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Targeting Cancer with Sweet Precision: Saccharide-Grafted Erlotinib for Enhanced Drug Delivery 精准锁定癌症:多糖接枝厄洛替尼增强给药效果
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-28 DOI: 10.1007/s12247-024-09871-5
Isha Shete, Smita Kumbhar, Rakesh Dhavale, Manish Bhatia

Purpose

This study aims to enhance the targeting of erlotinib by grafting saccharides—galactose, pectin, and chitosan via oxalyl chloride-mediated processes. The objective is to evaluate the potential of these saccharide derivatives as ligands for targeted drug delivery, particularly to improve therapeutic efficacy in cancer treatments.

Methods

Saccharides (galactose, pectin, and chitosan) were chemically grafted onto erlotinib, forming conjugates. Characterization was conducted using 1H NMR, differential scanning calorimetry (DSC), and Fourier-transform infrared spectroscopy (FTIR). The conjugates’ drug delivery efficiency was tested using A549 cell lines to assess their efficacy in targeting cancer cells.

Results

Characterization confirmed the successful grafting of saccharides onto erlotinib, as evidenced by 1H NMR, DSC, and FTIR. The in vitro drug release study demonstrated enhanced targeting efficiency of the saccharide-erlotinib conjugates, with improved cell-specific distribution and potential therapeutic benefits.

Conclusions

Grafting saccharides onto erlotinib offers a promising approach to enhance drug absorption, reduce degradation, and minimize side effects in cancer therapy. This targeted drug delivery strategy represents a significant advancement in biomedical engineering for optimizing cancer treatment efficacy.

目的 本研究旨在通过草酰氯介导的工艺接枝糖类--半乳糖、果胶和壳聚糖,增强厄洛替尼的靶向性。目的是评估这些糖衍生物作为配体用于靶向给药的潜力,特别是提高癌症治疗的疗效。方法将糖(半乳糖、果胶和壳聚糖)化学接枝到厄洛替尼上,形成共轭物。采用 1H NMR、差示扫描量热法(DSC)和傅立叶变换红外光谱法(FTIR)对共轭物进行了表征。结果表征结果表明,1H NMR、DSC 和傅立叶变换红外光谱证明糖类成功接枝到厄洛替尼上。体外药物释放研究表明,糖类-厄洛替尼共轭物的靶向效率得到提高,细胞特异性分布得到改善,具有潜在的治疗效果。这种靶向给药策略代表了生物医学工程在优化癌症疗效方面的重大进展。
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引用次数: 0
Development and Implementation of a Comprehensive Initiative to Educate Healthcare Providers and Patients in the United States about the Risk of Drug-Drug Interactions Associated with Nirmatrelvir/ritonavir during the COVID-19 Pandemic 在 COVID-19 大流行期间,制定并实施一项综合计划,对美国的医疗保健提供者和患者进行有关与 Nirmatrelvir/ritonavir 相关的药物相互作用风险的教育
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-28 DOI: 10.1007/s12247-024-09854-6
Iqra Arham, Donna Palumbo, Bharat Damle, Gurinder Sidhu, Domenick Francis, Alejandro Cané, Lubna Merchant, Jamie Wilkins, Reema Mehta, Amanda Radola, Karen Baker, Shoaib Khan, Vicky Hendrick, Aysha K Ali, Florin Draica

This case study describes the development of a comprehensive drug-drug interaction (DDI) education initiative for nirmatrelvir/ritonavir (Paxlovid™) during the COVID-19 pandemic. Following Emergency Use Authorization in December of 2021, the rapid dissemination of information on identification and management of DDIs was needed to ensure appropriate use of nirmatrelvir/ritonavir when treating patients with COVID-19 who were at an increased risk of progression to severe illness. The initiative included comprehensive outreach activities to compliantly inform healthcare providers and patients through the development of various educational materials and omnichannel engagement strategies. This case study may serve as an example to guide best practices for therapeutics requiring timely and comprehensive approaches to the dissemination of medical information in the future.

