonadotrophin for ovarian stimulation in assisted reproductive technology cycles. Hum Reprod Update. 2012; 18 (2): 111.

3. Recombinant Human FSH Product. Development Group. Recombinant follicle stimulating hormone: development of the first biotechnology product for the treatment of infertility. Hum Reprod Update. 1998; 4 (6): 862-81.

4. Olijve W., de Boer W., Mulders J.W., van Wezenbeek P.M. Molecular biology and biochemistry of human recombinant follicle stimulating hormone (Puregon). Mol Hum Reprod. 1996; 2 (5): 371-82.

5. Orvieto R., Nahum R., Rabinson J., Ashkenazi J., Anteby E.Y., Meltcer S. Follitropin-alpha (Gonal-F) versus follitropin-beta (Puregon) in controlled ovarian hyperstimulation for in vitro fertilization: is there any difference? Fertil Steril. 2009; 91 (4 Suppl): 1522-5.

6. Goa K.L., Wagstaff A.J. Follitropin alpha in infertility: a review. BioDrugs. 1998; 9 (3): 235-60.

7. Mulders J.W., Derksen M., Swolfs A., Maris F. Prediction of the in vivo biological activity of human recombinant folliclestimulating hormone using quantitative isoelectric focusing. Optimization of the model. Pharm Pharmacol Commun. 1999; 5: 51-5.

8. Vorobiev I.I., Semikhin A.S., Golovina E.O. The novel biosimilar of follitropin alfa to be manufactured in Russia starting from 2017 [Proizvodstvo novogo bioanalogovogo follitropina al'fa v Rossii – eto uzhe real'nost' v 2017 godu]. Akusherstvo, ginekologiya i reprodukciya. 2017; 11 (3): 116-26 (in Russian).

9. Voortman G., van de Post J., Schoemaker R.C., van Gerven J.M. Bioequivalence of subcutaneous injections of recombinant human follicle stimulating hormone (Puregon®) by Pen-injector and syringe. Hum Reprod. 1999; 14 (7): 1698-702.

10. La Marca A., Sunkara S.K. Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum Reprod Update. 2014; 20 (1): 124-40.

11. La Marca A., Papaleo E., Grisendi V., Argento C., Giulini S., Volpe A. Development of a nomogram based on markers of ovarian reserve for the individualization of the follicle-stimulating hormone starting dose in in vitro fertilization cycles. BJOG. 2012; 119 (10): 1171-9.

12. Muasher S.J., Abdallah R.T., Hubayter Z.R. Optimal stimulation protocols for in vitro fertilization. Fertil Steril. 2006; 86 (2): 267-73.

13. Oudshoorn S.C., van Tilborg T.C., Eijkemans M.J.C., Oosterhuis G.J.E., Friederich J., van Hooff M.H.A., van Santbrink E.J.P., Brinkhuis E.A., Smeenk J.M.J., Kwee J., de Koning C.H., Groen H., Lambalk C.B., Mol B.W.J., Broekmans F.J.M., Torrance H.L.; OPTIMIST study group. Individualized versus standard FSH dosing in women starting IVF/ICSI: an RCT. Part 2: The predicted hyper responder. Hum Reprod. 2017; 32 (12): 2506-14.

14. Van Tilborg T.C., Torrance H.L., Oudshoorn S.C., Eijkemans M.J.C., Koks C.A.M., Verhoeve H.R., Nap A.W., Scheffer G.J., Manger A.P., Schoot B.C., Sluijmer A.V., Verhoeff A., Groen H., Laven J.S.E., Mol B.W.J., Broekmans F.J.M.; OPTIMIST study group. Individualized versus standard FSH dosing in women starting IVF/ICSI: an RCT. Part 1: The predicted poor responder. Hum Reprod. 2017; 32 (12): 2496-505.

15. Fiedler K., Ezcurra D. Predicting and preventing ovarian hyperstimulation syndrome (OHSS): the need for individualized not standardized treatment. Reprod Biol Endocrinol. 2012; 10: 32.

16. Van Tilborg T.C, Oudshoorn S.C., Eijkemans M.J.C., Mochtar M.H., van Golde R.J.T., Hoek A., Kuchenbecker W.K.H., Fleischer K., de Bruin J.P., Groen H., van Wely M., Lambalk C.B., Laven J.S.E., Mol B.W.J, Broekmans F.J.M., Torrance H.L.; OPTIMIST study group. Individualized FSH dosing based on ovarian reserve testing in women starting IVF/ICSI: a multicentre trial and cost-effectiveness analysis. Hum Reprod. 2017; 32 (12): 2485-95.

17. Jeannerot F., Cusin A., Schertz J. Dose accuracy of the redesigned follitropin alfa pen injector for infertility treatment. Expert Opin Drug Deliv. 2016; 13 (12): 1661-9.

18. Vorobiev I.I., Kovnir S.V., Orlova N.A., Khodak Yu.A., Polzikov M.A. Compositions of aqueous solutions of the biologically active recombinant human folliclestimulating hormone [Sostavy rastvorov biologicheski aktivnogo rekombinantnogo follikulostimuliruyushchego gormona cheloveka]. Razrabotka i registraciya lekarstvennyh sredstv. 2015; 13: 122-6 (in Russian).

19. ISO 11608-1:2014(E): Needle-based injection systems for medical use – requirements and test methods – part 1: needle-based injection systems. 3-rd edition. Geneva: IEC/ISO. 2014: 50 р.

20. Hale L. Prevention of multiple pregnancy during ovulation induction. Twin Res. 2003; 6 (6): 540-2.


Review

For citations:


Podkorytov A.B., Zhilyaev O.V., Polzikov M.A. A PEN INJECTOR FOR SELF-ADMINISTRATION OF FOLLITROPIN ALPHA SOLUTION WITH A MINIMAL DOSE INCREMENT OF 5 IU. Obstetrics, Gynecology and Reproduction. 2017;11(4):35-42. (In Russ.) https://doi.org/10.17749/2313-7347.2017.11.4.035-042

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)