Eli Lilly¡­s ²òǤ¤¹¤ëd ¶ÛµÞ ÅüǢɠËãÌô ¡Êµ¡¤Î¡Ë¥«¥à from ¹©¾ì¡¿¿¢Êª Æõ­¤¹¤ë¡¿°úÍѤ¹¤ëd by FDA

By Dan Levine and Marisa Taylor

Oct 4 (Reuters) - A recently ²òǤ¤¹¤ëd ¡ÊÀ½ÉÊ¡¤¹©»öºàÎÁ¤Î¡Ë°ì²óʬ of Glucagon ¶ÛµÞ Æ»¶ñs, Eli Lilly and Co¡­s therapy for diabetic ´µ¼Ôs in ´íµ¡, was À½Â¤¡Ê¤¹¤ë¡Ëd at an Indiana factory Æõ­¤¹¤ë¡¿°úÍѤ¹¤ëd by U.S. health regulators this year for ¼Á-»ÙÇۡʤ¹¤ë¡Ë¡¿ÅýÀ©¤¹¤ë °ãÈ¿s, ´Þ¤àing several ȼ¤¦¡¿´Ø¤ï¤ëing that À½ÉÊ, ¤Ë¤è¤ì¤Ð the company and a Reuters review of Ϣˮ¤Î ºº»¡ µ­Ï¿¡¤µ­Ï¿Åª¤Ê¡¿µ­Ï¿¤¹¤ës.

The Indianapolis-based company on Sept. 24 ÌäÂ꡿ȯ¹Ô¤¹¤ëd a voluntary U.S. ²òǤ¤¹¤ë https://Åê»ñ²È.lilly.com/news-²òÊü¡Ê¤¹¤ë¡Ës/news-²òÊü¡Ê¤¹¤ë¡Ë-¾ÜºÙ¡Ê¤Ë½Ò¤Ù¤ë¡Ës/eli-lilly-and-company-ÌäÂ꡿ȯ¹Ô¤¹¤ës-voluntary-Á´¹ñŪ¤Ê-²òǤ¤¹¤ë-one-lot of one lot of the Æ»¶ñs whose ½ÅÍ×¤Ê À®Ê¬ is Glucagon, a ËãÌô used to °·¤¦¡¿¼£ÎŤ¹¤ë ´í¸±¤Ë low ·ì sugar in ÅüǢɠ´µ¼Ôs. The company ÌäÂ꡿ȯ¹Ô¤¹¤ëd a voluntary ²òǤ¤¹¤ë in Canada https://www.lilly.ca/en-CA/news/°µÎϡʤò¤«¤±¤ë¡Ë-²òÊü¡Ê¤¹¤ë¡Ës/21.09.25-voluntary-²òǤ¤¹¤ë-of-a-Áª¤Ó½Ð¤¹¡¿ÆÈ¿È-lot-of-Glucagon the ¤Ë°ú¤­Â³¤¤¤Æ day.

Lilly¡­s ²òǤ¤¹¤ë notices said that the company had received a Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬ of a ´µ¼Ô who experienced seizures even after ¸ºß ÃíÆþ¤¹¤ëd with the ËãÌô, a Ä´°õ¤¹¤ë that the ¼£ÎÅ was not potent enough to work. The company said the À½ÉÊ ¼ºÇÔ might be ´Ø·¸¤Î¤¢¤ë to its À½Â¤¶È¤Î ²áÄø, without (a)¼ê¤Î¹þ¤ó¤À¡¿(v)¾Ü½Ò¤¹¤ëing.

In ÊÖÅú to Reuters¡­ Ä´ººs, Lilly told the news organization that the ±Æ¶Á¤¹¤ë¡¿´¶¾ðd Æ»¶ñs were produced at a company »ÜÀß in Indianapolis, and that the Æ»¶ñ that Ͷȯ¤¹¤ëd the ²òǤ¤¹¤ë had been ʬÇÛ¤¹¤ëd in Canada. As Reuters Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬d in May, the Indianapolis ¹©¾ì¡¿¿¢Êª had been Æõ­¤¹¤ë¡¿°úÍѤ¹¤ëd by U.S. health regulators https://www.reuters.com/¾¦Çä¡¿»Å»ö/healthcare-À½Ìô¤Îs/ÇÓ½üŪ-lilly-¹¶·â¤¹¤ë¡¤¾×Æͤ¹¤ë-by-staff-¹ðÁÊ¡¤¹ðȯs-fda-scrutiny-covid-ËãÌô-factories-2021-05-05 for substandard ±ÒÀ¸ÀßÈ÷ and ÉʼÁ´ÉÍý ¼ê³¤­s.

