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Methods for Identifying OutofTrend Results in Ongoing Stability Data
It is important to distinguish between outof specification (OOS) and outoftrend (OOT) results in stability studies. The authors discuss three methods for identification of OOT results—the regressioncontrolchart method, the bytimepoint method, and the slopecontrolchart method—and further compare the zscore method and the tolerance interval in OOT analysis. The results highlight the need for issuing a regulatory confirmed guideline for identification of OOT results for ongoing stability data. The two terms outoftrend (OOT) and outofspecification (OOS) results are in many cases confused by pharmaceutical companies and regulatory agencies. OOT results are defined as a stability result that does not follow the expected trend, either in comparison with other stability batches or with respect to previous results collected during a stability study (1). OOT results are not necessarily OOS, but they do not look like a typical data point. Although OOT results are a serious problem, the scientific literature and regulatory guidelines do not fully address this issue. According to FDA's Guidance for Industry: Investigating OutOfSpecification (OOS) Test Results for Pharmaceutical Production (2), OOT results should be limited and scientifically justified. The guideline, however, does not define the process for identification of OOT results in stability data. The CMC Statistics and Stability Expert Teams of the Pharmaceutical Research and Manufacturers of America made an attempt to address this problem by suggesting several statistical methods for the identification of OOT results (3). The proposed statistical methods were redesigned and analyzed for the purposes of this study. The aim of this study was to make a statistical confirmation of the statistical methods, which will prove their functionality in identification of OOT results in ongoing stability data within a batch or data among batches. In addition, a comparison was made between the zscore method and the tolerance interval (TI) in terms of defining the limits for identification of the present OOT result. Materials and methods For the purpose of this study, data from ongoing stability studies of a final drug product with a shelf life of 36 months were used. The ongoing studies were conducted on 10 batches of Product X. Product X is manufactured in a tablet dosage form and consisted of one active substance with defined strength of 10 mg and packaged in a primary aluminium–polyvinyl chloride (Al–PVC) blister and a secondary package. The ongoing studies were conducted for 36 months in stability chambers at a constant temperature of 25 °C ± 2 °C and relative humidity of 60% ± 5% in accordance with the ICH guideline Q1A(R2) (4). The reported data are single data results for the assay attribute, calculated as a percentage of the declared active substance concentration. The assay attribute was analyzed in accordance to the validated internal method of the manufacturer at the time points of 0, 3, 6, 9, 12, 18, 24, and 36 months in all of the tested batches. The first nine batches were used as historical data for the purposes of the bytimepoint method and the slope controlchartmethod in addition to which the tenth batch was compared and analyzed. The historical data were used to define the limits for identification of present OOT results in the tenth batch; the regressioncontrolchartmethod analysis was conducted only on the tenth batch. In addition, simulated data also were implemented. The simulated data were comprised of eight test time points for each of the 10 simulated batches. Unlike the experiment, in the simulation, the 10 batches were tested using the regressioncontrolchart method. In the bytimepoint method and the slopecontrolchart method, however, the historical data of the real batches were used to individually analyze the 10 randomly generated batches.
To identify the present OOT result, the zscore test was used to calculate the z value for the slope at each time period of Batch 10. The value of z was limited to 2 < z <+2, provided that 95.45% of the future values will enter the interval of these limits. Unlike the previous two methods for identification of OOT results, where the absolute value of the result was analyzed, in this method, the authors analyzed the values for the slope. Because small changes in the slope value cause a significant change in the regression line (and in this case it would mean the kinetics of degradation), for this model, narrower limits for the zvalue were chosen.
