South Korea health authority warns on falsified tirzepatide pens
Reported from the analysis, not from a warning notice.
TheCompound Journal
Reporting on incretins, compounding & the peptide supply chain
Endotoxin
Purity, content, identity, sterility and endotoxin are five separate determinations. A single sheet of paper carrying one of them is not evidence about the other four.
We began looking at this seriously after a reader sent us a certificate with a query attached. The certificate reported 99.2 per cent purity for a lyophilised peptide, and the reader wanted to know whether that meant the remaining 0.8 per cent could be bacterial. It is a reasonable question and the answer is that the figure has nothing to do with bacteria in either direction. A vial containing a substantial microbial burden would very probably return a purity figure indistinguishable from a clean one, because the mass involved is far below the integration threshold of any method in commercial use.
Consider what happens physically when a certificate is produced. A few milligrams of lyophilised powder are weighed, dissolved in an aqueous mobile phase with an organic modifier, injected onto a reversed-phase column and separated over a programmed gradient while an ultraviolet detector records absorbance. The output is a trace. Software integrates the areas beneath its features, and the main peak area as a proportion of the total becomes the purity figure.
Every step of that procedure is blind to microbial contamination. A bacterial cell contributes no ultraviolet-absorbing peak at any retention time a peptide method would record. Endotoxin, a lipopolysaccharide, is not usefully detected at the wavelengths used for peptide bond absorbance and would in any case be present at a mass fraction several orders of magnitude below any integration threshold in commercial use. A vial holding a hundred colony-forming units and a vial holding none produce chromatograms that no analyst could distinguish.
This is not a defect of the method. Reversed-phase chromatography is an excellent way of determining what proportion of the chromatographically visible material is the intended species, and that is what it is being asked. The defect is in the reading. A document answering one question is being filed as evidence about five.
The lysate on which conventional endotoxin testing depends is harvested from horseshoe crabs, which are bled and returned to the sea with a mortality that is disputed and not negligible. The assay also inherits the biological variability of a natural product: lysate lots differ, and the cascade includes a branch responsive to beta-glucans, which is a common source of false positives in the presence of cellulose filter residues.
Recombinant factor C reagents replace the harvested cascade with an expressed enzyme, activated by lipopolysaccharide and read chromogenically or fluorimetrically. The response is specific to endotoxin and insensitive to the glucan branch, lot-to-lot consistency is a manufacturing rather than an ecological question, and comparative studies across a wide range of matrices have found agreement with conventional methods well within the variability of the conventional methods themselves.
The reagent has been available for well over a decade and its slow adoption was a regulatory rather than a scientific matter: for years it sat in an alternative-method chapter, obliging users to validate it as a departure. That has now changed, with dedicated chapters in both the United States and European compendia treating recombinant reagents as methods in their own right, and the Journal expects the harvested lysate to become the historical option within this decade.12
A stated negative is a fact a reader can use. An omission is a space a reader fills with an assumption.
The standing rule in this departmentThe limit is derived, not looked up. For a parenteral product other than an intrathecal one, the threshold pyrogenic dose is taken as five endotoxin units per kilogram of body weight per hour. The endotoxin limit for the product is that figure divided by the maximum dose per kilogram administered within an hour. For an intrathecal route the threshold falls to 0.2 endotoxin units per kilogram, a twenty-five-fold reduction that reflects the absence of the systemic buffering the bloodstream provides.
Work it for a concrete case. A seventy-kilogram subject has an hourly allowance of three hundred and fifty endotoxin units. A vial nominally containing five milligrams of peptide, reconstituted to two millilitres, from which a fifth of a millilitre is drawn, delivers a tenth of the vial contents. If the whole vial carried three hundred and fifty endotoxin units, that draw would deliver thirty-five — a tenth of the allowance. The limit expressed per milligram of peptide is what a certificate should carry, because it is the only form of the number that survives a change in reconstitution volume.
None of the arithmetic is difficult. What is missing from this trade is not the calculation but the measured numerator.3
| Question | Answered | Declined | No reply |
|---|---|---|---|
| Fill route: aseptic or terminal | 9 | 4 | 7 |
| Pre-filtration bioburden determined | 7 | 4 | 9 |
| Filter integrity tested post-use | 5 | 4 | 11 |
| Aseptic process simulation performed | 3 | 5 | 12 |
| Endotoxin determined on finished product | 4 | 4 | 12 |
| Questions were sent twice, four weeks apart, to the published contact address of each company. Declined denotes a reply that engaged with the question and refused it; no reply denotes two unanswered messages. Four of the declines cited the research-use-only basis of sale, which the Journal regards as a legally sound answer. | |||
The Journal tracks the release documentation of twenty companies. On sterility and endotoxin the picture is close to uniform. Every one publishes a purity figure. A minority publish an identity confirmation. Two publish peptide content. On the microbiological attributes, the standard document is silent, and the silence is not annotated: there is no line reading that sterility has not been determined, which would at least be informative.
Some of the practices we would like to see are already in use somewhere in the group. SSA reports peptide content on its certificates, having begun after correspondence with this publication. CPC and SWB describe their fill environment in general terms on request. QST and BCH answered our five questions in full. WXT and FGP declined on the grounds that research-use products are not represented as sterile injectables, which is a legally sound answer that concedes the point of the exercise. Several others did not respond, and we record non-response as non-response rather than as evasion.
What we are criticising is a documentary convention, not the conduct of any company named here. None of the twenty has been shown to us to have misrepresented anything. The convention is that a chemistry certificate stands in for a release package, and it is a convention this trade adopted collectively and could abandon the same way.
The compendial material in this article is drawn from the current general chapters of the United States Pharmacopeia and the European Pharmacopoeia, read in the original rather than in summary, and from the international standards on aseptic processing and on laboratory competence. Where a chapter has changed status recently — as the recombinant reagent chapters have — we say so, because a reader consulting an older edition will find a different framing.
Where the Journal reports a number it obtained itself, it states the laboratory’s accreditation status, the method family, whether method suitability was established, and the number of determinations. Where we report what a company told us, we distinguish an answer from a refusal and a refusal from a non-response, because those three things are routinely collapsed in coverage of this trade and they are not the same.
Corrections to this department are handled by the standards desk, which reads every letter and records the outcome in the log. Readers who believe a paragraph here overstates its evidence are asked to write to standards@compoundjournal.com; readers with documents to send, including certificates they would like read, should write to letters@compoundjournal.com. We do not publish correspondents’ names without permission and we do not identify the source of a certificate.
We will keep asking the five questions, printing the answers, and recording the refusals as refusals. Two companies changed their certificates after the first round of this correspondence, which is a small result for a year of letters and rather better than none. Documents to letters@compoundjournal.com; disputes about anything above to standards@compoundjournal.com.
Reported from the analysis, not from a warning notice.
Documentation practice is the only part of vendor quality a buyer can assess before purchase.
Reported from the analysis, not from a warning notice.
The Journal submitted the sample and paid for the analysis. The vendor was told in advance.
What a verification mark would have to carry to be checkable: a date, a lot, a method, a submitter and a link to the report.
The route did not close because of a rule about peptides.