Safety verification for polysorbate 20, pharmaceutical excipient for intramuscular administration, in Sprague-Dawley rats and New Zealand White rabbits

PLoS One. 2021 Aug 27;16(8):e0256869. doi: 10.1371/journal.pone.0256869. eCollection 2021.

Abstract

Human serum albumin (HSA) has been widely used as a pharmaceutical excipient in Botulinum toxin serotype A (BoNT/A) products that are indicated for use in therapeutics and cosmetics. However, HSA as a human-derived material has some concerns, such as the potential risk of transmission of infectious agents, an insufficient supply, and difficulty in maintaining a certain quality. For those reasons, newly developed BoNT/A products (CORETOX®, Medytox, Inc., Republic of Korea) contained polysorbate 20, a non-human-derived excipient, to replace the HSA. However, most safety studies of polysorbate 20 have been conducted with non-invasive routes of administration, and thus there are a few studies on the safety of polysorbate 20 when administered intramuscularly. To secure the in vivo safety profile of polysorbate 20, a four-week repeated intramuscular dose toxicity study (0.02, 0.1, and 0.4 mg/kg, one injection every two weeks for a total of three injections) was conducted in 66 Sprague-Dawley (SD) rats. An intradermal irritation study was further conducted with 18 New Zealand White (NZW) rabbits. The toxicological evaluation of HSA (0.06 and 0.12 mg/kg) was also carried out as a comparative substance. Systemic and local toxicities were not observed in any of the SD rats or NZW rabbits based on clinical signs, body weight, hematology, clinical biochemistry, macroscopic findings on necropsy, histopathology of the injection site, and allergic reactions. The current study suggested that intramuscular administration of polysorbate 20 was considered to be safe at a level similar to that of HSA, which has an in vivo safety profile accumulated over the years. This provided the basis for the in vivo safety profile of polysorbate 20 administered intramuscularly and the scientific reliability of the use of polysorbate 20 as an alternative to HSA, which is used as an excipient for various pharmaceuticals in terms of its safety.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Botulinum Toxins / antagonists & inhibitors
  • Botulism / drug therapy*
  • Excipients
  • Humans
  • Polysorbates / adverse effects
  • Polysorbates / pharmacology*
  • Rabbits
  • Rats
  • Rats, Sprague-Dawley
  • Republic of Korea
  • Serum Albumin, Human / adverse effects
  • Serum Albumin, Human / therapeutic use

Substances

  • Excipients
  • Polysorbates
  • Botulinum Toxins
  • Serum Albumin, Human

Grants and funding

This study was supported by the Technology Innovation Program, establishment of risk management platform with aim of reduce attrition of new drugs and its service [grant number: 10067737, 2016], funded by the Ministry of Trade, Industry & Energy in Republic of Korea (WCS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors [JK, SK, MSP, CHR, GHY, WhK] are employed by a commercial company, Medytox Inc., which only provided support in the form of salaries for authors, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.