Results and discussion The simulation gave the same results as the experiment. Therefore, this study was focused only on elaborating the experiment on its own. It must be noted that the obtained limits in this experiment will only apply to this final product in the given dosage form, strength, and primary and secondary packaging. With the use of the regressioncontrolchart method, three OOT results were detected in the time points of 9, 18, and 36 months (see Table I). The result in the 9month time point deviates approximately 0.19%. The result in the 18month time point deviated by 2%, and the result in the 36month time point deviated by 3% from the expected value according to the regression line. Taking into consideration that in the time point of 9 months, the regression line was constructed of only three points; the result was falsely identified as an OOT result, and it was not investigated further. In terms of the control limits, the zscore test provides a constant limit of 3σ standard deviations throughout the whole regression line unlike the TI that limits the results within 15σ for the time point of 6 months to 5σ for the time interval of 24 months. The bytimepoint method identified two OOT results in the time points of 18 and 24 months (see Table III). Compared with the results from the historical data for the appropriate time points, the results of the tested batch deviated approximately by 2%. According to the zvalue the results deviated 5σ from the average value of the historical data at those time points. In this method, the zscore test provided limits of 3σ, and the TI constant limit of 5.4σ (see Table IV). The slopecontrolchart method analysis resulted in identifying two OOT results (see Table V). The present OOT result for the time point of 18 months deviated 2.05σ and for 24 months deviated 5.97σ from the average value for the slope, according to the zvalue. The TI, on the other hand, provided limits of 3.6σ, which were wider than the limits comprised from the zscore test. Ultimately, each manufacturer is responsible for choosing its own control limits, suitable to the analysis of the corresponding final product with its own strength and primary and secondary packaging. This study provided a thorough explanation of the proposed methods for identification of OOT results. The methods were redesigned and improved to achieve proper evaluation of the tested stability data. The experiment revealed the positive and negative features of the proposed methods, thereby defining their appropriate use. The regressioncontrolchart method allowed analysis of the results within a batch, which was achieved by comparing the absolute values of the results and the predicted values that were obtained by extrapolation of the regression line. The main disadvantage of this method was the necessity of having results for each time point due to the fact that the construction of the regression line was based on gradually adding the values in each subsequent time point. For the time period of 0–9 months, the regression line was constructed only from three points; therefore, the calculations for the predicted values were prone to an error. This method, however, is suitable for identification of present OOT results in cases where there is no historical stability data. The bytimepoint method provides analysis of the results in each time point individually, and no assumptions about the shape of the degradation curve are needed. The main advantage of the method was that the absence of having a result in any time point did not affect the analysis of the previous or next time point result. In conclusion, this method is more appropriate for analysis of the results of the first four time points. The main disadvantage is that a large history of data is preferred for proper use of this method. This method, therefore, is not suitable for analysis of ongoing stability data at the beginning of the production of the final product. By measuring the slope of the regression line, the slopecontrolchart method provided analysis of each time point individually by analyzing the influence of each timepoint result on the regression line. Any small change in the value of the tested attribute from point to point was precisely recorded in the slope value of each time point. It is advised, therefore, to establish slightly narrower limits in this method in comparison to the first two methods. The main disadvantage of this method is that if the test of the attribute were omitted in any time point for various reasons, the limits of that time point may not be appropriate. In terms of the limits, the zscore method produced limits that remain constant around all of the time points in all of the methods for OOT results identification. The dependence of the TI on the number of samples included in the calculation was a major drawback for its use in the methods for OOT results identification. The TI requires a large number of results, which is difficult to meet in everyday practice within the pharmaceutical industry. The freedom of choosing the zscore limits remains a decision of each manufacturer, and it is determined according to its own requirements. Conclusion The pharmaceutical industry still lacks having a proper guideline for the identification of present OOT results among ongoing stability data. As a result, many pharmaceutical companies are not harmonized in the way they conduct this type of analysis. In this study, three methods for identification of OOT results in ongoing stability data were proposed: the regressioncontrolchart method, the bytimepoint method, and the slopecontrolchart method. To obtain more accurate identification of existing OOT results, simultaneous use of all three methods is advised, which will result in getting a visual image of the results of the analyzed batches. The use of the zscore method for defining the limits for the OOT results is preferred. Lastly, the study highlighted the necessity of issuing a regulatory confirmed guideline for identification of OOT results within ongoing stability data.
Adrijana Torbovska* is an analyst in the Quality Control Department of ReplekPharm, Kozle 188, 1000 Skopje, Macedonia, adrijana.torbovska@replek.com.mk * To whom all correspondence should be addressed. References 1. MHRA, Guidance for Out Of Secification Investigation, online presentation, (2010), www.mhra.gov.uk/home/groups/commscon/documents/websiteresources/con088215.pdf, accessed May 13, 2013. 2. FDA, Guidance for Industry: Investigating OutOfSpecification (OOS) Test Results for Pharmaceutical Production (Rockville, MD, 2006). 3. PhRMA CMC Statistics and Stability Expert Teams, Pharm. Technol. 27 (4), 3852 (2003). 4. ICH, Q1A (R2) Stability Testing of New Drug Substances and Products (Feb. 2003). 5. P.Rowe, Essential Statistics for the Pharmaceutical Sciences (John Wiley & Sons, West Sussex, UK, 2007), pp. 169194. 6. W.W. Daniel, Biostatistics A Foundation for Analysis in the Health Sciences (John Wiley & Sons, Hoboken, NJ, 9th ed., 2009), pp. 93131, 215304, and 409484. 7. S. Bolton and C. Bon, Pharmaceutical Statistics–Practical and Clinical Applications (Marcel Dekker Inc., Monticello, NY, Vol. 135, 4th ed., 2004), pp. 96150.

