INSTANT-VIEW BUP/NBUP URINE TEST. INSTANT-VERDICT BUP/NBUP URINE TEST; INSTANT-CONFIRMATORY BUP/NBUP URINE TEST

K060527 · Alfa Scientific Designs, Inc. · DJG · Jul 25, 2006 · Clinical Toxicology

Device Facts

• Record ID: K060527
• Device Name: INSTANT-VIEW BUP/NBUP URINE TEST. INSTANT-VERDICT BUP/NBUP URINE TEST; INSTANT-CONFIRMATORY BUP/NBUP URINE TEST
• Applicant: Alfa Scientific Designs, Inc.
• Product Code: DJG · Clinical Toxicology
• Decision Date: Jul 25, 2006
• Decision: SESE
• Submission Type: Abbreviated
• Regulation: 21 CFR 862.3650
• Device Class: Class 2

Indications for Use

This device is a qualitative immunoassay intended to detect buprenorphine (BUP) and its metabolite, norbuprenorphine (NBUP) in human urine. Results are preliminary positive when the combination of the concentrations of BUP and NBUP is greater than 10 ng/ml. It is for health care professional use only. This test provides only a preliminary result. A more specific alternate chemical method must be used in order to obtain a confirmed analytical result. Gas Chromatography / Mass Spectrometry (GC/MS) or High Performance Liquid Chromatography (HPLC) is the preferred confirmatory method. Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are obtained.

Device Story

Lateral flow chromatographic immunoassay; detects buprenorphine and norbuprenorphine in human urine. Input: urine specimen; test strip contains conjugate pad with colloidal gold-labeled rabbit anti-buprenorphine antibodies and mouse IgG; nitrocellulose membrane with test line (Buprenorphine-BSA) and control line (goat anti-mouse IgG). Operation: specimen migrates via capillary action; competitive binding occurs; visual appearance of lines indicates presence or absence of drug. Output: qualitative visual result (preliminary positive if combined BUP/NBUP > 10 ng/ml). Used in clinical settings (physician offices, reference labs) by healthcare professionals. Results require confirmation via GC/MS or HPLC. Assists clinicians in identifying potential drug abuse; supports clinical decision-making.

Clinical Evidence

Clinical study of 94 specimens (54 confirmed positive via HPLC/MS or GC/MS, 40 drug-free). Overall agreement with reference methods was 96.8%. Sensitivity 96.3%, specificity 97.3%. Reproducibility study across three sites (two physician offices, one reference lab) showed 97.1% agreement for BUP and 98.4% for NBUP. Interference studies confirmed no impact from urine pH (3.0-9.0) or specific gravity (1.002-1.035).

Technological Characteristics

Lateral flow immunochromatographic assay. Materials: nitrocellulose membrane, buprenorphine-BSA, rabbit anti-buprenorphine antibodies, mouse IgG, colloidal gold, goat anti-mouse IgG. Cutoff: 10 ng/mL (combined BUP/NBUP). Visual readout. No instrumentation required. Single-use device.

Indications for Use

Indicated for the qualitative detection of buprenorphine and its metabolite, norbuprenorphine, in human urine specimens for healthcare professional use. Used for preliminary screening of drug abuse.

Regulatory Classification

Identification

An opiate test system is a device intended to measure any of the addictive narcotic pain-relieving opiate drugs in blood, serum, urine, gastric contents, and saliva. An opiate is any natural or synthetic drug that has morphine-like pharmocological actions. The opiates include drugs such as morphine, morphine glucoronide, heroin, codeine, nalorphine, and meperedine. Measurements obtained by this device are used in the diagnosis and treatment of opiate use or overdose and in monitoring the levels of opiate administration to ensure appropriate therapy.

Special Controls

*Classification.* Class II (special controls). An opiate test system is not exempt if it is intended for any use other than employment or insurance testing or is intended for Federal drug testing programs. The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 862.9, provided the test system is intended for employment and insurance testing and includes a statement in the labeling that the device is intended solely for use in employment and insurance testing, and does not include devices intended for Federal drug testing programs (*e.g.,* programs run by the Substance Abuse and Mental Health Services Administration (SAMHSA), the Department of Transportation (DOT), and the U.S. military).

Predicate Devices

• OneStep Buprenorphine Test, New Bay Bioresearch, Co. Ltd.

Submission Summary (Full Text)

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# 510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY ASSAY ONLY TEMPLATE

A. 510(k) Number:
k060527

B. Purpose for Submission:
Clearance of a new device.

C. Measurand:
Buprenorphine and Norbuprenorphine

D. Type of Test:
Qualitative, visually read, immunochromatographic test

E. Applicant:
Alfa Scientific Designs, Inc.

F. Proprietary and Established Names:
Instant-View, Instant-Confirmatory, or Instant-Confirmatory
Buprenorphine/Norbuprenorphine Urine Test (Cassette and Dip-Strip)

G. Regulatory Information:
1. Regulation section:
21 CFR §862.3650, Opiate Test System
2. Classification:
Class II
3. Product code:
DJG
4. Panel:
Toxicology (91)

H. Intended Use:
1. Intended use(s):
This device is a qualitative immunoassay intended to detect buprenorphine (BUP) and its metabolite, norbuprenorphine (NBUP) in human urine. Results are preliminary positive when the combination of the concentrations of BUP and NBUP is greater than 10 ng/ml. It is for health care professional use only.

