2SPD-009 Impact of hospital transport systems, including pneumatic tubes, on protein stability in IV bags and syringes

<h3>Background and Importance</h3> In hospitals with centralised compounding cleanrooms, high-quality standards are achieved, ensuring both a safe occupational environment and financial benefits through vial sharing. However, reconstituted medications must be transported to the wards or patients via processes not described in the approved Summary of Product Characteristics. The use of pneumatic tubes is prohibited in many hospitals after studies demonstrating increased subvisible particles from protein aggregates¹ However, recent studies have reported no effect on product quality provided excipients are present in the IV bags.² <h3>Aim and Objectives</h3> The aim of this study is to evaluate the impact of pneumatic tube systems and electric platform trucks on protein stability in IV bags and ready-to-use syringes. <h3>Material and Methods</h3> Two examples of products were transported from a hospital compounding pharmacy using either a pneumatic tube system or an electric platform truck. Insulin was repackaged in disposable syringes to simulate vial sharing of expensive drugs and the monoclonal antibody trastuzumab was diluted in saline IV bags to represent compounding for oncological treatments. Smartlabels (CPI, UK) was used to investigate accelerometer data. Flow imaging microscopy, size-exclusion chromatography and visual inspection measurements were performed. <h3>Results</h3> The results showed that syringes had increased levels of spherical particles, most likely silicone oil, after transport using pneumatic tubes. This was not seen for electric platform truck transport. For IV bags the transport using pneumatic tubes increased the total subvisible particle count when there was headspace in the IV bags. This was also the case for IV bags with no added drug product indicating that the particles were released from the material. Although polysorbate 20 prevented particles over 10µm, the total particle levels increased when the surfactant was added to the IV bags. <h3>Conclusion and Relevance</h3> The high shock levels during transport using pneumatic tubes appear to release particles from the material in both syringes and IV bags. It is recommended to remove headspace during transport of IV bags especially during transport using pneumatic tube systems. <h3>References and/or Acknowledgements</h3> Linkuviene, V. <i>J.Pharm.Sci</i> 111.4 (2022):1024–39 Desai, K. <i>Mol.Pharm</i> 20.12 (2023):6474–91 <h3>Funding statement</h3> This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement N° 101007939 (RealHOPE). This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA. <h3>Conflict of Interest</h3> No conflict of interest