Some epilepsy medications may harm a developing fetus, so the findings point to a need for greater awareness of interactions between enzyme-inducing antiseizure medications and some hormonal contraceptives. These medications can accelerate the breakdown of contraceptive hormones in the body, potentially reducing protection against an unplanned pregnancy. The researchers emphasize the importance of informed counseling and shared decision-making so that people with epilepsy can choose medication and contraceptive options that reflect their health needs and preferences.

“Pregnancy planning is especially important for people with epilepsy, but patients may not realize that some antiseizure medications can interact with some forms of hormonal contraception,” said senior author Page B. Pennell, M.D., chair of the Department of Neurology at Pitt’s School of Medicine. “This study highlights an opportunity for neurologists, reproductive health clinicians, pharmacists and patients to have more coordinated conversations about medications, contraception and reproductive goals.”

Using U.S. Medicaid claims data, the researchers identified 110,976 people with epilepsy of childbearing potential who were receiving antiseizure medications. Nearly 1 in 5 had received a hormonal contraceptive that could be affected by enzyme-inducing antiseizure medications between 2018 and 2021. The contraceptive methods included combined and progestin-only pills, contraceptive patches, vaginal rings and subdermal implants.

Among those individuals, nearly one-third experienced at least one period of 14 days or longer when prescriptions for a susceptible contraceptive and an enzyme-inducing antiseizure medication overlapped. Among people with an overlap, the median duration was 218 days, or just over seven months.

“These were not simply brief or isolated prescription overlaps,” said corresponding author Laura Kirkpatrick, M.D., M.S., assistant professor of pediatrics and neurology at the University of Pittsburgh School of Medicine. “For many people, the overlap continued for months. Clinicians should routinely consider potential drug interactions and make sure patients understand their options, including contraceptive methods that are not affected by enzyme-inducing antiseizure medications.”

Certain groups were more likely to experience potentially reduced contraceptive effectiveness. People with intellectual disability had more than twice the odds of experiencing an overlap compared with people without intellectual disability. Those with drug-resistant epilepsy and those age 35 or older also had higher odds of overlap and longer periods of concurrent prescriptions.

Effective contraception can be particularly important for people with epilepsy because pregnancy can bring additional health considerations. Some antiseizure medications have been associated with risks to a developing fetus, as have uncontrolled seizures. An unplanned pregnancy may provide less opportunity to adjust medications to ones that are proven to be safe for both the mother and developing child.

The researchers noted that not all contraceptive methods are affected by these interactions. Intrauterine devices, including hormonal and copper devices, are not affected by enzyme-inducing antiseizure medications and may be discussed as an option when consistent with a patient’s preferences. Co-use of an interacting medication combination may also be appropriate in some circumstances when a patient understands the potential risks and benefits.

Future research will examine pregnancy rates among people who received overlapping prescriptions and explore why these medication combinations are prescribed. The authors also call for research into interventions such as electronic health record alerts, pharmacist review and patient- and clinician-facing education to improve awareness and support shared decision-making.

Additional authors were Elizabeth I. Harrison, M.D., of the University of Virginia; Caryn Dutton, M.D., of Beth Israel Deaconess Medical Center and Harvard University; Wesley T. Kerr, M.D., Ph.D., and Scott D. Rothenberger, Ph.D., of Pitt; and Samuel W. Terman, M.D., M.S., of the University of Michigan.

The research received support from the National Institute of Neurological Disorders and Stroke 5K12NS098482-07, NIH K23NS135134, K23NS124656, R25NS089450, U24NS107158), the National Institute on Aging (K23 AG081463), the American Epilepsy Society, the Epilepsy Foundation, the American Academy of Neurology, the American Brain Foundation, the Epilepsy Study Consortium and the UPMC Competitive Medical Research Fund.