This test provides only a preliminary result. A more specific alternate chemical method must be used in order to obtain a confirmed analytical result. Gas Chromatography / Mass Spectrometry (GC/MS) or High Performance Liquid Chromatography (HPLC) is the preferred confirmatory method. Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are obtained.

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2. Indication(s) for use:
See Intended Use above.

3. Special conditions for use statement(s):
A positive test result does not always mean an individual has taken the drug illegally as the drug can be administered legally.

4. Special instrument requirements:
Not applicable. The device is a visually read single-use device.

I. Device Description:

This assay is a one-step lateral flow chromatographic immunoassay. The test strip consists of 1) a burgundy-colored conjugate pad containing rabbit anti-buprenorphine antibodies and mouse IgG coupled to colloidal gold; and 2) a nitrocellulose membrane containing a Test (T) line and a Control (C) line. The T line is coated with buprenorphine-BSA, and the C line is coated with goat anti-mouse IgG antibody.

This test is a competitive binding immunoassay. The buprenorphine and norbuprenorphine in the urine specimen competes with the buprenorphine-BSA antigen coated on the nitrocellulose membrane for the limited binding sites of the conjugated anti-buprenorphine antibodies.

When an adequate amount of urine specimen is applied to the sample pad of the device, the urine specimen migrates by capillary action through the test strip. If the level of buprenorphine and / or norbuprenorphine in the urine specimen is below the cutoff concentration (10 ng/ml), the T line appears as a visible burgundy line. If the level of buprenorphine in the urine specimen is above the cutoff, no T line develops.

The C line will bind to the mouse IgG conjugate and form a burgundy color band regardless of the presence of buprenorphine. The C line serves as an internal qualitative control of the test system.

J. Substantial Equivalence Information:

1. Predicate device name(s):
OneStep Buprenorphine Test

2. Predicate 510(k) number(s):
k042988

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3. Comparison with predicate:

| Similarities | | |
| --- | --- | --- |
| Item | Device | Predicate |
| Sample Types | Urine | Urine |
| Test Method | Immunochromatographic | Immunochromatographic |
| Differences | | |
| --- | --- | --- |
| Item | Device | Predicate |
| Intended Use | Qualitative immunoassay intended to detect buprenorphine (BUP) and its metabolite, norbuprenorphine (NBUP) in human urine. | Qualitative immunoassay intended to detect buprenorphine (BUP) in human urine. |
| Cutoff | BUP+NBUP: 10 ng/mL | BUP: 10 ng/mL |
| Major Cross Reactors: | Detects BUP and NBUP equally | Detects BUP glucuronide metabolite at 2.5 ng/mL |

K. Standard/Guidance Document Referenced (if applicable):
None were identified by the applicant.

L. Test Principle:
See Section I., Device Description, above.

M. Performance Characteristics (if/when applicable):

1. Analytical performance:

a. Precision/Reproducibility:
Reproducibility was evaluated at three POL locations. Eighty-pooled drug-free human urine specimens were spiked with buprenorphine or norbuprenorphine at different levels. All specimens were blind labeled and tested. Results are summarized in the table below.

| Buprenorphine | | Site I | Site II | Site III | Expected Result |
| --- | --- | --- | --- | --- | --- |
| Controls | 0 ng/ml | 10 - | 10 - | 10 - | 10 - |
| | 5 ng/ml | 15- | 15- | 15- | 15- |
| | 7.5 ng/ml | 14-, 1+ | 14-, 1+ | 14-, 1+ | 15- |
| | 12.5 ng/ml | 14+, 1- | 13+, 2- | 14+, 1- | 15+ |
| | 15 ng/ml | 15+ | 15+ | 15+ | 15+ |
| | 30 ng/ml | 10+ | 10+ | 10+ | 10+ |
| Agreement | Site | 96.3% | 96.3% | 97.5% | |
| | Average | 97.1% | | | |

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| Norbuprenorphine | | Site I | Site II | Site III | Expected Result |
| --- | --- | --- | --- | --- | --- |
| Controls | 0 ng/ml | 10 - | 10 - | 10 - | 10 - |
| | 5 ng/ml | 15- | 15- | 15- | 15- |
| | 7.5 ng/ml | 14-, 1+ | 13-, 2+ | 14-, 1+ | 15- |
| | 12.5 ng/ml | 15+ | 15+ | 15+ | 15+ |
| | 15 ng/ml | 15+ | 15+ | 15+ | 15+ |
| | 30 ng/ml | 10+ | 10+ | 10+ | 10+ |
| Agreement | Site | 98.8% | 97.5% | 98.8% | |
| | Average | 98.4% | | | |

b. Linearity/assay reportable range:
Not applicable. This is a semi-quantitative device; a ‘positive’ result only suggests that buprenorphine is present in quantities above the cutoff level.

c. Traceability, Stability, Expected values (controls, calibrators, or methods):
This test contains a built-in control feature, the C line. The appearance of the burgundy C line indicates an adequate volume of specimen has been absorbed and the capillary flow through the test strip has occurred. The C line should always appear. If the Control line does not develop within 5 minutes, the sponsor suggests reviewing the entire procedure and repeating the test with a new device.

