Isotretinoin

辅料是药物制剂中除活性药物以外的其他成分，其添加的目的在于便于制剂的生产、增强制剂稳定性、调节释放以及提高生物利用度等。提起维生素大家首先想到的其是维持人体健康的重要营养元素，但其实在药物制剂中它已作为功能性辅料应用于包括口服、外用、注射等多种剂型中（见表1），本文主要概述了维生素作为辅料在制剂中发挥的作用。1、注射用剂型中的维生素Ÿ 维生素C：在制剂中主要以抗坏血酸、抗坏血酸钠、抗坏血酸棕榈酯形式存在，作用为抗氧剂、pH调节剂。抗坏血酸在奥卡西平肌肉注射混悬液、注射用多西环素、维替泊芬脂质体中作为抗氧剂使用；在一些含有放射性药物的制剂中，抗坏血酸钠和抗坏血酸可防止放射性药物分解，且无需在制剂基质中添加其它的稳定剂或缓冲剂；除作为抗氧剂，维生素C还可作为 pH 调节剂，用于需要非碱性介质的注射用溶液。Ÿ 维生素E：在罗米地辛静脉注射液和氟维司群注射液中，维生素E作为抗氧剂使用。维生素E还可用于静脉给药的脂质体，如免疫缺陷患者使用的抗真菌药两性霉素B脂质体，在此类制剂中维生素E能降低膜流动性，从而改善脂质堆积并减少渗透性，其构成脂质体外壳的一部分，有助于将API封装在脂质体内，提高制剂的稳定性及疗效。有研究表明维生素E还可添加至某些流感疫苗的佐剂中，发挥免疫刺激的协同作用，使得制剂产生更高的抗体应答。Ÿ 维生素B3：烟酰胺作为辅料加入到门冬胰岛素制剂中，可以与锌离子络合抑制，使得六聚体结构松散，其进入体内后解聚速度加快，从而促进制剂吸收。2、固体剂型中的维生素2.1固体制剂Ÿ 维生素C（抗坏血酸）在固体口服制剂中起到稳定剂和抗氧剂的作用，例如在辛伐他汀片剂中，辛伐他汀的共轭双键和羟基易氧化降解，而抗坏血酸的加入可提高其稳定性。此外，维生素C还在多种固体口服药物作为抗氧化剂使用，如治疗2型糖尿病的 沙格列汀、治疗银屑病的阿维A酸、十一酸睾酮和治疗骨质疏松的醋酸巴多昔芬等。Ÿ 维生素E（α-生育酚） 用于多种口服剂型，以提高API的稳定性、溶解度或分散性。免疫抑制剂西罗莫司和治疗高血压及前列腺增生的多沙唑嗪片剂均含有α-生育酚，以增强 API的稳定性。此外，维生素E衍生物聚乙二醇琥珀酸酯（TPGS） 也用于固体口服剂型，例如慢性偏头痛药物阿托吉泮的片剂含有 TPGS作为分散剂，用于治疗丙型肝炎的两种抗病毒药普瑞巴韦和格卡瑞韦 的组合制剂也含有TPGS，后者是一种固体口服分散体，TPGS作为增溶剂，可延缓或抑制药物再结晶。Ÿ 某些 B族维生素也被用作固体口服药物的辅料。维生素B1（硫胺素或硫胺素一水合物） 被列入乙肝药物恩替卡韦和抗抑郁药氟西汀的辅料清单中，但其具体作用尚不明确；维生素B2（核黄素）用作抗癫痫药奥卡西平和沙丙蝶呤的着色剂；维生素B3（烟酰胺） 在固体制剂中用作助溶剂，通过非胶束增溶作用提高疏水性物质的溶解度，多种难溶性双氯芬酸制剂中也含有烟酰胺，推测用于提高API溶解度。2.2半固体制剂维生素E（α-生育酚）及其衍生物TPGS在半固体口服剂型中具有多重功能，α-生育酚作为抗氧化剂添加至半固体制剂的油相中，例如在免疫抑制剂环孢素的软胶囊制剂中，该处方中α-生育酚作为油相成分，用于减轻环孢素诱导的肾毒性；对于高不稳定性脂溶性痤疮药物异维A酸（软明胶胶囊），α-生育酚与丁基羟基茴香醚（BHA）联用比单独使用BHA或BHT更能提高稳定性。TPGS也可提高低渗透性API的生物利用度，例如安普那韦因生物利用度低导致患者需服用大量制剂，而TPGS通过改善其溶解度和渗透性，使剂量降低从而提高患者的依从性。2.3液体制剂维生素C（抗坏血酸及其衍生物）在液体口服剂型中主要发挥三大作用：（1）抗氧化与稳定性调控：作为抗氧化剂稳定药物成分（如利司扑兰、雷帕霉素），防止活性成分氧化分解；（2）提高生物利用度：通过调节胃 pH 值（增加酸度），提高伊曲康唑等药物的吸收效率，尤其适用于胃酸不足的HIV患者；（3）pH 调节与缓冲作用：在口服疫苗中构建碳酸氢盐 - 抗坏血酸缓冲体系，抵御胃部较低的pH对疫苗活性的破坏（如霍乱、布鲁氏菌病疫苗）。3、局部给药剂型中的维生素维生素在局部给药中作为辅料主要发挥以下作用：（1）活性成分与皮肤改善：化妆品和医用局部制剂中添加的维生素既可以作为活性成分改善皮肤状况，也可作为非活性成分发挥防止酸败或皮肤调理作用；（2）提高制剂稳定性：维生素E（α-生育酚及其酯类）防止脂质基质氧化和光降解，例如在维A酸的乳膏中加入维生素 E（α-生育酚）可改善其光稳定性，在卡巴拉汀透皮贴中α- 生育酚的抗氧化特性用于确保卡巴拉汀在透皮贴剂中的稳定性，用于治疗帕金森病的罗替戈汀透皮贴剂含有维生素 C（抗坏血酸棕榈酸酯）和维生素 E（α- 生育酚），其作为抗氧化剂提高产品的稳定性。（3）促吸收：维生素 B5（泛醇）作为辅料或佐剂用于局部制剂，右旋泛醇可改善皮肤水合作用和渗透性，从而促进原料药的经皮吸收。4、维生素作为辅料的注意事项在药物制剂中选择维生素作为辅料，需考虑其在应用条件下的物理化学稳定性，以及药物、辅料与其之间的相互作用。Ÿ维生素C：通常与碱性溶质、重金属及某些活性成分（如盐酸去氧肾上腺素、马来酸吡咯胺、水杨酰胺、亚硝酸钠、水杨酸钠、水杨酸可可碱、阿替洛尔）不相容；其调节 pH 的特性可能导致与某些 API 不相容，例如青霉素G 的注射溶液与抗坏血酸反应；辅料中的痕量污染物也需考虑，如用作填充剂的蔗糖粉可能含痕量金属，催化抗坏血酸的非酶促褐变。ŸB族维生素：维生素 B1（硫胺素）干燥状态吸湿性强，在高湿环境下长期暴露会转化为水合物，水溶液 pH<5时稳定（除非加热至 140℃），可发生氧化和还原反应；维生素 B2（核黄素）溶液对光和还原剂敏感（尤其在碱性条件下），但耐氧化，酸性溶液中更稳定；维生素 B3（烟酸）除高温外通常稳定；维生素 B6（吡哆醇）对光敏感，与酸形成盐，在中性或碱性溶液中加热易分解；维生素B12（氰钴胺）吸湿性强，水溶液稳定，但可被硫醇还原，高温（>120℃）和极端 pH（<3或> 8）下分解；维生素B7（生物素）的结晶状态对热和空气稳定，但暴露于紫外线、氧化剂、强酸和强碱时不稳定。Ÿ 维生素D：对紫外线、热、空气和矿物酸敏感，重金属离子会加剧敏感性。Ÿ 维生素E：避光避氧时稳定，接触氧气并同时暴露于光、热和金属离子时易氧化，酯化可增强稳定性。维生素E衍生物（如TPGS）可能与API（如四氢大麻酚）反应，导致药物不稳定。从剂量与安全性方面考虑，长期用药需确保维生素辅料总剂量不超过耐受上限，避免毒性风险，另外某些维生素（如维生素B1衍生物、维生素B6）无辅料使用历史，在选择使用时可能被要求按照新辅料进行评估。总体而言，维生素是一类理想的辅料，能够显著提升注射、口服和局部用制剂的安全性和有效性。原文出自：Anne-Cécile V. Bayne, Pessi J , Bird J K ,et al.Vitamins as excipients in pharmaceutical products[J].European Journal of Pharmaceutical Sciences, 2025, 206(000).文章DOI:10.1016/j.ejps.2025.107020.药事纵横投稿须知：稿费已上调，欢迎投稿

Data from longest and largest hemophilia gene therapy study demonstrates sustained factor VIII expression and bleed control, with 81.3% of individuals remaining off prophylaxis No new safety signals observed SAN RAFAEL, Calif., June 24, 2025 /PRNewswire/ -- BioMarin Pharmaceutical Inc. (Nasdaq: BMRN) today announced new data underscoring the long-term efficacy and safety of ROCTAVIAN® (valoctocogene roxaparvovec-rvox) were presented at the 33rd Congress of the International Society on Thrombosis and Haemostasis (ISTH) in Washington, D.C., June 21-25, 2025. The Phase 3 GENEr8-1 trial demonstrated that durable bleed control and sustained factor VIII (FVIII) expression were maintained five years after treatment with ROCTAVIAN. FVIII activity remained consistent with previously reported results, and no new safety signals were observed. Across the entire trial, no participants developed FVIII inhibitors or experienced thromboembolic events, and there were no treatment-related malignancies across the five years of the study. "I am impressed that the strong efficacy and safety results for ROCTAVIAN are sustained five years after individuals with severe hemophilia A received gene therapy, with only one adult returning to prophylaxis since the last data cut," said Andrew Leavitt, M.D., director of the University of California San Francisco's program for noncancerous blood disorders and Adult Hemophilia Treatment Center. "These results highlight the role that gene therapy may play in addressing the burdens of chronic disease management in people living with hemophilia A, while maintaining excellent bleed control." Among the 134 individuals who received ROCTAVIAN in the study, the rollover population of 112 patients from the 270-902 noninterventional lead-in study had baseline annualized bleeding rate (ABR) data prospectively collected during a period of at least six months while on routine FVIII prophylaxis prior to receiving ROCTAVIAN, and two of the 112 patients discontinued the study prior to year five. After five years, FVIII activity was nearly stable compared to year four, with mean FVIII activity in the mild hemophilia range (one-stage assay = 24.0 IU/dL; chromogenic assay = 13.7 IU/dL); 73.5% of participants had FVIII levels in the mild hemophilia to normal range. The mean ABR for treated bleeds for the rollover population was 0.6 bleeds/year after year five. During year five, 77.8% of the remaining participants (n=108) in the rollover population had zero treated bleeds. At the end of year five, 81.3% (n=109) of participants remained off prophylaxis. Additionally, clinically relevant changes in health-related quality of life measures were observed over five years. "We hope these results demonstrating the long-term durability of gene therapy equip individuals with severe hemophilia A with the knowledge to make informed decisions regarding treatment," said Dawn Rotellini, Chief Operating Officer at the National Bleeding Disorders Foundation. "It is meaningful for the bleeding disorders community to see a continued commitment to highlighting the benefits of hemophilia A gene therapy." Additional data presented at the meeting described a framework for the measurement of the "hemophilia-free mind" in people who have received a ROCTAVIAN infusion, which represents an easing of the physical and psychological burden of hemophilia. Researchers leveraged clinical data as well as questionnaires to assess a number of quality of life outcomes from baseline to week 104. The analysis showed that people who received ROCTAVIAN in the Phase 3 GENEr8-1 study experienced improvements across all measures, including bleeding risk, joint pain, injection schedule, physical activity, travel, employment and education, and impact on family members and caregivers. "These five-year data reinforce our confidence in ROCTAVIAN's profile, showing that people living with severe hemophilia A can experience long-term bleed control without the need for prophylaxis, meaningfully impacting the mental and clinical burdens of this condition," said Greg Friberg, M.D., Executive Vice President and Chief Research & Development Officer at BioMarin. "We remain committed to supporting the medical community and individuals living with severe hemophilia A in the clinical adoption of this gene therapy so they can experience the benefits that