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WHO Expert Committee on Biological Standardization: sixty-eighth report Web Edition - 1011.1 [Pehme köide]

This report presents the recommendations of a WHO Expert Committee commissioned to coordinate activities leading to the adoption of international recommendations for the production and control of vaccines and other biological substances, and the establishment of international biological reference materials.

Following a brief introduction, the report summarizes a number of general issues brought to the attention of the Committee. The next part of the report, of particular relevance to manufacturers and national regulatory authorities, outlines the discussions held on the development and adoption of new and revised WHO Recommendations, Guidelines, and guidance documents.

Following these discussions, WHO Guidelines on the quality, safety and efficacy of Ebola vaccines, and WHO Guidelines on procedures and data requirements for changes to approved biotherapeutic products were adopted on the recommendation of the Committee. In addition, the following two WHO guidance documents on the WHO prequalification of in vitro diagnostic medical devices were also adopted: (a) Technical Specifications Series (TSS) for WHO Prequalification - Diagnostic Assessment: Human immunodeficiency virus (HIV) rapid diagnostic tests for professional use and/or self-testing; and (b) Technical Guidance Series (TGS) for WHO Prequalification - Diagnostic Assessment: Establishing stability of in vitro diagnostic medical devices. Subsequent sections of the report provide information on the current status, proposed development and establishment of international reference materials in the areas of: antibiotics, biotherapeutics other than blood products; blood products and related substances; in vitro diagnostics; and vaccines and related substances.