The sponsor also recommends that users follow appropriate federal, state, and local guidelines concerning the running of external quality controls.

d. Detection limit:
Sensitivity of qualitative assays may be characterized by validating performance around the claimed cutoff concentration of the assay, and demonstrating the lowest concentration of drug that is capable of or consistently producing a positive result. This information appears the Precision/Reproducibility section above.

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# e. Analytical specificity:

# Cross-Reactivity

To evaluate the cross-reactivity of the device, compounds structurally related to buprenorphine were studied. The lowest concentration of the drugs producing a positive response equivalent to the cutoff level of the device was listed in the table below.

| Compounds Name | Concentration (ng/ml) |
| --- | --- |
| Buprenorphine | 10 |
| Norbuprenorphine | 10 |
| Buprenorphine-3-β-D-glucuronide | 750 |
| Norbuprenorphine-3-β-D-glucuronide | 30,000 |
| Nalorphine | 100,000 |

# Interfering Substances

The following substances, evaluated separately, were spiked with $100\mu \mathrm{g / ml}$ of the substance and evaluated in urine pools containing combined concentrations of buprenorphine and norbuprenorphine at 0 and $15\mathrm{ng / ml}$ . No interference was observed from those analytes at the concentration listed in the following tables.

| Acetaminophen | Cortisone |
| --- | --- |
| Acetylsalicylic Acid | Dextromethorphan |
| Amikacin | Ethanol |
| Amitriptyline | Lidocaine |
| Ampicillin | Methadone |
| Arterenal | Methanol |
| Aspirin | Oxalic Acid |
| Benzoic Acid | Penicillin-G (Benzylpenicillin) |
| Benzoylecgonine | β-phenylthylamine |
| Caffeine | Phenylpropanalamine |
| (+)-Chlorpheniramine | Ranitidine |
| (+/-)-Chlorpheniramine | Salicyclic Acid |
| Cocaine | Thioridazine |

The following endogenous substances, tested the same as the above substances, were tested and confirmed not to interfere with the BUP/NBUP test device at listed concentration.

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| Biological Analytes | Concentration |
| --- | --- |
| Albumin(serum) | 2,000 μg/ml |
| Bilirubin | 1,000 μg/ml |
| Creatine | 1,000 μg/ml |
| Hemoglobin | 1,000 μg/ml |
| Glucose | 2,000 μg/ml |
| Vitamin C (L-Ascorbic Acid) | 1,000 μg/ml |
| Uric Acid | 1,000 μg/ml |
| pH | 5.0-9.0 |

f. Assay cut-off:

The stated cutoff of this assay is 10 ng/mL. Characterization of how the device performs analytically around the claimed cutoff concentration appears in the Detection limit section, above. The Substance Abuse and Mental Health Services Administration (SAMHSA) has not recommended cutoff levels for buprenorphine tests.

2. Comparison studies:

a. Method comparison with predicate device:

The accuracy of this device was evaluated using 54 clinical urine specimens and 40 drug free urine samples with varying un-hydrolyzed concentrations of both buprenorphine and norbuprenorphine in different ratios, each blind-labeled. The results from this test device agreed 100% with the HPLC/MS and GC/MS on the non-hydrolyzed specimens at levels below 75% of the cutoff (negative) and above 125% of the cutoff (positive). Three (3) discrepancies were observed on the specimens of buprenorphine/norbuprenorphine at the level between 75% and 125% of the cutoff. The overall agreement was 96.8% (3 discrepancies/94 specimens).

| Buprenorphine/Norbuprenorphine | BUP and NBUP | | Total | Agreement | |
| --- | --- | --- | --- | --- | --- |
| | | Positive | | | Negative |
| HPLC/MS (ng/ml) | Negative (<75%) | 0 | 49 | 49 | 100% |
| | 75%-Cutoff | 1* | 5 | 6 | 83.3% |
| | Cutoff-125% | 18 | 2* | 20 | 90% |
| | Positive (>12.5) | 19 | 0 | 19 | 100% |
| Total | | 38 | 56 | 94 | |

* indicates discrepancy.

b. Matrix comparison:

Not applicable.

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3. Clinical studies:
a. Clinical Sensitivity: Not applicable.
b. Clinical specificity: Not applicable.
c. Other clinical supportive data (when a. and b. are not applicable): Not applicable.

4. Clinical cut-off: Not applicable.

5. Expected values/Reference range: No elicit drugs should be present in urine.

N. Proposed Labeling:

The labeling is sufficient and it satisfies the requirements of 21 CFR Part 809.10.

O. Conclusion:

The submitted information in this premarket notification is complete and supports a substantial equivalence decision.

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