this treatment can offer." Below are key presentations for BioMarin and ROCTAVIAN at ISTH (all times Eastern Daylight Time): Efficacy, Safety and Quality of Life 5 Years After Valoctocogene Roxaparvovec Gene Transfer Poster PB0804 Monday, June 23, 2025, 1:45 – 2:45 p.m. Final Analysis of the Phase 1/2 Trial of Valoctocogene Roxaparvovec for Severe Hemophilia A Poster PB0822 Monday, June 23, 2025, 1:45 – 2:45 p.m. Impact of Valoctocogene Roxaparvovec on Hemophilia-Free Mind: A Visual Multidimensional Method Poster PB0838 Monday, June 23, 2025, 1:45 – 2:45 p.m. Mechanisms of AAV Vector Persistence Following Infant Gene Therapy in Severe Hemophilia A Dogs Oral OC 51.1 Tuesday, June 24, 2025, 9:30 – 9:45 a.m. Steady Musculoskeletal Health After Gene Therapy in Severe Hemophilia A: 5-Year Results Oral OC 69.1 Wednesday, June 25, 2025, 10:15 – 10:30 a.m. About Hemophilia A Hemophilia A, also called factor VIII (FVIII) deficiency or classic hemophilia, is an X-linked genetic condition caused by missing or defective FVIII, a clotting protein. Although it is passed down from parents to children, about one-third of cases are caused by a spontaneous mutation, a new mutation that was not inherited. Approximately 1 in 10,000 people have hemophilia A. About ROCTAVIAN ROCTAVIAN is an adeno-associated virus vector-based gene therapy used for the treatment of adults with severe hemophilia A who do not have antibodies to adeno-associated virus serotype 5 (AAV5), which is determined by a blood test. The one-time infusion works by delivering a functional gene that is designed to enable the body to produce FVIII on its own, reducing the need for ongoing prophylaxis. The European Commission (EC) granted conditional marketing authorization to ROCTAVIAN on August 24, 2022. The U.S. Food and Drug Administration (FDA) approved ROCTAVIAN on June 29, 2023. More information on testing to determine eligibility to receive ROCTAVIAN can be found at in the U.S. and in Germany. U.S. Important Safety Information ROCTAVIAN U.S. Important Safety Information Contraindications: Patients with active infections, either acute (such as acute respiratory infections or acute hepatitis) or uncontrolled chronic (such as chronic active hepatitis B). Patients with known significant hepatic fibrosis (stage 3 or 4 on the Batts-Ludwig scale or equivalent), or cirrhosis, and patients with known hypersensitivity to mannitol. Infusion-related reactions including hypersensitivity reactions and anaphylaxis, have occurred. Monitor during and for at least 3 hours after ROCTAVIAN administration. Administer ROCTAVIAN in a setting where personnel and equipment are immediately available to treat infusion-related reactions. Discontinue infusion for anaphylaxis. Hepatotoxicity: The safety and effectiveness of ROCTAVIAN in patients with hepatic impairment has not been established. Perform liver health assessments prior to administration. The majority of patients treated with ROCTAVIAN experienced ALT elevations and required corticosteroids for ALT elevation. Assess patient's ability to receive corticosteroids and/or other immunosuppressive therapy that may be required for an extended period. Live vaccines should not be administered to patients while on immunosuppressive therapy. Monitor ALT weekly for at least 26 weeks and as clinically indicated, during corticosteroid therapy and institute corticosteroid treatment in response to ALT elevations as required. Continue to monitor ALT until it returns to baseline. Monitor factor VIII activity levels since ALT elevation may be accompanied by a decrease in factor VIII activity. One case of autoimmune hepatitis was reported during third year follow-up in a