Resumen
As vacinas contra a hepatite B são produzidas pela expressão do gene viral codificado para o antígeno de superfície do vírus da hepatite B (HBsAg) em levedura, há mais de 20 anos. De acordo com os dados da OMS, a vacina de hepatite B tem até três anos de estabilidade quando armazenada entre 2 ºC e 8 ºC. O objetivo deste estudo foi de avaliar se, no momento da liberação, os critérios de qualidade da vacina de hepatite B foram mantidos após sete anos da data de validade. Foram analisados frascos de vacinas multi-dose (10 e 5 doses), sendo três lotes de cada produtor (A, B e C). Todos os lotes foram avaliados quanto às características de aparência visual, potência, endotoxina bacteriana, presença de timerosal, conteúdo de hidróxido de alumínio e pH por meio de testes validados. Os nove lotes avaliados sete anos após a data de expiração tiveram resultados similares quando comparados às concentrações na época de liberação dos lotes, realizada pelo Instituto Nacional de Controle de Qualidade em Saúde (INCQS). Os estudos confirmaram a manutenção da qualidade da vacina após o período de expiração. Estes dados podem subsidiar uma futura avaliação para extensão do prazo de validade das vacinas.
Citas
1. Seeger C, Zoulim F, Mason WS. Hepadnaviruses. In: Fields Virology. 6ª ed. Knipe DM, Howley PM (eds). Lippincott Williams & Wilkins, PA, USA, 2013. 2185-221.
2. Zanetti AR, Van Damme P, Shouval D. The global impact of vaccination against hepatitis B: a historical overview. Vaccine.2008;26:6266-73. [DOI: 10.1016/j.vaccine.2008.09.056].
3. World Health Organization -WHO. Immunization, Vaccines and Biologicals. Hepatitis B. Geneva; 2010.
4. World Health Organization -WHO. Immunization, Vaccines and Biologicals. Hepatitis B. Geneva; 2014. [acesso 2014 Nov 20]. Disponível em: [http://www.who.int/immunization/diseases/hepatitisB/en/].
5. Decker MD. Principles of pediatric combination vaccines and practical issues related to use in clinical practice. Pediatr Infect Dis J.2001;20(11 Suppl):S10-8.
6. Decker M, Bogaerts H, Edwards K. Combination vaccines. In: Plotkin S, Orenstein W, Offit PA (eds).Vaccines. 5a ed. USA: Saunders Co; 2008. p. 1069-101.
7. Ellis RW. Development of combination vaccines. Vaccine.1999;17(13-14):1635-42. [DOI: 10.1016/S0264-410X(98)00424-1].
8. Pichichero ME. New combination vaccines. Pediatr Clin North Am.2000;47(2):407-26. [DOI: 10.1016/S0031-3955(05)70214-5].
9. World Health Organization - WHO. Requirements for Hepatitis B vaccines Made Recombinant DNA Techniques. In: WHO Expert Committee on Biological Standardization. Thirty–ninth report. Geneva, 1989, Annex 2, WHO Technical Report Series n. 786.
10. World Health Organization -WHO. Requirements for Hepatitis B vaccines Made Recombinant DNA Techniques. In: WHO Expert Committee on Biological Standardization. Forty–eighth report. Geneva, 1999, Annex 4, WHO Technical Report Series n. 889. p. 94-95. [acesso 2014 Out 20]. Disponível em: [http://apps.who.int/iris/bitstream/10665/42202/1/WHO_TRS_889.pdf ].
11. European Pharmacopoeia. Hepatitis B vaccine, 8.0, volume I, 01/2014. Strasbourg: EDQM Council of Europe.
12. U.S. Food and Drug Administration - FDA. Biological Products: general provisions. Code of Federal Regulations. Title 21, sec 600.15 -Temperatures during shipment. Washington, DC: US Government Printing Office; 2007.
13. European Directorate for the Quality of Medicines & Health Care – EDQM. EU Administrative procedure for Official Control Authority batch release: Control authority batch release of vaccines and blood products. Strasbourg: Council of Europe, 2012.
14. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância das Doenças Transmissíveis. Nota Técnica Conjunta n.2/2013/CGPNI/DEVEP e CGDHRV/DST-AIDS/SVS/MS. Ampliação da oferta da vacina hepatite B para a faixa etária de 30 a 49 anos em 2013. Brasília: Ministério da Saúde, 2013. [acesso 2015 Jun 11]. Disponível em: [http://www.saude.rs.gov.br/upload/1372685606_11%20Nota%20Tecnica%20N%C2%BA%20022013%20-%20vacina%20hepatite%20B%2030%20a%2049%20anos.pdf].
