Mihalchik-Burhans AL, Sullivan DW. 2019. Bridging issues of route. In: Gad S (ed), Integrated Safety and Risk Assessment for Medical Devices and Combination Products, pp. 273–297. Springer.
Abstract
Current regulatory guidelines call for the identification and quantification of chemical compounds which may migrate out of a medical device, combination product, or a drug container closure system, and into an individual. Compounds that migrate from these devices often have little available toxicity data resulting in a major challenge in performing an adequate assessment of biological or toxicological risks and thus potentially compromising patient safety. These limited toxicity data may exist by alternative routes. Therefore, route-to-route extrapolation of the available data may be considered for use in these instances. Here we discuss the factors to consider when performing route-to-route extrapolations for L&E compounds beginning with historic and regulatory approaches. This will be followed by a review of pharmacokinetic and pharmacodynamic considerations regarding the applicability of route-to-route extrapolation. Finally, we will discuss route-specific considerations and the derivation of safe exposure limits.
