美国与欧盟孤儿药研发上市管理制度及对我国的启示

目的通过对美国与欧盟对孤儿药研发上市相关管理政策的分析,为我国孤儿药研发上市管理提供借鉴。方法分析美国和欧盟药政管理部门公开的法规文献和数据库检索数据,总结其对孤儿药的激励政策,分析获得孤儿药资格认定和批准上市的药物特点。结果美国和欧盟对孤儿药研发均颁布实施了诸如市场独占期、政府资助、审评专家对研究方案的指导等相应的激励政策。研发机构应采取及早申请孤儿药认定、多途径发现孤儿药及孤儿药的再开发等研发策略。结论美国和欧盟对孤儿药的研发与上市激励政策,刺激了制药企业对罕见病治疗药物的研发热情,有效缓解了罕见病无药可治的现状,对我国制定相关孤儿药政策提供了有益的借鉴。国内创新型制药企业应尽早布局孤儿药的研发,应重点关注国内已经被大众接受的罕见病和治疗,以及超说明书使用的问题;重点关注生物仿制药如单克隆抗体的研发动态;重点关注国际孤儿药专业公司的研发动态,使孤儿药在国内相关法律法规建立健全后,立即有所响应,尽早抢占孤儿药研发的领先地位和市场地位。     

药物毒理学技术方法研究进展

药物是否安全和有效是药物研发成功与否的决定性因素。就药物研发的整个流程而言,毒性是终止药物研发的重要原因之一。药物毒理学研究贯穿于新药发现阶段、临床前安全性评价和上市后跟踪监督的全过程,因此药物的毒理学研究至关重要。简要综述了药物毒理学研究过程中所涉及的技术方法以及研究新动向,并主要介绍了组学技术的发展。     

大数据和人工智能技术用于计算机辅助药物设计的研究进展

大数据和人工智能（AI）技术不仅可以对海量的生物医学数据进行准确和综合地分析,而且可以帮助构建药物设计领域的预测模型。随着算法和统计方法的发展,大数据和AI技术已应用于计算机辅助药物设计（CADD）。CADD可被用于有效克服药物设计领域的困难,从而高效地设计和开发新药。介绍了药物设计和发现过程中数据预处理和建模步骤、药物设计和发现过程中基于AI的建模方法、大数据和AI技术在CADD中的最新应用,以期为我国药物设计和开发提供参考。     

Model-Based Drug Development: The Road to Quantitative Pharmacology

High development costs and low success rates in bringing new medicines to the market demand more efficient and effective approaches. Identified by the FDA as a valuable prognostic tool for fulfilling such a demand, model-based drug development is a mathematical and statistical approach that constructs, validates, and utilizes disease models, drug exposure-response models, and pharmacometric models to facilitate drug development. Quantitative pharmacology is a discipline that learns and confirms the key characteristics of new molecular entities in a quantitative manner, with goal of providing explicit, reproducible, and predictive evidence for optimizing drug development plans and enabling critical decision making. Model-based drug development serves as an integral part of quantitative pharmacology. This work reviews the general concept, basic elements, and evolving role of model-based drug development in quantitative pharmacology. Two case studies are presented to illustrate how the model-based drug development approach can facilitate knowledge management and decision making during drug development. The case studies also highlight the organizational learning that comes through implementation of quantitative pharmacology as a discipline. Finally, the prospects of quantitative pharmacology as an emerging discipline are discussed. Advances in this discipline will require continued collaboration between academia, industry and regulatory agencies.     

美国的儿科药品政策研究及对我国的启示

目的:为我国建立促进儿科药品发展的相关政策提供借鉴和参考。方法:全面研究美国的儿科药品政策及其影响。结果与结论:美国在儿科药品方面实行的是强制加激励的政策,并已取得一定的效果。我国可以借鉴美国的成功经验,建立符合我国儿科药品现状的政策,促进儿科药品的发展,从而提高我国儿童健康水平。     

药效团技术在抗感染新药研究中的应用

药效团（pharmacophore）是指药物分子中对活性起重要作用的“药效特征元素”及其空间排列形式。药效团技术作为1种发展迅速的计算机辅助药物设计方法,已广泛应用于虚拟筛选、全新药物设计、先导化合物优化和ADMET预测等新药的设计和研发过程中,可提高药物研发的成功率,降低研发成本,缩短研发周期。近年来,禽流感、甲流感及超级细菌等新型传染性疾病的出现,为抗感染新药研发提出了新的挑战,为此,综述近年来国内、外发表的有关药效团模建技术的研究进展及其在抗感染新药研发中应用的文献以促进计算机辅助药物设计手段在抗感染新药研发中的应用。     

Theoretical predictions of drug absorption in drug discovery and development

The clinical development of new drugs is often terminated because of unfavourable pharmacokinetic properties such as poor intestinal absorption after oral administration. Intestinal permeability and solubility are two of the most important factors that determine the absorption properties of a compound. Efficient and reliable computational models that predict these properties as early as possible in drug discovery and development are therefore desirable. In this review, we first discuss the implementation of predictive models of intestinal drug permeability and solubility in drug discovery and development. Secondly, we discuss the mechanisms of intestinal drug permeability and computational methods that can be used to predict it. We then discuss factors influencing drug solubility and models for predicting it. We finally speculate that once these and other predictive computational models are implemented in drug discovery and development, these processes will become much more effective. Further, an increased fraction of drug candidates that are less likely to fail during clinical development will be selected.     

