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CHMP position statement on Creutzfeldt-Jakob disease and plasma ...

CHMP position statement on Creutzfeldt-Jakob disease and plasma ...

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Figure 1:<br />

Plasma-Derived Medicinal Products: estimati<strong>on</strong> of potential reducti<strong>on</strong> capacity of specific<br />

manufacturing processes<br />

Important Note: this flow diagram should be read in c<strong>on</strong>juncti<strong>on</strong> with the preceding text in 9.2.3. It is<br />

recommended to c<strong>on</strong>sult the relevant competent authorities at the milest<strong>on</strong>es in this estimati<strong>on</strong>. Give priority<br />

to studies <strong>on</strong> products with the lowest potential removal capacity.<br />

1. Theoretical c<strong>on</strong>siderati<strong>on</strong> of potential reducti<strong>on</strong> of<br />

infectivity by manufacturing process<br />

Available<br />

data is<br />

relevant<br />

to<br />

product?<br />

Yes<br />

Go to 4<br />

No<br />

2. Investigati<strong>on</strong>al studies using biochemical assays<br />

Has<br />

biochemical<br />

assay been<br />

correlated<br />

with<br />

infectivity<br />

assay?<br />

Yes<br />

Go to 4<br />

No<br />

Is the step<br />

critical for<br />

removal of<br />

infectivity?<br />

No<br />

Go to 4<br />

Yes<br />

3. C<strong>on</strong>firm investigati<strong>on</strong> with infectivity assay for critical<br />

step(s)<br />

4. Estimate reducti<strong>on</strong> capacity<br />

Is<br />

reducti<strong>on</strong><br />

capacity<br />

limited?<br />

No<br />

No further acti<strong>on</strong><br />

Yes<br />

5. C<strong>on</strong>sider additi<strong>on</strong> of step that may increase reducti<strong>on</strong><br />

capacity<br />

9.2.4. Recall of batches where informati<strong>on</strong> becomes available postd<strong>on</strong>ati<strong>on</strong><br />

In view of the lack of adequate informati<strong>on</strong> <strong>on</strong> vCJD, it is prudent to recall batches of <strong>plasma</strong>-derived<br />

medicinal products where a d<strong>on</strong>or to a <strong>plasma</strong> pool subsequently develops vCJD. Recall should also<br />

include medicinal products c<strong>on</strong>taining <strong>plasma</strong>-derived products as excipients (see also 9.2.5).<br />

However, in both cases, c<strong>on</strong>sequences for essential medicinal products where alternatives are not<br />

available will need careful c<strong>on</strong>siderati<strong>on</strong> by the competent authorities.<br />

17/26

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