title: Establishment of the first WHO International Standard for etanercept, a TNF receptor II Fc fusion protein: Report of an international collaborative study.
abstract: Etanercept, a recombinant human tumor necrosis factor (TNF) receptor Fc fusion protein is an effective treatment option in adults with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis or plaque psoriasis and paediatrics with juvenile idiotypic arthritis and plaque psoriasis. Patent expiration in Europe and intense development of various etanercept products worldwide triggered a need for an international reference standard to facilitate determination of biological activity. Therefore, three candidate preparations of etanercept were lyophilized and evaluated in a multi-centre collaborative study comprising twenty eight laboratories from 15 countries for their suitability to serve as an international standard for the bioactivity of TNF receptor II Fc fusion proteins (international nonproprietary name, Etanercept). The preparations were tested for neutralization activity against the third TNF-α international standard (IS) in different in vitro cell-based assays, e.g., cytotoxicity, apoptosis and reporter gene methods. Regardless of the assay and the amount of TNF-α IS used, potency estimates for the different preparations were very similar. An indication of the inhibitory activity of etanercept in terms of the biological activity of the TNF-α IS based on ED50 data derived from a limited number of laboratories using a cytotoxicity assay was also derived. Results indicated that the candidate preparation coded 13/204 was stable and suitable to serve as an international standard for the biological activity of etanercept. Therefore, the preparation coded 13/204 was established by the WHO Expert Committee on Biological Standardization (ECBS) in 2015 as the WHO first International Standard for TNF receptor II Fc fusion protein (INN, etanercept) with an assigned in vitro bioactivity of 10,000IU per ampoule. It should be noted that this first-in-class international standard for a Fc fusion protein, available from the National Institute for Biological Standards and Control and also as a biological reference preparation (BRP) from the European Directorate for the Quality of Medicines and Healthcare, is intended for controlling the performance of biological assays for etanercept and to support the establishment of in-house bioassay standards. This standard is not intended for describing the labelling or dosage of etanercept therapeutic products or for use as a comparator (reference product) for biosimilarity determination.
authors.affiliation: Cytokines and Growth Factors Section, Biotherapeutics Group, National Institute for Biological Standards and Control, Medicines and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, HERTS EN6 3QG, UK. Electronic address: Meenu.Wadhwa@nibsc.org.
authors.forename: Meenu
authors.initials: M
authors.lastname: Wadhwa
authors.affiliation: Cytokines and Growth Factors Section, Biotherapeutics Group, National Institute for Biological Standards and Control, Medicines and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, HERTS EN6 3QG, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Bird
authors.affiliation: Cytokines and Growth Factors Section, Biotherapeutics Group, National Institute for Biological Standards and Control, Medicines and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, HERTS EN6 3QG, UK.
authors.forename: Paula
authors.initials: P
authors.lastname: Dilger
authors.affiliation: Statistics Section, Technology Development and Infrastructure, National Institute for Biological Standards and Control, Medicines and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, HERTS EN6 3QG, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Rigsby
authors.affiliation: Cytokines and Growth Factors Section, Biotherapeutics Group, National Institute for Biological Standards and Control, Medicines and Healthcare products Regulatory Agency, Blanche Lane, South Mimms, Potters Bar, HERTS EN6 3QG, UK.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Jia
authors.affiliation: European Directorate for the Quality of Medicines & HealthCare, 7 allée Kastner, CS 30026, F-67081 Strasbourg, France.
authors.forename: Marie Emmanuelle Behr
authors.initials: MEB
authors.lastname: Gross
mesh_terms: D000818:Animals; D002138:Calibration; D002460:Cell Line; D045744:Cell Line, Tumor; D004355:Drug Stability; D004356:Drug Storage; D000068800:Etanercept / Q000737:chemistry / Q000494:pharmacology* / Q000592:standards*; D005612:Freeze Drying; D006801:Humans; D007391:International Cooperation; D051379:Mice; D012015:Reference Standards; D014944:World Health Organization
chemical_list: D000068800:Etanercept