A series of annexes are then presented which include an updated list of all WHO Recommendations, Guidelines, and other documents on biological substances used in medicine (Annex 1). The above four WHO documents adopted on the advice of the Committee are then published as part of this report (Annexes 2-5). Finally, all additions and discontinuations made during the 2017 meeting to the list of International Standards, Reference Reagents and Reference Panels for biological substances maintained by WHO are summarized in Annex 6. The updated full catalog of WHO International Reference Preparations is available at: http://www.who.int/bloodproducts/catalogue/en/.
Abbreviations xiii
1 Introduction
1(2)
2 General
3(26)
2.1 Current directions
3(7)
2.1.1 Strategic directions in the regulation of medicines and other health technologies
3(2)
2.1.2 Vaccines and biotherapeutics: recent and planned activities in biological standardization
5(3)
2.1.3 Blood products and in vitro diagnostics: recent and planned activities in biological standardization
8(2)
2.2 Reports
10(3)
2.2.1 Report from the WHO Blood Regulators Network
10(2)
2.2.2 Report from the WHO network of collaborating centres on standardization and regulatory evaluation of vaccines
12(1)
2.2.3 Report from the WHO network of collaborating centres for blood products and in vitro diagnostics
13(1)
2.3 Feedback from custodian laboratories
13(3)
2.3.1 Developments and scientific issues highlighted by custodians of WHO biological reference preparations
13(3)
2.4 Cross-cutting activities of other WHO committees and groups
16(9)
2.4.1 Update from the WHO Expert Committee on Specifications for Pharmaceutical Preparations
16(1)
2.4.2 WHO Global Benchmarking Tool
17(1)
2.4.3 Development of WHO guidelines on good regulatory practices
18(1)
2.4.4 Snake-bite envenoming
19(2)
2.4.5 Update from the WHO Product Development for Vaccines Advisory Committee
21(1)
2.4.6 Pilot WHO prequalification of biosimilar monoclonal antibodies
22(1)
2.4.7 Model NRA Lot Release Certificate for prequalified vaccines
23(1)
2.4.8 Planned proficiency testing study of a standardized method for determining total and free saccharide content of Hib liquid combined vaccines
24(1)
2.4.9 Vaccine prequalification-establishment of the WHO-NNB
24(1)
2.5 Strategic issues
25(4)
2.5.1 Standards for priority pathogens for public health emergencies
25(2)
2.5.2 International standards and reference preparations - revision of TRS 932 Annex 2
27(2)
3 International Recommendations, Guidelines and other matters related to the manufacture, quality control and evaluation of biological substances
29(9)
3.1 Biotherapeutics other than blood products
29(1)
3.1.1 Guidelines on procedures and data requirements for changes to approved biotherapeutic products
29(1)
3.2 Cellular and gene therapies
30(1)
3.2.1 Global activities in cell therapy products
30(1)
3.3 In vitro diagnostics
31(5)
3.3.1 WHO IVD prequalification: update report
31(2)
3.3.2 Human immunodeficiency virus rapid diagnostic tests for professional use and/or self-testing
33(1)
3.3.3 Establishing stability of in vitro diagnostic medical devices
34(1)
3.3.4 WHO consultation on the First WHO International Standard for anti-rubella immunoglobulin
35(1)
3.4 Vaccines and related substances
36(2)
3.4.1 Guidelines on the quality, safety and efficacy of Ebola vaccines
36(2)
4 International reference materials - antibiotics
38(1)
4.1 Proposed new projects and updates-antibiotics
38(1)
4.1.1 Proposed Third WHO International Standard for erythromycin
38(1)
5 International reference materials - biotherapeutics other than blood products
39(5)
5.1 WHO International Standards and Reference Reagents - biotherapeutics other than blood products
39(5)
5.1.1 Second WHO International Standard for parathyroid hormone 1-34 (recombinant, human)
39(1)
5.1.2 First WHO International Standard for rituximab
40(1)
5.1.3 First WHO International Standard for infliximab
41(3)
6 International reference materials - blood products and related substances
44(4)
6.1 WHO International Standards and Reference Reagents - blood products and related substances
44(4)
6.1.1 First WHO Reference Reagent for activated blood coagulation factor X (human)
44(1)
6.1.2 Second WHO International Standard for activated blood coagulation factor IX (human)
45(1)
6.1.3 First WHO International Standard for blood coagulation factor XII (plasma, human) via assignment of additional analytes to the current Second WHO International Standard for blood coagulation factor XI (plasma, human)
46(2)
7 International reference materials - in vitro diagnostics
48(20)
7.1 WHO International Standards and Reference Reagents - in vitro diagnostics
48(11)
7.1.1 First WHO Reference Reagent for lupus anti-dsDNA serum
48(1)
7.1.2 Third WHO International Standard for hepatitis A virus RNA for NAT-based assays
49(1)
7.1.3 Fourth WHO International Standard for HIV-1 RNA for NAT-based assays
50(1)
7.1.4 First WHO International Standard for Ebola virus antibodies (plasma, human); and First WHO Reference Panel for Ebola virus antibodies (plasma, human)
51(1)
7.1.5 First WHO Reference Panel for genomic KRAS codons 12 and 13 mutations
52(2)
7.1.6 First WHO International Standard for human herpes virus 6B DNA for NAT-based assays
54(1)
7.1.7 First WHO International Standard for Plasmodium falciparum antigens
55(1)
7.1.8 First WHO International Standard for anti-cytomegalovirus immunoglobulin G
56(1)
7.1.9 First WHO International Standard for chikungunya virus RNA for NAT-based assays
57(1)
7.1.10 First WHO International Standard for Zika virus antibodies (immunoglobulin G and immunoglobulin M) (human)
58(1)
7.2 Proposed new projects and updates - in vitro diagnostics
59(9)
7.2.1 Proposed First WHO Reference Panel for cancer mutation detection
59(1)
7.2.2 Proposed Third WHO International Standard for prekallikrein activator
60(1)
7.2.3 Proposed First WHO Reference Reagent for anti-human platelet antigen 15b
60(1)
7.2.4 Proposed First WHO International Standard for anti-cyclic citrullinated peptide antibodies
61(1)
7.2.5 Proposed Second WHO International Standard for rheumatoid factor
62(1)
7.2.6 Proposed Second WHO reference reagents for dengue virus subtypes 1-4
63(1)
7.2.7 Proposed First WHO International Standard for cutaneous leishmaniasis; and FirstWHO Reference Panel for cutaneous leishmaniasis
63(1)
7.2.8 Proposed First WHO International Standard for Plasmodium vivax antigens; and First WHO Reference Reagent for anti-malaria (Plasmodium vivax) serum
64(1)
7.2.9 Proposed First WHO International Standard for anti-MERS-CoV serum
65(1)
7.2.10 Proposed First WHO International Standard for MERS-CoV RNA for NAT-based assays
65(1)
7.2.11 Proposed Sixth WHO International Standard for hepatitis C virus RNA for NAT-based assays
66(2)
8 International reference materials - vaccines and related substances
68(13)
8.1 WHO International Standards and Reference Reagents - vaccines and related substances
68(6)
8.1.1 First WHO international standards for oral poliomyelitis vaccines
68(1)
8.1.2 Second WHO International Standard for pertussis toxin
69(1)
8.1.3 First WHO international standards for Citrobacter freundii and Salmonella Typhi Vi polysaccharides
70(2)
8.1.4 First WHO International Standard for anti-typhoid capsular Vi polysaccharide immunoglobulin G (human)
72(1)
8.1.5 First WHO International Standard for antiserum to respiratory syncytial virus
73(1)
8.2 Proposed new projects and updates - vaccines and related substances
74(7)
8.2.1 Proposed First WHO Reference Panel for Vibrio cholera 01 and 0139 lipopolysaccharides
74(1)
8.2.2 Proposed First WHO Reference Panel for anti-Wbrio cholera 01 and 0139 lipopolysaccharide serums (rabbit)
75(1)
8.2.3 Proposed First WHO International Standard for Vibrio cholera vaccine (oral, inactivated)
76(1)
8.2.4 Proposed FirstWHO International Standard for antibody to the influenza virus haemagglutinin stem domain
76(1)
8.2.5 Proposed First WHO international standards for influenza virus pathogenicity for safety testing
77(1)
8.2.6 Proposed Third WHO International Standard for anti-rabies immunoglobulin (human)
78(3)
Annex 1 WHO Recommendations, Guidelines and other documents related to the manufacture, quality control and evaluation of biological substances used in medicine 81(6)
Annex 2 Guidelines on the quality, safety and efficacy of Ebola vaccines 87(94)
Annex 3 Guidelines on procedures and data requirements for changes to approved biotherapeutic products 181(100)
Annex 4 Technical Specifications Series (TSS) for WHO Prequalification - Diagnostic Assessment 281(34)
Annex 5 Technical Guidance Series (TGS) for WHO Prequalification - Diagnostic Assessment 315(62)
Annex 6 Biological substances: WHO International Standards, Reference Reagents and Reference Panels 377