patient with history of hepatitis C and steatohepatitis. It is recommended that patients abstain from consuming alcohol for at least 1 year after administration and thereafter limit alcohol use. Concomitant medications may cause hepatotoxicity, decrease factor VIII activity, or change plasma corticosteroid levels which may impact liver enzyme elevation and/or factor VIII activity or decrease the efficacy of the corticosteroid regimen or increase their side effects. Closely monitor concomitant medication use including herbal products and nutritional supplements and consider alternative medications in case of potential drug interactions. Thromboembolic events: Factor VIII activity above ULN has been reported following ROCTAVIAN infusion. Thromboembolic events may occur in the setting of elevated factor VIII activity above ULN. Evaluate patients for risk of thrombosis including general cardiovascular risk factors before and after administration of ROCTAVIAN. Advise patients on their individual risk of thrombosis in relation to their factor VIII activity levels above ULN and consider prophylactic anticoagulation. Advise patients to seek immediate medical attention for signs or symptoms indicative of a thrombotic event. Factor VIII inhibitors and Monitoring for inhibitors: The safety and effectiveness of ROCTAVIAN in patients with prior or active factor VIII inhibitors have not been established. Patients with active factor VIII inhibitors should not take ROCTAVIAN. Following administration, monitor patients for factor VIII inhibitors (neutralizing antibodies to factor VIII). Test for factor VIII inhibitors especially if bleeding is not controlled, or plasma factor VIII activity levels decrease. Monitor Factor VIII using the same schedule for ALT monitoring. It may take several weeks after ROCTAVIAN infusion before ROCTAVIAN-derived factor VIII activity rises to a level sufficient for prevention of spontaneous bleeding episodes. Exogenous factor VIII or other hemostatic products may also be required in case of surgery, invasive procedures, trauma, or bleeds. Consider more frequent monitoring in patients with factor VIII activity levels ≤ 5 IU/dL and evidence of bleeding, taking into account the stability of factor VIII levels since the previous measurement. Factor VIII activity produced by ROCTAVIAN in human plasma is higher if measured with one-stage clotting assays compared to chromogenic substrate assays. When switching from hemostatic products prior to ROCTAVIAN treatment, physicians should refer to the relevant prescribing information to avoid the potential for factor VIII activity assay interference during the transition period. Malignancy: The integration of liver-targeting AAV vector DNA into the genome may carry the theoretical risk of hepatocellular carcinoma development. ROCTAVIAN can also insert into the DNA of other human body cells. Monitor patients with risk factors for hepatocellular carcinoma (e.g., hepatitis B or C, non-alcoholic fatty liver disease, chronic alcohol consumption, non-alcoholic steatohepatitis, advanced age) with regular liver ultrasound (e.g., annually) and alpha-fetoprotein testing for 5 years following ROCTAVIAN administration. In the event that any malignancy occurs after treatment with ROCTAVIAN, contact BioMarin Pharmaceutical Inc. at 1-866-906-6100. Most Common Adverse Reactions: Most common adverse reactions (incidence ≥ 5%) were nausea, fatigue, headache, infusion-related reactions, vomiting, and abdominal pain. Most common laboratory abnormalities (incidence ≥ 10%) were ALT, AST, LDH, CPK, factor VIII activity levels, GGT and bilirubin > ULN. Patients also experienced adverse reactions from corticosteroid