Explore the full study and related resources:

• Contraceptive and Enzyme-Inducing Antiseizure Medication Co-Prescription Among U.S. Medicaid Beneficiaries with Epilepsy |Neurology
• Epilepsy & Birth Control | Epilepsy & Pregnancy Medical Consortium
• Epilepsy Research | Department of Neurology
• Comprehensive Epilepsy Center | UPMC
• Women’s Neurology Services | UPMC

DOI – 10.1212/WNL.0000000000218679

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In the trial, 39 adults with prior GLP-1-induced weight loss were randomized to usual care, a digital wellness application, or medically tailored meals at the time of GLP-1 cessation, continuing for 4 months.

Surveys showed that diet quality, perceived health, adherence, and satisfaction did not differ significantly by group, though some estimates suggested possible trends favoring the wellness application. Relative to the control group, the other groups experienced less weight gain. Over 4 months, participants in the control group gained an estimated 10.75% body weight, compared with 3.60% in the wellness application group and 3.58% in the medically tailored meals group.

“People invest significant time and effort in improving their health and achieving weight loss,” said corresponding author Kelseanna Hollis-Hansen, PhD, MPH, of Tufts University Food is Medicine Institute. “We need evidence-based strategies to support them if and when they discontinue GLP-1 medication, so they can maintain those gains and continue building long-term health, vitality, and well-being.”

URL upon publication: https://onlinelibrary.wiley.com/doi/10.1002/osp4.70194

About the Journal
Obesity Science & Practice is an open access journal which offers prompt publication of high-quality original research related to all aspects of obesity and its comorbidities. The journal publishes papers of interest to researchers in academic, clinical, government and industry roles working to develop, test, and refine new medical, behavioral, dietary, pharmacologic and surgical approaches to treat obesity. The journal also publishes papers of interest to professionals engaged in the clinical management of obesity and its related comorbidities as well as individuals actively involved in the prevention of obesity at the local, regional, national and international level.

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Pharmaceutical cartridges for 3D printing can be stored for six months and still produce printed oral doses that meet European Pharmacopoeia requirements, according to Léna Lemierre (MB Therapeutics and ICGM, Montpellier) and colleagues. The ability to store cartridges and print on demand, by means of semi-solid extrusion 3D printing, could give pharmacies considerable flexibility.

There is a growing need for personalised doses. Manual and semi-automated compounding suffer from operator-dependent variability and are difficult to scale up. Automated compounding by 3D printing offers greater reproducibility and flexibility. However, it requires semi-solid formulations that remain suitable for printing after storage.

In this study, five batches of a semi-solid formulation containing an active pharmaceutical ingredient – melatonin – were filled into cartridges. Printed oral dosage forms (POFs) were produced by semi-solid extrusion on a MED-U PROD® printer (MB Therapeutics). The team compared POFs made from freshly prepared cartridges with those made from cartridges stored for six months under long-term conditions before printing. Stability studies followed ICH Q1A(R2), under long-term (25°C) and accelerated (40°C/75% relative humidity) conditions. Drug content and content uniformity were assessed according to the European Pharmacopoeia (2.9.40), with an acceptance value of 15 or below considered compliant. Microbiological quality was tested according to the European Pharmacopoeia (5.1.4).

POFs made from fresh cartridges remained compliant throughout the study, which covered up to 12 months under long-term conditions and 6 months under accelerated conditions. Mean drug content was 97.7–99.8% of the label claim, and acceptance values ranged from 10.0 to 14.1. POFs made from cartridges stored for six months performed at least as well. Mean drug content was 97.6–101.8%, and acceptance values were 6.6–8.9, well below the limit. There was no evidence of degradation or increased variability. Microbiological quality was compliant in all samples: total aerobic microbial and yeast/mould counts were below the limits, and Escherichia coli was not detected.

The authors concluded that cartridges stored for six months produced POFs of comparable quality to those from freshly prepared cartridges. This supports a strategy of storing cartridges upstream and printing on demand to respond quickly to patients’ needs. The study of POFs from stored cartridges is ongoing.

Lemierre L, Guillotin S, Perez M et al. Impact of cartridge storage on the stability of 3D-printed oral dosage forms manufactured by semi-solid extrusion. Poster. GERPAC Congress 2026

This e-poster was awarded first prize in the Stability Studies/Formulation and Quality Control category.