ʬ¤«¤ì¤Æ, Lilly is ľÌ̤¹¤ëing a Ϣˮ¤Î ÈȺá¤Î Ä´ºº https://www.reuters.com/¾¦Çä¡¿»Å»ö/¹çˡŪ¤Ê/ÇÓ½üŪ-us-opens-ÈȺá¤Î-Ä´ºº¡Ê¤¹¤ë¡Ë-into-¿½¤·Î©¤Æ¤é¤ì¤¿¡¿µ¿¤ï¤·¤¤-lapses-eli-lilly-¹©¾ì¡¿¿¢Êª-2021-05-27 into ¿½¤·Î©¤Æ¤é¤ì¤¿¡¿µ¿¤ï¤·¤¤ À½Â¤¶È¤Î ÉÔÀµ¹Ô°Ùs ȼ¤¦¡¿´Ø¤ï¤ëing anothe r of its U.S. factories in New Jersey, ¾ÜºÙ¡Ê¤Ë½Ò¤Ù¤ë¡Ës of which were first Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬d by Reuters https://www.reuters.com/article/us-health-elililly-special-Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬/special-Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬-insider-¼çÄ¥¤¹¤ës-eli-lilly-Éõº¿¤¹¤ëd-her-À®²Ì¡¿ÅØÎÏs-to-sound-alarms-about-u-s-ËãÌô-factory-idUSKBN2B31K5 earlier this year. The ²òǤ¤¹¤ë of Glucagon Æ»¶ñs made in Indianapolis is the first »Ø¼¨¡¤É½¼¨¤¹¤ëʪ of ²ÄǽÀ­¤Î¤¢¤ë ´µ¼Ô ³²¡Ê¤òÍ¿¤¨¤ë¡Ë ͽÄê to ºÇ¶á¤Î À½Â¤¶È¤Î ÌäÂ꡿ȯ¹Ô¤¹¤ës at the company¡­s ¹©¾ì¡¿¿¢Êªs.

"Lilly is ¿¼¤¯¡¤¶¯Îõ¤Ë committed to À½Â¤¶È¤Î high-¼Á Ìô¡¿°å³Øs for ´µ¼Ôs who need them-nothing is more important to us," the company said in a À¼ÌÀ. "We take our µÁ̳s Ëܵ¤¤Ç and have rigorous ¼Á systems in place to ³Î¼Â¤Ë¤¹¤ë Ʊ°Õ¡¿Éþ½¾ with stringent regulatory ɬÍ×ʪ¡¿É¬Í×¾ò·ïs."

In all, ³µÎ¬¤Ç 66,000 Glucagon ¶ÛµÞ Æ»¶ñs were ±Æ¶Á¤¹¤ë¡¿´¶¾ðd by the ²òǤ¤¹¤ës, Lilly spokeswoman Kathryn Beiser told Reuters. She said about 19,000 of those were ʬÇÛ¤¹¤ëd to U.S. ¸ÜµÒs and nearly all the »Ä¤ê¡¿µÙ·Æ¡Ê¤¹¤ë¡Ë in Canada. She said the Æ»¶ñs were produced at the Indianapolis ¹©¾ì¡¿¿¢Êª around May 2020. Beiser µñÀ䤹¤ë¡¿Äã²¼¤¹¤ëd to say whether Lilly has received other Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬s of µÕ¤Î events ´Ø·¸¤Î¤¢¤ë to the Glucagon Æ»¶ñs.

EMERGENCY KITS

The ²òǤ¤¹¤ëd Glucagon ¶ÛµÞ Æ»¶ñ was designed for ÅüǢɠ´µ¼Ôs whose ·ì sugar is µÞÍ¤ëing, and who need to raise it quickly to Èò¤±¤ë Ê£»¨²½s that can ´Þ¤à seizures or death. The Æ»¶ñ consists of a vial, which is supposed to ´Þ¤à¡¿Éõ¤¸¹þ¤á¤ë Åà·ë¤¹¤ë-´¥Á礷¤¿¡¤Æü¾È¤ê¤Îd Glucagon ºÕ¤¯, and a separate Àö¾ô´ï¡¿Èé²¼Ãí¼Í¡¿Þ±Ä²´ï filled with liquid.

