Is minus 20 °C an acceptable storage condition for lyophilised cagrilintide?

Stated plainly: minus 20 °C · cagrilintide.

This has the shape of a fact but I cannot find its origin.

What I found instead were three secondary sources all citing each other.

Can anyone point me at a primary source, or confirm that there is not one?

The honest answer is that published stability data for these specific molecules in a research-grade presentation essentially does not exist, so what you get is extrapolation from the licensed formulations and from general peptide chemistry. That extrapolation is reasonable. It is still extrapolation.

A domestic freezer holds roughly minus eighteen degrees and cycles by several degrees on its defrost schedule, which for a lyophilised solid is entirely adequate and for a frozen solution means repeated partial melting at the surface. If you are going to freeze a solution, an unopened chest freezer is materially better than the compartment in the top of a fridge.

The 28-day figure for a reconstituted preserved vial is microbiological, not chemical. Chemically, a well-behaved peptide at 5 mg/mL at 4 °C will typically lose well under a per cent of content per month. The reason to respect the date is bioburden, and bioburden is a function of how many times you have opened it, not of the calendar.

General guidance on lyophilised peptide storage from the major synthesis houses converges on minus twenty degrees for long-term storage of solids and refrigerated storage for solutions in use, with the explicit note that repeated freeze-thaw of solutions should be avoided. It is consistent advice precisely because it follows from the chemistry rather than from a study.

Minimise transitions rather than minimising temperature. One freeze and one thaw is fine; five is a different question.

The relevant detail is that the lyophilised solid is far more robust than anything anyone says about it, and the solution is far less robust. Most of the confusion in this area comes from advice about one being applied to the other.

Practical thermal arithmetic for a shipment: a single 250 g phase-change pack in a thin-walled polystyrene box holds sub-ten-degrees for roughly 24 to 48 hours in a 25 °C ambient, and considerably less at 35 °C. Any lane taking eight to fourteen days is therefore not temperature-controlled for most of its duration regardless of what was in the box, which is the argument for shipping the material lyophilised.

Specifically, on re-freezing something that thawed in transit: if it arrived as a lyophilised solid that warmed but never got wet, re-freezing costs you nothing except the thermal cycle. If it arrived as a solution that thawed, re-freezing adds a second transition and therefore a second dose of ice-front shear. The asymmetry is worth internalising.

If the material arrived warm and it was lyophilised, test it and proceed on the result. If it arrived warm and it was in solution, the result is more likely to be interesting than reassuring.

edited 10 Sept 2025 by ruaidhri_o_shea — added a caveat about sampling

Concretely, start by separating chemical degradation from physical degradation, because they fail differently and they are detected differently. Chemical degradation changes the molecule and shows up as new peaks on a chromatogram. Physical degradation aggregates the molecule and often shows up as nothing at all on reverse-phase HPLC, because the aggregate never makes it onto the column.

Freeze-concentration is the mechanism people miss. As ice forms, everything that is not water is excluded into a shrinking unfrozen fraction, so the local concentration of peptide, buffer salts and preservative rises sharply. If the buffer components crystallise at different rates, local pH can shift by more than a unit. That is why a phosphate-buffered solution can behave badly on freezing while an unbuffered one is fine.

Where community-submitted samples with known thermal excursions have been tested at Janoshik or Medutest, the recurring finding is that lyophilised material tolerates warm transit far better than intuition suggests, while reconstituted material shipped warm does not. The asymmetry is consistent enough to plan around.

One qualification: none of this addresses sterility. A vial can be chemically pristine and microbiologically compromised, and a chromatogram will not tell you which.

Store solid, store cold, store dry, and reconstitute what you will use rather than what fits in the vial.

On the detail: degradation is not one process, and which one dominates depends on the condition you are asking about. In solution at refrigerated temperature the rate-limiting pathway is usually deamidation and hydrolysis; at room temperature aggregation overtakes them; frozen, the damage happens during the transitions rather than during the hold.

Aggregation is the failure mode that reverse-phase HPLC is worst at detecting, because a large soluble aggregate may not elute at all and an insoluble one is filtered out during sample preparation. If your purity result comes back normal but the vial looks hazy, believe the vial. Size-exclusion chromatography is the method that sees this.

The caveat is that "within specification" and "unchanged" are different claims. A vial can lose a few per cent of content and still be usable for its purpose while no longer matching its certificate.

The practical rule is that time and temperature multiply, so shorten whichever one you control.