15. US Centers for Disease Control and Prevention - CDC. Update expanded availability of thimerosal preservative – free hepatitis B vaccine. Morb Mort Weekly Rep.2000;49(28):642-65.
16. Clapp T, Siebert P, Chen D, Braun LTJ. Vaccines with aluminum-containing adjuvants: optimizing vaccine efficacy and thermal stability. J Pharm Sci.2011;100(2):388-401. [DOI: 10.1002/jps.22284].
17. United States Pharmacopeia – USP 23 - National Formulary 19. Rockville: The United States Pharmacopeial Convention; 2000.
18. Birner J, Garnet JR. Thimerosal as a preservative in biological preparations. I. Application of polarography to the determination of thimerosal in aqueous solutions and vaccines. J Pharm Sci.1964 Oct; 53:1264-5.
19. Page JE, Waller JG. Polarographic determination of thiomersalate. Analyst.1949;74:292-6. [DOI: 10.1039/AN9497400292].
20. The International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). ICH Harmonised Tripartite Guideline. ICH Q1A (R2): Stability Testing of New Drug Substances and Products. February 6, 2003. [acesso 2014 Out 24]. Disponível em: [http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Quality/Q1A_R2/Step4/Q1A_R2__Guideline.pdf].
21. U.S. Food and Drug Administration - FDA. Biological Products: general provisions. Code of federal regulations. Title 21, sec 600.3. Washington, DC: US Government Printing Office; 2007.
22. World Health Organization – WHO, Global Programme for Vaccines and Immunization. Thermostability of vaccines. Geneva: WHO; 1998. (Publication WHO/GPV/98.07)
23. Dobbelaer R. Collaborative study for the establishment of biological reference preparations for rDNA hepatitis B vaccine. Pharmeuropa Special Issue, BIO 1997; 2:3-18.
24. European Pharmacopeia. Method of analysis, Biological assays. Assay of hepatitis B vaccine (rDNA). General chapter 2.7.15. 5ª ed. Strasbourg, France: Council of Europe; 2005.
25. European Pharmacopeia. Statistical analysis, 8.0, volume I, 01/2014. Strasbourg: EDQM Council of Europe.
26. European Pharmacopeia. Bacterial Endotoxins, 7.0. Strasbourg: Council of Europe, 2011; p.171-5.
27. Farmacopeia Brasileira. 4 ed., parte 2, n. 5, São Paulo: Atheneu, 2004.
28. Birner J, Garnet JR. Thimerosal as a preservation in biological preparations. Application of polarography to the determination of thimerosal in aqueous solutions and vaccines. J Pharm Sci.1964;53(10):1263-5.
29. Baylor NW, Egan W, Richman P. Aluminum salts in vaccines – US perspective. Vaccine.2002;20(Suppl 3):S18-23.
30. Gupta RK. Aluminum compounds as vaccine adjuvants. Adv Drug Deliv Rev.1998;32(3):155-172.
31. Finney DJ. Chapter 4 Parallel line assays. In: Statistical Methods in Biological Assay. 3ª ed. London: Charles Griffin and Company Ltd; 1978. p. 69-104.
32. Hendriksen CFM, Garthoff B, Aggerbeck H, Bruckner L, Castle P, Cussler K et al. Alternatives to animal testing in the quality control of immunobiologicals: current status and future prospects. The report and recommendations of ECVAM workshop 4. ATLA.1994; 22:420-34.
33. Pierard I, Spelte G, Le Tallec D, Duchêne M. Consideration on a few aspects of the stability studies post licensure. Biologicals.2009;37(6):403-6. [DOI: 10.1016/j.biologicals.2009.08.011].
34. Fairweather WR, Mogg R, Bennett PS, Zhong J, Morrisey C, Schofield TL. Monitoring the stability of human vaccines. J Biopharm Stat.2003;13(3):395-413. [DOI:10.1081/BIP-120022762].
35. Schofield TL. Maintenance of vaccine stability through annual stability and comparability studies. Biologicals.2009;37(6):397-402.[DOI: 10.1016/j.biologicals.2009.08.010].
36. World Health Organization - WHO. Recommendations to Assure the Quality, Safety and Efficacy of Recombinant Hepatitis B Vaccines. Proposed replacement of: WHO Technical Report Series, Nº 786, Annex 2 and Technical Report Series, Nº 889, Annex 4. Geneva, World Health Organization, 2010. [acesso 2014 Nov 06]. Disponível em: [http://www.who.int/biologicals/HEP_B_Recomm_after_ECBS_endorsment_final].
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