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Dexmedetomidine diluted in 5% glucose and stored in polypropylene syringes is physicochemically stable for at least 21 days at 0.4 µg/mL and 28 days at 4 µg/mL, at either 4°C or room temperature, according to Loan Chonkel (Pharmacy Department, Henri Mondor Hospital, Créteil). These are the first stability data for dexmedetomidine in this diluent.

Dexmedetomidine is a selective α2-adrenergic agonist that is increasingly used in neonatology, because it provides sedation with minimal respiratory depression. Sodium intake is often restricted in preterm infants, so 5% glucose is frequently used as the diluent instead of saline. Until now, there have been no data on the stability of dexmedetomidine in 5% glucose, particularly at the low concentrations used in neonates.

Two independent batches of dexmedetomidine were diluted in 5% glucose to 0.4 µg/mL and 4 µg/mL and packaged in polypropylene syringes. The syringes were stored for 28 days at 4°C, 25°C and 40°C. Drug concentrations were measured by HPLC with UV detection and the preparations were inspected visually at each sampling time.

At both 4°C and room temperature, concentrations stayed above 90% for 21 days at 0.4 µg/mL and for 28 days at 4 µg/mL. At day 28, residual concentrations of the 4 µg/mL solution were 98.3% at both temperatures. The 0.4 µg/mL solution had dropped just below the limit, to 87.7% at 4°C and 89.9% at room temperature. At 40°C, concentrations began to fall from day 7. By day 28, the concentrations had fallen to 33.5% of the 0.4 µg/mL solution and 53.8% of the 4 µg/mL solution. No degradation peaks, discoloration or particles were seen at any temperature.

The authors concluded that stability depends on both concentration and temperature: more dilute solutions are less stable, and high temperatures cause marked degradation. However, their findings support the advance preparation of dexmedetomidine syringes in hospital pharmacies, provided that appropriate storage conditions are maintained. The study is being extended to 5% glucose infusion bags.

Chonkel L, Viellard V, Dowek A, Paul M. Physicochemical stability of dexmedetomidine diluted in 5% glucose solution in polypropylene syringes. Poster. GERPAC Congress 2026.

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In-process quality control using augmented reality smart glasses (FlexOprep®) reduced risk levels and improved traceability in chemotherapy compounding, according to Loélya Istace (Pharmacy Department, Vivalia Hospital, Arlon, Belgium). The trade-off was a longer preparation time.

Anticancer drugs have a narrow therapeutic index and high toxicity, so medication errors during compounding are a major threat to patient safety. Current quality control methods have important limitations. The FlexOprep glasses are smart glasses equipped with artificial intelligence. After a chemotherapy prescription has been validated by a pharmacist, the information is loaded into the FlexOprep system. The glasses are entirely hands-free and voice-controlled, and they display context-specific instructions in the operator’s field of view at each step of the preparation. They check the pharmaceutical products, expiry dates, the type of bag, pump and diluent, the volumes drawn and the secondary lines, and they alert the operator to errors. Every step is recorded in a report, which provides full traceability. Ms Istace compared the system to an aircraft’s black box.

FlexOprep glasses

This study used a prospective before-and-after design. A multidisciplinary team of 12 people from three hospitals carried out a failure mode and effects analysis (FMEA). They compared risk priority numbers before and after the glasses were introduced. Preparation times were measured for eight drugs, chosen to cover all types of preparation (syringes, bags, pumps and reconstitution). Usability was assessed with the French System Usability Scale (F-SUS), and user experience with the User Experience Questionnaire (UEQ).

The FMEA identified 24 potential failure modes, and half of them became less critical after implementation. The overall risk priority score fell by 40%, and by 67% for the 12 failure modes directly affected by the glasses. All high-risk failures were downgraded, and most moderate risks were reduced to low risk. The largest improvements were in error detection, for example selecting the wrong medicine or volume, and in failing to detect a preparation error before release. However, some new technology-related risks emerged.