本案例研究介绍了在 COVID-19 大流行期间针对 nirmatrelvir/ritonavir(Paxlovid™)开展的全面药物相互作用 (DDI) 教育活动。在 2021 年 12 月获得紧急使用授权后,需要迅速传播有关 DDIs 识别和管理的信息,以确保在治疗 COVID-19 患者时适当使用 nirmatrelvir/ritonavir,因为这些患者病情恶化的风险较高。该倡议包括全面的推广活动,通过开发各种教育材料和全渠道参与策略,向医疗服务提供者和患者提供合规的信息。本案例研究可作为一个范例,为今后需要及时、全面地传播医疗信息的治疗方法提供最佳实践指导。
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引用次数: 0
Ensuring Product Safety: A Comprehensive Retrospective Study of USFDA Drug Recalls (2019–2023) 确保产品安全:美国食品和药物管理局药品召回全面回顾性研究(2019-2023年)
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-28 DOI: 10.1007/s12247-024-09869-z
Muhammad Nizam VP, Sravani Yerram, Jayasri Devi Patnam, Ajmal CS, Gayatri Aglave, Ramesh Joga, Rajeev Singh Raghuvanshi, Saurabh Srivastava

Purpose

Despite stringent regulations enforced by the United States Food and Drug Administration (USFDA), numerous drug products still enter the market without adequate assurance of safety and efficacy, resulting in frequent recalls. To explore the real picture of such recalls, this analysis focuses on the USFDA drug recalls with a glance at medical devices, food products, biological products, cosmetics, tobacco products, and veterinary products from 2019 to 2023. The research aims to quantify and categorize these drug recalls, examining various contributing factors to recommend strategies for minimizing future recalls. Additionally, it investigates the influence of global and national crises, such as the COVID-19 pandemic, on the USFDA’s drug recall process.

Methods

Data from USFDA Enforcement reports were collected and sorted, and descriptive statistics were used to analyse drug recalls.

Results

Between 2019 and 2023, the USFDA documented 31125 recalls, of which 6217 involved drug products from 593 different companies. These recalls are frequently initiated by the companies themselves, with primary causes including sterility assurance failures, contamination, and improper storage conditions.

Conclusions

Drug recalls are a double-edged sword: while they are essential for protecting public health, they can also disrupt supply chains and lead to drug shortages, especially when there are no alternatives available. To prevent such disruptions, strict adherence to current Good Manufacturing Practices, along with comprehensive internal audits and rigorous USFDA inspections are vital for manufacturers to maintain quality standards and minimize the risk of recalls.

目的尽管美国食品和药物管理局(USFDA)实施了严格的法规,但仍有大量药品在安全性和有效性没有得到充分保证的情况下进入市场,导致召回事件频发。为了探究此类召回的真实情况,本分析报告重点关注美国食品药品管理局 2019 年至 2023 年的药品召回情况,并对医疗器械、食品、生物制品、化妆品、烟草制品和兽医产品进行了分析。本研究旨在对这些药品召回进行量化和分类,研究各种诱因,从而为尽量减少未来召回提出策略建议。此外,它还调查了全球和国家危机(如 COVID-19 大流行病)对美国食品与药物管理局药品召回过程的影响。研究方法从美国食品与药物管理局执法报告中收集数据并进行分类,使用描述性统计来分析药品召回。这些召回通常由公司自己发起,主要原因包括无菌保证失败、污染和不当储存条件。结论药品召回是一把双刃剑:虽然它们对保护公众健康至关重要,但也会扰乱供应链并导致药品短缺,尤其是在没有替代品的情况下。为防止出现这种情况,生产商必须严格遵守现行的《药品生产质量管理规范》,同时进行全面的内部审计和美国食品药物管理局的严格检查,以保持质量标准并最大限度地降低召回风险。
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引用次数: 0
Quality by Design (QbD) Enabled and Central-Composite Design Assisted Approach for Formulation of Oral Herbal Gastro-retentive In-situ Gel 采用质量源于设计(QbD)和中央复合设计辅助方法配制口服中药保胃原位凝胶
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-26 DOI: 10.1007/s12247-024-09863-5
Rishabh P Malge, V. S. Mannur, Rahul Koli

