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Integrated Safety and Risk Assessment for Medical Devices and Combination Products (Paperback, 1st ed. 2019)
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Integrated Safety and Risk Assessment for Medical Devices and Combination Products (Paperback, 1st ed. 2019)
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While the safety assessment ("biocompatibility") of medical devices
has been focused on issues of local tissue tolerance (irritation,
sensitization, cytotoxicity) and selected quantal effects
(genotoxicity and acute lethality) since first being regulated in
the late 1950s, this has changed as devices assumed a much more
important role in healthcare and became more complex in both
composition and in their design and operation. Add to this that
devices now frequently serve as delivery systems for drugs, and
that drugs may be combined with devices to improve device
performance, and the problems of ensuring patient safety with
devices has become significantly more complex. A part of this,
requirements for ensuring safety (once based on use of previously
acceptable materials - largely polymers and metals) have come to
requiring determining which chemical entities are potentially
released from a device into patients (and how much is released).
Then an appropriate and relevant (yet also conservative) risk
assessment must be performed for each identified chemical
structure. The challenges inherent in meeting the current
requirements are multifold, and this text seeks to identify,
understand, and solve all of them. * Identify and verify the most
appropriate available data. * As in most cases such data is for a
different route of exposure, transform it for use in assessing
exposure by the route of interest. * As the duration (and rate) of
exposure to moieties released from a device are most frequently
different (longer) than what available data speaks to,
transformation across tissue is required. * As innate and adaptive
immune responses are a central part of device/patient interaction,
assessing potential risks on this basis are required. *
Incorporating assessments for special populations such as neonates.
* Use of (Q)SAR (Quantitative Structure Activity Relationships)
modeling in assessments. * Performance and presentation of
integrative assessments covering all potential biologic risks.
Appendices will contain summarized available biocompatibility data
for commonly used device materials (polymers and metals) and safety
assessments on the frequently seen moieties in extractions from
devices.
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