Preparation time increased significantly for all eight drugs (p=0.008). The median increase was 86 seconds per preparation (+34%), ranging from 19.2% for paclitaxel to 54.7% for fluorouracil bags. The increase did not depend on the number of preparation steps; preparations that were initially quicker showed proportionally larger increases. Ms Istace noted that the extra time was probably overestimated, because it was measured immediately after the glasses were introduced, without an adaptation period. Usability was rated excellent, with a mean F-SUS score of 86.7/100. UEQ results were positive in every dimension, particularly novelty and stimulation.

The authors concluded that augmented reality-assisted in-process quality control is a significant advance in the safety and traceability of chemotherapy preparations. In particular, it eliminates the need for a second checker during the compounding process and it was well accepted by staff. Rigorous validation and long-term follow-up will be needed. Next steps include documenting new failure modes, carrying out an ergonomic analysis, improving the reading of syringes and secondary lines, and automating report validation. Ms Istace concluded with an aviation analogy: better to take off late than never arrive.

During the discussion Ms Istace confirmed that technicians are able to wear the glasses all day without complaining of visual problems. The costs are similar to those of a fixed video camera but FlexOprep has the advantage that the pharmacy technicians can move from one isolator/cabinet to another because, in this case, the camera is mobile i.e. attached to the technician.

Istace L, Leynen O, Denoël M, Roland I. Impact of augmented reality-assisted in-process quality control (FlexOprep®) on the safety and traceability of chemotherapy preparations. Short communication. GERPAC Congress 2026

Image: Loélya Istace

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Spironolactone gel tablets for paediatric patients can be reliably and reproducibly 3D printed in the hospital pharmacy at doses from 4 to 20 mg, according to Tamás Vincze (Department of Pharmacy, University Medical Center of Johannes Gutenberg University, Mainz).

Spironolactone is widely used in children with heart failure, and doses must be individualised by body weight. 3D printing allows pharmacies to prepare single-dose tablets in patient-specific doses over a wide range, according to a medical prescription. Gel tablets also have practical advantages for children: they are easy to administer and swallow and they taste better than conventional tablets.

The printing ink contained 2% spironolactone and 2.6% polysorbate 80 in Curablend® gel tablet excipient base, mixed by centrifugation. Gel tablets were printed at 41°C into blister packs on a Pharma Printer (CurifyLabs) with an integrated balance. Different doses were obtained by varying the tablet weight: 200 mg for 4 mg tablets, 500 mg for 10 mg and 1,000 mg for 20 mg. Three batches of 30 tablets of each strength were printed on three different days. To measure drug content, the team developed and validated a stability-indicating HPLC-UV assay adapted from the USP monograph for spironolactone tablets. Ten tablets from each batch were analysed.

The HPLC assay met all the validation criteria for linearity, precision and accuracy. Placebo tablets and forced degradation studies confirmed that no other peaks overlapped with the spironolactone peak. Mean drug content was 101.3%, 103.5% and 104.8% of the nominal content for the 4 mg, 10 mg and 20 mg tablets, respectively. All batches met the European Pharmacpoeia requirements for content (85–115%), content uniformity (acceptance values 2.8–12.9, below the limit of 15) and uniformity of mass.

The authors concluded that the HPLC assay is robust and reliable, and that pharmacy preparation of 3D-printed spironolactone gel tablets is precise and reproducible. Further tests of water content, stability, disintegration and dissolution are ongoing.

Vincze T, Tubic-Grozdanis M, Krämer I et al. Preparation and quality control of 3D printed spironolactone gel-tablets for paediatric patients. Poster. GERPAC Congress 2026.

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People who already have glaucoma who are taking statins appear less likely to need stronger treatments like extra eye drops or surgery to keep it under control, the US study finds.

Glaucoma, a leading cause of irreversible blindness, is caused by permanent damage to the optic nerve.

Statins are prescribed to lower cholesterol levels but studies have indicated that they may also prevent or slow nerve cell death. Their potential role in preventing or slowing down glaucoma is poorly understood.