ÉáÄ̤Ï, a caregiver ÁÞÆþ¤¹¤ës the liquid-filled Àö¾ô´ï¡¿Èé²¼Ãí¼Í¡¿Þ±Ä²´ï needle into the Glucagon vial ¡¼¤¹¤ë¤¿¤á¤Ë dilute the ºÕ¤¯ before ¼£¤á¤ëing it. Lilly's ²òǤ¤¹¤ë ¹ð¼¨ said the vial used by the stricken ´µ¼Ô ´Þ¤à¡¿Éõ¤¸¹þ¤á¤ëd liquid, instead of ºÕ¤¯.

The company¡­s Indianapolis ¹©¾ì¡¿¿¢Êª À®¤·¿ë¤²¤ës what is known in the »º¶È as "fill and finish" - receiving raw ËãÌôs made at other »ÜÀßs, putting them into vials and Àö¾ô´ï¡¿Èé²¼Ãí¼Í¡¿Þ±Ä²´ïs, and shipping them to ¸ÜµÒs.

U.S. Food and ËãÌô ¹ÔÀ¯ ins pection µ­Ï¿¡¤µ­Ï¿Åª¤Ê¡¿µ­Ï¿¤¹¤ës from March 2021 ¸«²ò¡Ê¤ò¤È¤ë¡Ëd by Reuters Æõ­¤¹¤ë¡¿°úÍѤ¹¤ëd Èó¾ï¤Ë¡¿Â¿¿ô¤Î ¼Á-»ÙÇۡʤ¹¤ë¡Ë¡¿ÅýÀ©¤¹¤ë °ãÈ¿s at that ¹©¾ì¡¿¿¢Êª, such as staff failing to ŬÀÚ¤Ë ´Æ»ë¤¹¤ë ´Ä¶­¤Î ¾ò·ïs where the finished ËãÌôs are made and failing to ÀßΩ¤¹¤ë appropriate ¼ê³¤­s to ˸¤²¤ë ±øÀ÷.

The FDA »ë»¡´±s said they ´Ñ»¡¤¹¤ëd lapses in the À½Â¤¶È¤Î of the Glucagon Æ»¶ñs ƱÍÍ¤Ë as in Lilly¡­s COVID-19 antibody therapy bamlanivimab and several other ËãÌôs, ¤Ë¤è¤ì¤Ð the ºº»¡ µ­Ï¿¡¤µ­Ï¿Åª¤Ê¡¿µ­Ï¿¤¹¤ës, »þÂåÃÙ¤ì¤Î March 16. They ·ëÏÀ¤¹¤ëd that Lilly must take steps to ¼£ÎÅ¡ÊÌô¡Ë the lapses but did not recommend regulatory ³èÆ°¡¿ÀïÆ® on the part of the FDA.

Lilly spokeswoman Beiser said U.S. ÇÛÅö of Glucagon ¶ÛµÞ Æ»¶ñs from the lot that was later ²òǤ¤¹¤ëd had Ãæ»ß¤¹¤ëd by March 25, a little more than a week after the FDA ºº»¡ Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬. Beiser said the ÇÛÅö of the lot followed its Àµµ¬¤Î¡¿ÀµÁª¼ê ²áÄø ·Ðͳ¤Ç ²·Çä¶È¼Ô channels and was not ´Ø·¸¤Î¤¢¤ë to the FDA Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬, Äɲ乤ëing that "any suggestion" it ended for other ¿äÏÀ¤¹¤ë¡¿Íýͳs is ¸í¤Ã¤¿.

°ìÊý¡¿¹ç´Ö, ¶ÛµÞ Æ»¶ñs from that same ¡ÊÀ½ÉÊ¡¤¹©»öºàÎÁ¤Î¡Ë°ì²óʬ continued to be ʬÇÛ¤¹¤ëd in Canada, Beiser said. ÇÛÅö of 44,000 Æ»¶ñs in Canada began in February 2021 and continued through the middle of September, she said. The ´µ¼Ô ¡Ê̱»ö¤Î¡Ë¹ðÁÊ that Ͷȯ¤¹¤ë¡¿°ú¤­µ¯¤³¤¹d the late September ²òǤ¤¹¤ë ȼ¤¦¡¿´Ø¤ï¤ëd a Æ»¶ñ that had been shipped to Canada, Beiser told Reuters.

Beiser µñÀ䤹¤ë¡¿Äã²¼¤¹¤ëd to comment ÆÃ¤Ë on why ÇÛÅö of Glucagon ¶ÛµÞ Æ»¶ñs from the ¡ÊÀ½ÉÊ¡¤¹©»öºàÎÁ¤Î¡Ë°ì²óʬ continued for another six months in Canada after ÇÛÅö had Ãæ»ß¤¹¤ëd in the ÉôÂâd ÌÀ¸À¤¹¤ë¡¿¸øɽ¤¹¤ës. She did not answer questions about whether the ±Æ¶Á¤¹¤ë¡¿´¶¾ðd ´µ¼Ô ²óÉü¤¹¤ëd.

Health Canada, a regulatory µ¡´Ø Îà»÷¤Î to the U.S. FDA, µñÀ䤹¤ë¡¿Äã²¼¤¹¤ëd to comment about Lilly¡­s voluntary ²òǤ¤¹¤ë of the Glucagon ¶ÛµÞ Æ»¶ñs, or why Æ»¶ñs from the ¡ÊÀ½ÉÊ¡¤¹©»öºàÎÁ¤Î¡Ë°ì²óʬ continued to be ʬÇÛ¤¹¤ëd in Canada for months after they had Ãæ»ß¤¹¤ëd to be ʬÇÛ¤¹¤ëd in the ÉôÂâd ÌÀ¸À¤¹¤ë¡¿¸øɽ¤¹¤ës.

The FDA µñÀ䤹¤ë¡¿Äã²¼¤¹¤ëd to comment on ÇÛÅö of the Æ»¶ñs, whether it had r eceived other Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬s of µÕ¤Î events, had re-¸¡ºº¡¿»ë»¡¤¹¤ëd Lilly's Indianapolis »ÜÀß or if it planned Éղà ³èÆ°¡¿ÀïÆ®s ´Ø·¸¤Î¤¢¤ë to the ²òǤ¤¹¤ë.

"It is important to ¸ø¼°Ê¸½ñ¡¤Ç§¤á¤ë that this ²òǤ¤¹¤ë was a voluntary ³èÆ°¡¿ÀïÆ® taken by the company," FDA ¹­ÊóôÅö¼Ô Jeremy Kahn said, without (a)¼ê¤Î¹þ¤ó¤À¡¿(v)¾Ü½Ò¤¹¤ëing. "We have been closely ɾ²Á¤¹¤ëing this event and will continue to ´Æ»ë¤¹¤ë the marketplace and À½Â¤¶È¤Î À®²Ì¡¿ÅØÎÏs to help ³Î¼Â¤Ë¤¹¤ë the availability of °ÂÁ´¤Ê À½ÉÊs for U.S. ¾ÃÈñ¼Ôs."

FEDERAL PROBE

The ²òǤ¤¹¤ë comes as Lilly ľÌ̤¹¤ës a ÈȺá¤Î Ä´ºº by the U.S. »ÊË¡¾Ê into ¿½¤·Î©¤Æ¤é¤ì¤¿¡¿µ¿¤ï¤·¤¤ À½Â¤¶È¤Î ÉÔÀµ¹Ô°Ùs and µ­Ï¿¡¤µ­Ï¿Åª¤Ê¡¿µ­Ï¿¤¹¤ës-tampering at a separate factory in Branchburg, New Jersey, that produces bamlanivimab and other ËãÌôs.

The »ÊË¡¡Ê´±¡Ë Department has not ¡Ê·º»ö¡ËÈï¹ð Lilly of any °­»ö¤òƯ¤¯¤³¤È, and the company said earlier this year that it is ¶¨ÎϤ¹¤ëing in the Ä´ºº¡Ê¤¹¤ë¡Ë. Lilly did not Åú¤¨¤ë¡¿±þ¤¸¤ë to a question from Reuters about the status of that Ä´ºº. The »ÊË¡¡Ê´±¡Ë Department did not Åú¤¨¤ë¡¿±þ¤¸¤ë to a request for comment.