Purpose

The delivery of herbal medications is currently a growing area in pharmacy. One of the areas of interest for the scientists conducting pharmaceutical research is the use of floating drug delivery system (FDDS) for herbal medicine. In this study, we developed an oral herbal gastro-retentive in-situ gel using extracts from Azadirachta indica and Piper longum Linn, employing the quality by design (QbD) approach.

Methods

For the formulation and optimization of an oral herbal in-situ gel, a central composite design (CCD) was used. This design is based on 2-level factorial designs that have been supplemented with center and axial points to match quadratic models. The amounts of two independent variables, gellan gum (X1) and calcium carbonate (X2), were altered at five distinct levels. For the current investigation, the response variables viscosity (Y1), floating lag time (Y2), and gelling time (Y3) were used. According to DoE software, a total of 13 formulations were prepared by changing the gellan gum and calcium carbonate concentrations.

Results

The optimized formulation (OF2), which contains gellan gum 0.293% & calcium carbonate 0.706, satisfies the requirements of quality target product profile (QTPP) and critical quality attributes (CQA) for oral herbal in-situ gel with 75% and 73% drug content. OF2 had a 35.5 s gelling time, a 53 s floating lag time, and a viscosity of 53 cps. The formulated oral herbal in-situ gel exhibited stability for over 2 months under both freezing (-4 °C) and 40 °C with 60% relative humidity (RH) storage conditions.

Conclusion

The developed formulation presents a promising and innovative approach to enhance the gastric retention of herbal extracts, ultimately amplifying their therapeutic efficacy. This paper establishes the foundation for future preclinical and clinical studies on an oral herbal in-situ gel containing long pepper and neem leaf extracts for the treatment of peptic ulcer disease (PUD).

目的 目前,中草药的给药是一个不断发展的制药领域。将浮动给药系统(FDDS)用于中草药是从事制药研究的科学家们感兴趣的领域之一。在这项研究中,我们采用质量源于设计(QbD)的方法,利用 Azadirachta indica 和 Piper longum Linn 的提取物开发了一种口服中草药保胃原位凝胶。该设计基于 2 级阶乘设计,并辅以中心点和轴心点以匹配二次方程模型。两个自变量,即结冷胶(X1)和碳酸钙(X2)的量在五个不同的水平上发生变化。本次研究使用了粘度(Y1)、浮动滞后时间(Y2)和胶凝时间(Y3)这三个响应变量。结果含有结冷胶 0.293% & 碳酸钙 0.706 的优化配方(OF2)满足药物含量分别为 75% 和 73% 的口服中药原位凝胶的质量目标曲线(QTPP)和关键质量属性(CQA)的要求。OF2 的胶凝时间为 35.5 秒,漂浮滞后时间为 53 秒,粘度为 53 cps。所配制的口服中草药原位凝胶在冷冻(-4 °C)和 40 °C、相对湿度(RH)为 60% 的贮藏条件下均表现出 2 个月以上的稳定性。本文为今后对含有长胡椒和楝树叶提取物的口服中草药原位凝胶治疗消化性溃疡病(PUD)进行临床前和临床研究奠定了基础。
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引用次数: 0
Preparation and Characterization of Electrospun Polyvinylpyrrolidone Nanofiber Mat Containing Phillyrea Latifolia L. Herbal Extract and Evaluation of Antioxidant Mechanism 含 Phillyrea Latifolia L. 草本提取物的电纺聚乙烯吡咯烷酮纳米纤维垫的制备、表征及抗氧化机制评估
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-26 DOI: 10.1007/s12247-024-09867-1
Juste Baranauskaite, Mehmet Ali Oçkun

Purpose

Fast-disintegrating dosage forms based on nanofibers hold promise as effective carriers for a diverse array of drugs. In this study, our objective was to evaluate the effect of polymer polyvinylpyrrolidone (PVP) concentration on the disintegration time and drug release behavior of fast dissolving mats containing P. latifolia leaf extract.