To strengthen the evidence base, researchers searched a large global database covering 165 million individuals.

They compared more than 210 000 people who had a record of statin use between August 2006 and August 2026 with a matched control group of 210 000 people who had no record of using statins. Individuals in both groups had to have a recorded ophthalmological follow up.

Statin use was associated with a 15% lower risk of developing open angle glaucoma, the researchers found.

At five years, there were 4771 new diagnoses of glaucoma in the statin group (2.3%) and 5491 in the control group (2.6%).

In a separate analysis, more than 30 000 individuals with glaucoma who were taking statins were compared with almost 250 000 individuals with glaucoma who were not taking statins.

Statins were linked to a lower risk of the individual progressing to need glaucoma surgery or other treatment.

At five years, statin use was associated with a 36% lower risk of incisional glaucoma surgery and a 55% reduced risk of minimally invasive glaucoma surgery (MIGS) – a keyhole procedure to lower the intraocular pressure in the eye.

Statins were also associated with a 60% lower risk of selective laser trabeculoplasty (SLT) – a procedure that lowers the pressure in the eye by using laser pulses. There was also a 12% reduced risk of eye drops to reduce the pressure in the eye linked to statin use.

After 10 years, statin use continued to be associated with a lower risk of incision glaucoma surgery, MIGS, SLT, and use of eye drops, the researchers found.

This is an observational study and as such, no firm conclusions can be drawn about cause and effect.

Another limitation of the study is that the researchers did not have access to individual patient data, including intraocular pressure measurements or surgical details

This means they were unable to determine whether surgery was performed due to increased disease severity or because the patient was not adhering to treatment.

Nevertheless, they say their findings add to the growing literature about the neuroprotective effect of statins. Prospective randomised trials are now needed to better understand the effects of statin use on glaucoma incidence and treatment, they add.

“Our findings suggest that statin usage is associated with both lower incidence of primary open-angle glaucoma as well as decreased treatment escalation, “the researchers say.

DOI – 10.1136/bjo-2026-330339

Method of Research – Observational study

Subject of Research – People

Article Title – Statin use is associated with lower risk of open-angle glaucoma incidence and treatment escalation

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“By turning a familiar object like a lollipop into both a saliva collection device and a sensor, Lollylab can collect the sample and perform the measurement directly at the point of care.” – Sina Khazaee Nejad

Acetaminophen is an ingredient in many over-the-counter products, including pain relievers, cold and flu medications, and more. But taking more than the maximum recommended dose can cause serious side effects, such as liver damage. This is especially concerning for children who can be at risk of an unintentional overdose at low levels of the medication. Because acetaminophen concentrations in saliva closely reflect those in blood, Sina Khazaee Nejad, Maral Mousavi, and colleagues thought saliva could be a simple, noninvasive way to monitor the medication’s levels.

Mousavi says they were inspired by the saliva sampling system CandyCollect — a lollipop-like device meant to replace throat swabs — but those specimens need to be analyzed elsewhere. In this work, the researchers wanted to create a miniature laboratory-on-a-lollipop, or Lollylab. “By turning a familiar object like a lollipop into both a saliva collection device and a sensor, Lollylab can collect the sample and perform the measurement directly at the point of care,” says Nejad, the first author of the paper.

Lollylab is built from two plastic pieces (each with a round end and a thinner stem) snapped together, with holes at the top for saliva to enter through. The team coated the top of the device with a red, peach-flavored edible candy shell, which did not interfere with measurements. Saliva flows through the glass fiber paper-lined lollipop stem toward a graphene sensor at the bottom, which measures acetaminophen levels as changes in electrical current. The prototype device detected acetaminophen in both artificial and human saliva.

As proof of concept, six adults used Lollylab before and an hour after taking a standard adult dose of acetaminophen (650 milligrams). The device reliably measured the drug in the participants’ saliva in less than two minutes, and they said it was easy to use and more comfortable than typical saliva swabs.

“The main takeaway is that diagnostic testing can be made much easier and more comfortable, especially for children,” says Nejad. Next, the researchers plan to validate Lollylab’s acetaminophen measurements with more participants, including children, and develop it to detect other substances in saliva such as naturally occurring stress markers. “Our longer-term goal is to create a multi-assay platform capable of measuring several biomarkers, which could then be evaluated alongside acetaminophen in larger clinical studies.”

The authors acknowledge funding from the 3M Nontenured Faculty Award, Women in Science and Engineering at the University of Southern California, and the President’s Sustainability Research Award. The authors also thank Dr. Ashleigh Theberge for insightful conversations about the CandyCollect manufacturing.

Some of the authors have filed a provisional patent based on this device.

Image: The red, peach-flavored candy coating on Lollylab stimulates saliva production, and a sensor at the bottom analyzes it for acetaminophen.

View more Credit: Adapted from ACS Sensors 2026, DOI: 10.1021/acssensors.6c00691

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Automated compounding of 5-fluorouracil (5-FU) elastomeric infusion pumps cut preparation time and reduced the physical strain on pharmacy technicians, according to an ergonomic study presented by Romy Linossier-Rocher (Centralised Cytotoxic Preparation Unit of CH Victor Dupouy, Argenteuil).

Filling 5-FU infusion devices by hand involves many repetitive movements and increases the risk of musculoskeletal disorders. The pharmacy acquired a dual-channel compounding system, which uses a peristaltic pump for the diluent, a syringe pump for the 5-FU and an integrated balance. The researchers compared this automated system with the previous manual, gravimetry-assisted method of filling elastomeric pumps.

Pharmacy technicians completed a self-assessment questionnaire before the system was introduced and again one year later. The questionnaire recorded the location of any pain and its intensity, on a scale from no pain to unbearable pain. The two methods were also systematically observed using activity logs (Actograph® software). These assessed posture, joint ranges of motion, movements, grasping areas, interactions with the computer system and timing.

Automation reduced the preparation time from 8 min 30 s to 5 min 30 s. The number of movements fell from 13 to 8 per minute, and manual operations dropped from 90% to 48% of the preparation time. Interactions with the computer system halved, from 26% to 13% of the time. The working area became larger: the share of activity within the close reach zone fell from 76% to 57%. The proportion of time spent on checks increased from 62% to 73%, mainly to confirm correct filling of the 5-FU syringe.

Six questionnaires were analysed. The location of pain was unchanged, remaining mainly in the upper limbs, but its overall intensity fell. Reports of severe pain dropped from 5 to 0, moderate pain from 10 to 9 and mild pain from 3 to 2.

The authors concluded that automation reduced both preparation time and the physical strain on the upper limbs. It also transformed the technicians’ work, with less manual handling and a greater focus on visual inspection.

Rainotte-Santraine A, NeglokpeE, Fercocq C, Linossier-Rocher R et al. Automated compounding of 5-fluorouracil elastomeric infusion pump: impact on the prevention and reduction of musculoskeletal disorders (MSDs) through an ergonomic study. Poster. GERPAC Congress 2026

Click to enlarge

Image: Romy Linossier-Rocher

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The interview study explored pharmaceutical sector stakeholders’ views on how changes to EU chemicals legislation affect the green transformation in the sector, as well as their practices for supporting it. The interviewees came from seven European countries and worked in the pharmaceutical industry, industry associations, non-governmental organisations, public authorities and academia. The study was carried out as part of the PharGTrans project, funded by the Research Council of Finland.

Views among pharmaceutical sector stakeholders varied on how legislation affects the green transformation

“Many stakeholders in the pharmaceutical sector viewed the various legislative changes, such as the proposed restriction of PFASs under the REACH Regulation, and the Regulation on Packaging and Packaging Waste, as supporting the green transformation,” says Doctoral Researcher Sanja Riikonen of the University of Eastern Finland.

Pharmaceutical sector stakeholders found that these regulations encourage the development of environmentally less harmful compounds that could, in the future, replace substances of concern used in pharmaceutical production processes and increase the use of recycled materials in packaging. Changes aimed at improving information sharing and transparency, such as the regulation establishing a common data platform on chemicals, were likewise seen as supporting the green transformation in the pharmaceutical sector.

On the other hand, the stakeholders interviewed for the study felt that several of the changes also posed major challenges for the sector and questioned their contribution to advancing the green transformation.

“The restriction of PFASs under the REACH Regulation, together with the recast Urban Wastewater Treatment Directive and its extended producer responsibility scheme, prompted considerable discussion, particularly among interviewees from pharmaceutical companies and industry associations,” Riikonen notes.

Although the proposed restriction of PFASs does not apply to active pharmaceutical ingredients the pharmaceutical industry uses many PFAS-containing materials in its production processes. The interviewees viewed a rapid transition to alternative materials as challenging. The extended producer responsibility scheme under the Urban Wastewater Treatment Directive has direct implications for the pharmaceutical industry, as it requires the pharmaceutical and cosmetics industries to cover a large proportion of the costs associated with upgrading wastewater treatment processes in EU Member States. The interviewees found that requiring industry to bear these costs could divert companies’ resources and attention away from other measures that promote sustainability.

Greater collaboration is needed across sectors and among stakeholders

According to the study, closer collaboration between different policy sectors and stakeholder groups is needed in the legislative drafting process. Several stakeholders highlighted challenges arising from shortcomings in communication and a limited understanding of the broader picture across sectors. According to the interviewees, more transparent preparatory processes, better information-sharing and more inclusive dialogue could reduce inconsistencies between regulations affecting the chemicals, environmental and pharmaceutical sectors and promote more coherent decision-making.

“The effects of regulation supporting the green transformation on different stakeholders should also be taken into account more effectively. This could help to avoid unintended consequences of regulation that may even slow down the green transformation it is intended to advance,” Riikonen concludes.

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Trastuzumab deruxtecan (Enhertu®) diluted in 5% glucose keeps its physicochemical, structural and functional characteristics for at least 28 days at 2–8°C when protected from light, according to Yara Bendiab (Pitié-Salpêtrière University Hospital, AP-HP, Paris). This is a major improvement on the 24 hours stated in the Summary of Product Characteristics (SmPC). At room temperature, however, glycation and oxidation gradually reduce the drug’s biological activity.

Trastuzumab deruxtecan (T-DXd) is a third-generation antibody-drug conjugate used in HER2-positive breast cancer. It consists of an anti-HER2 antibody linked to about eight molecules of deruxtecan. Its short post-dilution shelf-life prevents advance preparation and limits flexibility for outpatient and home care. It also leads to waste: the hospital’s losses on this drug came to more than €74,000 in 2024.

In this study, three batches of T-DXd at 1 mg/mL and 4 mg/mL were prepared in 5% glucose in multilayer polypropylene bags. The bags were stored for 28 days at 2–8°C or at 25°C. Forced degradation studies (heat, pH, light, agitation, oxidation and freeze–thaw cycles) were also carried out. The team used a wide range of complementary analytical methods covering colloidal stability, aggregation and fragmentation, hydrophobicity, glycosylation, charge variants and structural modifications. Biological activity was assessed by HER2 ELISA and Fc receptor affinity. They also checked the integrity of the drug–antibody linkage.

Under refrigeration, all the parameters remained essentially unchanged. The pH stayed at 5.4–5.5 and no visible particles appeared. Antibody concentrations varied by less than 5%, regardless of concentration, temperature or batch. There was no aggregation, fragmentation, change in glycosylation or loss of the drug payload. HER2-binding activity was 94% of the initial value after 28 days.

At 25°C, mass spectrometry detected glycation and oxidation of the antibody after one to two weeks. An increase in acidic variants followed from day 21. By day 28, HER2-binding activity had fallen to 78%.

The authors concluded that diluted T-DXd preparations can be stored for at least 28 days under refrigeration and protected from light. This would allow doses to be prepared in advance, with benefits for patients, hospitals and the environment. The bags should not be stored at room temperature for prolonged periods.