use. Isotretinoin, Efavirenz, and HIV Positive Patients: Isotretinoin is not recommended in patients who are benefiting from ROCTAVIAN. Efavirenz is not recommended in patients treated with ROCTAVIAN. Clinical studies of ROCTAVIAN did not include sufficient numbers of patients with HIV to determine whether the efficacy and safety differs compared to patients without HIV infection. Females and Males of Reproductive Potential: ROCTAVIAN is not intended for administration in women. There are no data on the use of ROCTAVIAN in pregnant women or regarding lactation. For 6 months after administration of ROCTAVIAN, men of reproductive potential and their female partners must prevent or postpone pregnancy using an effective form of contraception, and men must not donate semen. You may report side effects to the FDA at (800) FDA-1088 or . You may also report side effects to BioMarin at 1-866-906-6100. Please see the ROCTAVIAN full Prescribing Information for additional Important Safety Information. About BioMarin BioMarin is a global biotechnology company dedicated to translating the promise of genetic discovery into medicines that make a profound impact on the life of each patient. The San Rafael, California-based company, founded in 1997, has a proven track record of innovation with eight commercial therapies and a strong clinical and preclinical pipeline. Using a distinctive approach to drug discovery and development, BioMarin seeks to unleash the full potential of genetic science by pursuing category-defining medicines that offer new possibilities for people living with genetically defined conditions around the world. To learn more, please visit . Forward-Looking Statements This press release contains forward-looking statements about the business prospects of BioMarin Pharmaceutical Inc. (BioMarin), including without limitation, statements about: data presented at the 33rd Congress of the International Society on Thrombosis and Haemostasis (ISTH), including the oral and poster presentations; ROCTAVIAN's efficacy, safety and benefits to individuals with hemophilia A, including health-related quality of life; and BioMarin's commitment to supporting the medical community and individuals living with severe hemophilia A in the clinical adoption of ROCTAVIAN. These forward-looking statements are predictions and involve risks and uncertainties such that actual results may differ materially from these statements. These risks and uncertainties include, among others: BioMarin's success in the commercialization of ROCTAVIAN; results and timing of current and planned pre-clinical studies and clinical trials of ROCTAVIAN; any potential adverse events observed in the continuing monitoring of the patients in the clinical trials; the content and timing of decisions by the U.S. Food and Drug Administration, the European Commission, and other regulatory authorities; and those factors detailed in BioMarin's filings with the Securities and Exchange Commission, including, without limitation, the factors contained under the caption "Risk Factors" in BioMarin's Quarterly Report on Form 10-Q for the quarter ended March 31, 2025, as such factors may be updated by any subsequent reports. Stockholders are urged not to place undue reliance on forward-looking statements, which speak only as of the date hereof. BioMarin is under no obligation, and expressly disclaims any obligation to update or alter any forward-looking statement, whether as a result of new information, future events or otherwise. BioMarin® and ROCTAVIAN® are registered trademarks of BioMarin Pharmaceutical Inc. SOURCE BioMarin Pharmaceutical Inc. WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED