Quantitative Analysis of Spaceflight Drug Stability Data to Support a Predictive Pharmaceutical Testing Strategy

To systematically quantify the time-dependent effect of spaceflight on active pharmaceutical ingredient (API) degradation, data were extracted from available published and unpublished spaceflight drug stability studies. Seven studies were identified that investigated the stability of individual medications following storage aboard crewed spacecraft. Medications stored for up to 2.4 years in low earth orbit (LEO) show limited change in API potency that, in all cases, falls within 10% of matched terrestrial controls, and within 5% of controls for the most drugs. This investigation shows that spaceflight is associated with a ~1.5-fold increase in the degradation rate relative to lot-matched terrestrial controls. Spaceflight is associated with an increased probability of drug failure over time; however, the incremental increase in degradation risk associated with spaceflight is minor compared to the baseline risk associated with terrestrial controls. Since most drugs across all NASA-supported studies were repackaged solid oral formulations that had been removed from protective manufacturer packaging, it is likely that prolonged exposure to atmospheric factors during both terrestrial and spaceflight treatments is a key contributor to degradation. Unique spaceflight environmental factors, particularly ionizing radiation and elevated CO2, may contribute to the additional cumulative effect of spaceflight. The results of this study show that the effect of spaceflight on drug stability is minor relative to the terrestrial baseline; however, the degradation rate and time-dependent failure of terrestrial controls highlights an extremely critical need to evaluate the effect of current repackaging methods and development of operationally appropriate methods to protected repackaged solid oral medications from environmental factors that mediate degradation.