Juul C, Bendiab YM, Hindès E  et al. Glycation and oxidation: key determinants of the physicochemical behaviour of trastuzumab deruxtecan (Enhertu®) in a glucose infusion solution. Short communication. GERPAC Congress 2026

Image: Yara Bendiab

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A new study led by researchers at Boston University School of Public Health (BUSPH) shows that these closures are occurring disproportionately among communities with a majority of racial and ethnic minority residents.

Published in JAMA Network Open, the nationwide study found that predominantly White communities (defined by census block group) had more pharmacies than other racial and ethnic communities, both before and after the COVID-19 pandemic. Predominantly White neighborhoods had 15 percent more pharmacies per 10,000 people than neighborhoods with predominantly minority populations. Tracking movement of mobile devices, the researchers also examined frequency of pharmacy visits and found that people in White communities most commonly visited pharmacies in similar neighborhoods, while people in other racial and ethnic minority communities with fewer pharmacies tended to utilize pharmacy services in diverse neighborhoods, instead.

This unprecedented decline in pharmacy closures across the US is more than an inconvenience to community members; it may also lead to negative health outcomes. Data indicates that past pharmacy closures have led to a decline in both access and adherence to life-saving medications, including cardiovascular medicine and anticonvulsant medicine. Beyond medication pick-up sites, pharmacies have expanded to become trusted community health hubs over the last several decades, and these shutterings are leaving residents with a dearth of local resources for other clinical support.

“When a pharmacy is absent in a neighborhood because it closed or was never there, this can create barriers for residents to not only obtain medications, but other essential health services such as vaccines, testing and treatment for multiple diseases and conditions, and other health services,” says study lead and corresponding author Dr. Elaine Nsoesie, associate professor of global health at BUSPH, who was inspired to study pharmacy availability and visits after writing a 2024 opinion piece about the impact of pharmacy deserts on Black and Latino communities in The Boston Globe and receiving a variety of responses from the community. “Our findings show that individuals from predominantly Black and other racial-minority areas might prefer to visit pharmacies in diverse neighborhoods, if they do not have an available pharmacy.”

For the study, Dr. Nsoesie and colleagues from BUSPH and The Thayer School of Engineering at Dartmouth College analyzed mobility data from mobile phones in more than 112,000 census block groups across 45 states and Washington, DC between January 2019-January 2020 (before the pandemic) and from January 2023-January 2024 (after the acute phase of the pandemic). Examining demographics, pharmacy availability and visits, the team found that predominantly White and diverse neighborhoods had more pharmacies in 2019 and in 2023 than racial-minority neighborhoods. While White and diverse neighborhoods with at least one pharmacy had a higher median household income than neighborhoods with no pharmacies, neighborhoods with a majority of racial and ethnic minority residents had nearly the same median household income in areas with and without pharmacies, suggesting that race and ethnicity might be a stronger determinant of a pharmacy desert than income alone.

Vehicle ownership, percentage of single-family homes, and median age were linked to neighborhoods with an increase in pharmacies per 10,000 people, while percentage of females, increases in median household income, and percentage of residents born outside the US were linked to neighborhoods with a decrease in pharmacies per 10,000 people.

A number of factors are driving these closures, including thin profit margins, reduced reimbursement rates for medications, and a workforce shortage. The researchers hope this insight emphasizes the need to combine financial reforms with practical local policies that make it easier for residents in pharmacy deserts to access the medicines and care they need.

“Researchers have written about the need to develop policies and financing programs that encourage pharmacies to be located in pharmacy deserts,” Dr. Nsoesie says. “We suggest that such policies could be coupled with affordable and accessible transportation. However, any long-term solutions should consider the specific needs of the local community to ensure that solutions are effective.”

The study was coauthored by Andrew Philips, research fellow at BUSPH at the time of the study; Dr. Nina Cesare, research scientist in the Biostatistics and Epidemiology Data Analytics Center at BUSPH; and Zou Yang, a PhD student at The Thayer School of Engineering at Dartmouth at the time of the study.

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