Bamlanivimab, the COVID-19 antibody, À½Â¤¡Ê¤¹¤ë¡Ëd at the Branchburg »ÜÀß has been sent to the Indianapolis fill-and-finish ¹©¾ì¡¿¿¢Êª to be put into vials and shipped.

A group of FDA »ë»¡´±s arrived at the Indianapolis ¹©¾ì¡¿¿¢Êª in Ãæ±û¤Î-February and stayed for more than two weeks, ¤Ë¤è¤ì¤Ð a redacted ¸«²ò¡¿ËÝÌõ¡¿ÈÇ of their Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬, which Reuters ÆÀ¤ëd ·Ðͳ¤Ç a Freedom of ¡Ê·Ù»¡¤Ê¤É¤Ø¤Î¡ËÌ©¹ð¡¤¹ðÁʡʾõ¡Ë ¹Ô°Ù¡¿Ë¡Îá¡¿¹ÔÆ°¤¹¤ë request.

In their Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬, the »ë»¡´±s ̾Êí¡Ê¤ËºÜ¤»¤ë¡Ë¡¿É½¡Ê¤Ë¤¢¤²¤ë¡Ëd Glucagon as ¤ÎÃæ¤Ç the ËãÌôs where Lilly "failed to ÀßΩ¤¹¤ë an Ŭ¤¹¤ë system for ´Æ»ë¤¹¤ëing ´Ä¶­¤Î ¾ò·ïs," and ¸ø¼°Ê¸½ñ¡¤Ç§¤á¤ëd that Lilly failed to ÀßΩ¤¹¤ë and follow appropriate written ¼ê³¤­s "to ˸¤²¤ë microbiological ±øÀ÷ of ËãÌô À½ÉÊs ¼ñ»Ýing to be sterile."

In ¿·µ¬²ÃÆþ, the »ë»¡´±s said Lilly did not ŬÀÚ¤Ë ¹Ô°Ù¡¿¹Ô¤¦ ¼Á-»ÙÇۡʤ¹¤ë¡Ë¡¿ÅýÀ©¤¹¤ë ¸«ËÜing of glass ¹½À®Í×ÁÇs like vials and À½Ìô¤Î À®Ê¬s for ËãÌôs ´Þ¤àing Glucagon, bamlanivimab and the ´â ËãÌô Cyramza.

In Lilly¡ ­s April 6 ÊÖÅú to the FDA ÆÀ¤ëd by Reuters through an open µ­Ï¿¡¤µ­Ï¿Åª¤Ê¡¿µ­Ï¿¤¹¤ës request, the company said it takes the »ë»¡´±s¡­ findings "very Ëܵ¤¤Ç" and is ´ï¶ñ¡¿¼Â»Ü¤¹¤ëing ³èÆ°¡¿ÀïÆ®s to ²ò·è¤¹¤ë ´Ø¿´s "on ÀѶËŪ¤Ê timelines."

Lilly said it has ÀßΩ¤¹¤ëd a Êñ³çŪ¤Ê ´Ä¶­¤Î ´Æ»ë¤¹¤ëing program designed to ººÄꤹ¤ë¡¿¡ÊÀǶâ¤Ê¤É¤ò¡Ë²Ý¤¹ microbiological »ÙÇۡʤ¹¤ë¡Ë¡¿ÅýÀ©¤¹¤ë of À½Â¤¶È¤Î spaces, the redacted ÊÖÅú said. The company did not Åú¤¨¤ë¡¿±þ¤¸¤ë to questions about the status of its À®²Ì¡¿ÅØÎÏs to ½¤Àµ¤¹¤ë °ãÈ¿s ¸ø¼°Ê¸½ñ¡¤Ç§¤á¤ëd by the FDA at the Indianapolis ¹©¾ì¡¿¿¢Êª.

(Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬ing by Dan Levine in San Francisco and Marisa Taylor in Washington, DC; Éղà Êó¹ð¡Ê¤¹¤ë¡Ë¡¿²±Â¬ing by Allison Martell in Toronto; Editing by Michele Gershberg and Marla Dickerson)

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