Methods

To accomplish this goal, we created fast-dissolving nanofiber mats using different concentrations of PVP (20% and 25% w/w). The characterization of the rapidly dissolving nanofiber mats encompassed aspects such as drug content, fiber diameter, morphology, disintegration time, drug release behavior, and interactions between the drug and excipients.

Results

The diameter of nanofibers increased with the increase in PVP concentration in the formulations. The dissolution rate of the PVPE-20 and PVPE-25 formulations showed a high release of antioxidants from both formulations. The results revealed that a significantly higher release of antioxidants was observed in the PVPE-25 formulation, displaying the highest initial burst release of approximately 70.9% within the first minute, and releasing the entire drug, about 87.5%, within the first 5 min. Stability tests showed that the formulations were not significantly affected by storage.

Conclusion

The preliminary results presented here as a proof-of-concept demonstration will illuminate future designs and applications of fast-dissolving mats incorporating P. latifolia leaf extract via the electrospinning method.

Graphical Abstract

目的 基于纳米纤维的快速崩解剂型有望成为多种药物的有效载体。在本研究中,我们的目标是评估聚合物聚乙烯吡咯烷酮(PVP)的浓度对含有花叶蕨类植物叶提取物的快速溶解毡的崩解时间和药物释放行为的影响。快速溶解纳米纤维毡的表征包括药物含量、纤维直径、形态、崩解时间、药物释放行为以及药物与辅料之间的相互作用等方面。PVPE-20 和 PVPE-25 制剂的溶解速率表明,两种制剂的抗氧化剂释放量都很高。结果表明,PVPE-25 制剂的抗氧化剂释放量明显更高,在第一分钟内显示出最高的初始猝灭释放率,约为 70.9%,并在前 5 分钟内释放出全部药物,约为 87.5%。结论本文作为概念验证展示的初步结果将有助于今后通过电纺丝方法设计和应用含有花叶蕨类植物叶提取物的快速溶解垫。
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引用次数: 0
Improving the Doxorubicin Loading to PLGA Nanoparticles with TOPSIS-Based Taguchi Design Approach: Effect of the Water Phase 用基于TOPSIS的田口设计方法提高PLGA纳米颗粒的多柔比星负载量:水相的影响
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-24 DOI: 10.1007/s12247-024-09868-0
Hayrettin Tonbul, Gözde Ultav

Purpose

PLGA nanoparticles are one of the most investigated drug delivery systems among all polymeric nanoparticles. Although there are several successfully developed and marketed microparticulate PLGA systems, unfortunately, there was little progress in the in vitro to clinic and marketing translation of PLGA nanoparticulate systems. One of the main reasons is the very low drug-loading capacity of PLGA nanoparticles. This situation becomes more problematic in some drugs such as doxorubicin. Doxorubicin is a very interesting molecule whose solubility and characteristics dramatically change depending on pH and the presence of various ions and compounds in the medium. This property of the doxorubicin probably directly influences the drug loading of the doxorubicin to PLGA nanoparticles. In this study, it was aimed to improve the doxorubicin loading to PLGA nanoparticles while the average particle size and polydispersity index are in the acceptable ranges.

Method

TOPSIS-based Taguchi experimental design was adopted and the effect mainly water phase additive on drug loading, encapsulation efficiency, particle size, and polydispersity index were investigated.

Result

Results show that generally using PBS and HEPES improves the overall results when compared with blank water as the water phase.

Conclusion

Within the study, TOPSIS-based Taguchi design was successfully applied to the optimization of a PLGA nanoparticle formulation, and the optimum water phase additive was determined. These findings will be very beneficial to the researcher in the field of doxorubicin-loaded PLGA nanoparticles in their future studies.

目的 PLGA 纳米颗粒是所有聚合物纳米颗粒中研究最多的给药系统之一。虽然已有几种 PLGA 微粒系统成功开发并上市销售,但遗憾的是,PLGA 纳米颗粒系统在从体外到临床和市场转化方面进展甚微。其中一个主要原因是 PLGA 纳米颗粒的药物负载能力非常低。这种情况在某些药物(如多柔比星)中变得更加棘手。多柔比星是一种非常有趣的分子,其溶解度和特性会随着 pH 值以及介质中各种离子和化合物的存在而发生显著变化。多柔比星的这一特性可能会直接影响多柔比星在 PLGA 纳米颗粒中的载药量。本研究旨在提高多柔比星在 PLGA 纳米粒子中的载药量,同时使平均粒径和多分散指数处于可接受的范围内。方法采用基于田口试验设计(TOPSIS-based Taguchi experimental design)的方法,主要考察水相添加剂对药物载量、包封效率、粒径和多分散指数的影响。结果结果表明,与空白水作为水相相比,使用 PBS 和 HEPES 可以改善总体结果。这些发现将对负载多柔比星的 PLGA 纳米粒子领域的研究人员今后的研究大有裨益。
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引用次数: 0
Improving Continuous Loss-in-weight Feeding Accuracy by a Novel Hopper Design 通过新型料斗设计提高连续失重喂料精度
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-23 DOI: 10.1007/s12247-024-09858-2
Sara Fathollahi, Valjon Demiri, Theresa R. Hörmann-Kincses, Snjezana Maljuric, Julia Massoner, Greg Mehos, Johannes G. Khinast

Purpose

Powder feeding is a vital unit operation in the continuous manufacturing of pharmaceutical products. Loss-in-weight twin-screw feeders are commonly used in continuous manufacturing lines. The feeding performance, i.e., the accuracy and consistency of feeding, influences the content uniformity of the final drug product. In this study, a redesigned hopper for K-Tron KT20 twin-screw feeder was designed, implemented, and investigated to improve feeding performance. The basic idea was to design the hopper in such a way that the stresses on top of the screw entrance are independent of the fill level.

Methods

Our study compared the novel system to that of the original cylindrical hopper. The effect of the redesigned hopper on the start-up, the process’ sensitivity to refill level, and the refill portion size were studied. A free-flowing, barely compressible powder and a compressible blend were used in this study to evaluate the feeding performance and the refill effects.

Results

When using compressible powders, the results showed a larger process window for refilling in the redesigned hopper and a lower refill-level sensitivity compared to the original hopper.

Conclusion

The homogenization of stresses in the redesigned hopper allowed operating at lower refill levels, and variability, especially due to refilling, was reduced. This study demonstrates novel design approaches for successfully implementing hard-to-feed materials in continuous manufacturing.

目的粉末喂料是连续生产医药产品的重要单元操作。失重式双螺杆喂料机通常用于连续生产线。喂料性能,即喂料的准确性和一致性,影响着最终药物产品的含量均匀性。本研究为 K-Tron KT20 双螺杆喂料机设计、实施和研究了重新设计的料斗,以提高喂料性能。我们的研究将新系统与原始圆柱形料斗进行了比较。研究了重新设计的料斗对启动的影响、工艺对加料水平的敏感性以及加料部分的大小。结果当使用可压缩粉末时,结果表明与原始料斗相比,重新设计的料斗具有更大的加料过程窗口和更低的加料水平敏感性。结论重新设计的料斗应力均匀,可以在较低的加料水平下运行,并且减少了可变性,特别是由于加料引起的可变性。这项研究展示了在连续生产中成功实施难喂材料的新型设计方法。
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引用次数: 0
Development and In-Vitro Characterization of Capsaicin Microsponges Loaded Topical Gels for Management of Arthritis 用于治疗关节炎的辣椒素微海绵外用凝胶的开发和体外表征
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-17 DOI: 10.1007/s12247-024-09860-8
G. Gnanarajan, Shaffi Tangri

Arthritis is the one of the leading causes of disability among a large group of population. It is a slowly progressive disorder that effects the joints to a stage where they are not considerably functional and mobile. Counter Anti-inflammatory agents are among the first choice of treatments that leads to reduction in swelling, inflammation and pain primarily.

The current study was aimed to develop topical gels loaded with microsponges of Capsaicin. The prepared microsponges were intended to release drug in the controlled manner thus effectively managing the red flags of arthritis. Microsponges technology is recognized as a novel technology of drug delivery that provides enhanced action for longer duration. In this study Boswellia Serrata a natural resin is also incorporated with capsaicin to study the possible effects of the two when given in combination. Capsaicin was procured in the purest form by AOS Products Private Limited which was then used to prepare microsponges and were further incorporated in the form of topical gels using various concentrations of Boswellia Serrata.

This research focuses on the possible positive effects of Capsaicin in the form of microsponges to manage the conditions of arthritis. The prepared formulations were optimized and were evaluated on the basis of experimental outcomes. DPPH model was used to calculate the Anti- inflammatory effect of using Capsaicin loaded microsponges in combination with Boswellia Serrata resin.

The study concludes that for management of arthritis certain naturally available agents can show equivalent efficacy and results when compared to marketed available dosage forms. Moreover, the microsponge technology ensures controlled release that provides excellent therapeutic action for extended periods of time.

目的 关节炎是导致许多人残疾的主要原因之一。它是一种缓慢进展的疾病,会影响关节,使其无法正常活动。目前的研究旨在开发含有辣椒素微海绵的外用凝胶。制备的微海绵旨在以可控的方式释放药物,从而有效控制关节炎。微海绵技术被认为是一种新型的给药技术,能在更长的时间内发挥更大的作用。在这项研究中,天然树脂 Boswellia Serrata 也与辣椒素结合使用,以研究两者结合使用时可能产生的效果。辣椒素的纯度由 AOS 产品私人有限公司提供,然后用于制备微海绵,并使用不同浓度的乳香 Serrata 进一步制成外用凝胶。根据实验结果对制备的配方进行了优化和评估。使用 DPPH 模型计算了将含有辣椒素的微海绵与乳香树脂结合使用的抗炎效果。此外,微海绵技术可确保控制释放,从而在较长时间内提供出色的治疗效果。
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引用次数: 0
Assessment of the HaLCon® Protein Analyzer for At-Line Titer Measurements in Biomanufacturing Applications 评估 HaLCon® 蛋白质分析仪在生物制造应用中的在线滴度测量效果
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-05 DOI: 10.1007/s12247-024-09866-2
Yuxiang Zhao, Peter Trearchis, Ishaan Shandil, Dhanuka Wasalathanthri, Gloria Li, Anthony Leone

Purpose

With the increasing demand for intensified processes in biopharmaceutical manufacturing, there is a growing requirement for a rapid and precise analytical method to measure product yield. Aligning with FDA guidelines, this requirement aims to enhance process monitoring and control. Currently, the monitoring of monoclonal antibody (mAb) titer during manufacturing heavily relies on offline testing conducted in quality control laboratories. However, the lengthy turnaround time for analytical results, often taking hours or even days, undermines their usefulness for process control and decision-making.

Methods

This manuscript presents a case study on HaLCon® protein analyzer, a compact Liquid Chromatography (LC) system equipped with a Protein A affinity column. HaLCon® is specifically designed for at-line/on-line titer measurement directly at the biopharmaceutical manufacturing site, enabling the rapid acquisition of product yield information. The study investigates the capabilities, performance, and potential applications of HaLCon® at the laboratory scale.

Results and Conclusion

The results obtained demonstrate the effectiveness and reliability of HaLCon® as an analytical instrument for at-line titer measurement, offering valuable insights into its potential application within the biopharmaceutical manufacturing industry.

目的随着生物制药生产对强化工艺的需求不断增加,对快速、精确测量产品产量的分析方法的要求也越来越高。根据美国食品及药物管理局(FDA)的指导方针,这一要求旨在加强工艺监测和控制。目前,生产过程中对单克隆抗体(mAb)滴度的监控主要依赖于质量控制实验室进行的离线测试。本手稿介绍了一项关于 HaLCon® 蛋白质分析仪的案例研究,这是一种配备了蛋白 A 亲和柱的紧凑型液相色谱 (LC) 系统。HaLCon® 专为直接在生物制药生产现场进行在线/在线滴度测量而设计,可快速获取产品产量信息。研究调查了 HaLCon® 在实验室规模上的能力、性能和潜在应用。结果与结论所获得的结果证明了 HaLCon® 作为在线滴度测量分析仪器的有效性和可靠性,为其在生物制药行业的潜在应用提供了宝贵的见解。
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引用次数: 0
Accelerated Approval for Cancer Drugs in the United States and the Clinical Evidence Required for Conversion to Regular Approval 美国癌症药物加速审批及转为常规审批所需的临床证据
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-04 DOI: 10.1007/s12247-024-09851-9
Satoshi Kato, Shunsuke Ono

Purpose

Oncology products often leverage accelerated approval program to seek earlier launches in the United States. Little is known about how the Food and Drug Administration (FDA) has been balancing evidence and access, and the factors that may characterize post-accelerated approval requirements. The present study aimed to obtain insights on how accelerated approval is determined by investigating the balance between pre-accelerated approval and supplemental clinical evidence required for future regular approval.

Methods

The product properties, pre-accelerated approval evidence, rationale, post-accelerated approval requirements, and prior regulatory designations for oncology accelerated approvals were summarized based on public databases. Regression analyses were performed to investigate factors that may have been associated with the post-accelerated approval requirements.

Results

Hundred fifty-seven accelerated approvals were granted between 1992 and 2021. An increase in the number of pre-accelerated approval trials by one trial resulted in a 20% decrease in supplemental trials. The endpoint for the post-accelerated approval trial tended to be more robust when products were indicated for common cancers, while less robust when products had been used to treat fewer subjects, when products were indicated for respiratory and skin cancers, or when less malignant cancers were targeted.

Conclusions

Accelerated approvals for oncology products were often based on the response rate of a noncomparative trial. However, considerable variation was observed in the post-accelerated approval requirements. Factors such as the quality and quantity of pre-accelerated approval evidence, regulatory designations, and operational feasibility may have been considered when determining the accelerated approvals and post-accelerated approval requirements.

目的肿瘤产品经常利用加速审批计划来争取更早在美国上市。人们对美国食品药品管理局(FDA)如何平衡证据与准入之间的关系,以及可能影响加速审批后要求的因素知之甚少。本研究旨在通过调查加速审批前与未来常规审批所需的补充临床证据之间的平衡,深入了解加速审批是如何确定的。方法根据公共数据库总结了肿瘤加速审批的产品特性、加速审批前的证据、理由、加速审批后的要求以及之前的监管指定。结果1992年至2021年间共批准了175项加速审批。加速审批前试验增加一项,补充试验就减少 20%。当产品用于治疗常见癌症时,加速审批后试验的终点往往更可靠,而当产品用于治疗的受试者较少、产品用于治疗呼吸系统癌症和皮肤癌或针对的恶性程度较低的癌症时,终点则不那么可靠。然而,在加速审批后的要求中也发现了相当大的差异。在确定加速审批和加速审批后的要求时,可能会考虑加速审批前证据的质量和数量、监管指定和操作可行性等因素。
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Journal of Pharmaceutical Innovation
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