新药开发中的基因导向型个体化发展战略

药物基因组学在新药开发的多个阶段可发挥重要作用。研究者可借助基因组信息更好地发现新药的作用靶点及其作用机制,药物基因组及其相关技术的发展帮助研究者在新药开发的临床前研究阶段淘汰化学性质不良的化合物,还可指导新药开发的临床试验设计以增加药物有效性和安全性,同时降低开发所需的时间和成本。     

The current role of model-based drug development

Importance of the field: Current drug discovery and development programs are under growing scrutiny for low productivity and escalating costs. Model-based drug development (MBDD) has been recognized as a promising tool to address some of the related challenges. Areas covered in this review: This review introduces the concept of MBDD and the associated quantitative pharmacology-based iterative 'learn and confirm' paradigm in the drug discovery and development process to provide concise information for rational decision making. It summarizes the evolving role of MBDD in drug development programs and outlines the full armamentarium of modeling and simulation approaches utilized to facilitate its application. What the reader will gain: Different aspects and applications of MBDD are introduced to the reader and illustrated in prime examples. The reader is provided with an understanding of potential applications of MBDD in drug development as well as the associated limitations and challenges in its implementation. Take home message: MBDD is a tool that is increasingly used throughout the drug discovery and development continuum to support fast and rationale decision making and has thereby the potential to accelerate and increase the cost-effectiveness of the drug development process.     

生物标志物在药品生命周期中的应用与展望

生物标志物(biomarker)是一种能客观测量并评价正常生物过程、病理过程或对药物干预反应的指示物,可有效提高新药研究开发决策,指导候选药物早期临床试验,降低新药研发失败的风险,其在药品生命周期中的重要作用已引起业内普遍关注。欧美等国家和地区相继出台关于生物标志物研究开发和资格鉴定程序的指南,鼓励医药企业将生物标志物作为创新药物发现的工具,在药品上市后通过生物标志物监控其安全性和有效性。本文针对我国药品生命周期特点,对生物标志物在药物基础研究、先导化合物/创新药物的设计与发现、临床前药物开发、临床研究、新药研究及上市后再评价等药品生命周期各个环节中作用情况进行综述,并对其应用前景进行展望。     

Promises of biomarkers in drug development--a reality check

Biomarkers have been a buzz word in drug development for the last 5 years. But where do we stand now? This perspective article will demonstrate to which extent biomarkers have impacted drug development and the use of drugs. In particular, the different types of biomarkers, their identification, validation and use in different phases of drug development from drug discovery, to approval, to clinical application will be discussed as well as the state‐of‐the‐art biomarker technologies and promising future methods. The high interest in biomarkers has generated the need for development of new technologies and refinement of existing ones. Besides discussing their perspectives of applications, the present article also illustrates the future of biomarker development in terms of qualification for regulatory use and co‐development.     

改革开放40周年我国药品标准工作回顾与展望

药品标准是药品质量和安全的最基本要求。改革开放以来,在党和政府的正确领导下,我国药品标准工作经历了一系列改革发展历程,取得了许多令人瞩目的成就,为药品监督管理工作提供了有力的技术支撑。在改革开放40周年之际,本文全面回顾了改革开放以来我国药品标准工作的发展历程,系统总结了40年来取得的一系列理论和实践成果,并结合当前我国药品标准工作中存在的问题提出发展思路和对策建议,为今后进一步做好药品标准工作提供借鉴和参考。     

药物制剂产业化发展的前沿科学技术问题探讨

随着国际医药产业格局的变化,新药投入风险越来越大。与开发一个新分子实体相比,新剂型的创新路径具有周期短、投资少、风险小、回报高等特点。企业逐步从原料药研发向下游制剂和具有自主品牌的高端制剂创新发展。国家政策鼓励药企创新发展制剂技术和药物释放系统(DDS)等,开发新型制剂、改良型制剂(如创新的给药释药系统),以及鼓励中药“经典名方”向高端中药制剂研发,提高已上市药物的安全性、有效性和临床依从性。高端制剂是新药研发的重要方向,也是应对国际、国内药企竞争的发展战略和策略。本文针对中国药物制剂高质量发展所关注的问题,对比分析国内外药物制剂情况,围绕药物制剂发展的挑战、高端制剂、释药技术与药动学、科学技术问题等方面予以评述。     

浅析我国药品标准及其在新时期的地位与作用

本文结合国内外药品标准的实际，较系统地阐述了药品标准的内涵、我国药品标准管理概况、国内外药品标准的发展状况，提出了我国药品标准在新时期的地位与作用，为科学制定与准确理解药品标准，使之促进并服务于我国医药事业的发展提供了有益的参考。     

Pharmacokinetic/pharmacodynamic studies in drug product development.

In the quest of ways for rationalizing and accelerating drug product development, integrated pharmacokinetic/pharmacodynamic (PK/PD) concepts provide a highly promising tool. PK/PD modeling concepts can be applied in all stages of preclinical and clinical drug development, and their benefits are multifold. At the preclinical stage, potential applications might comprise the evaluation of in vivo potency and intrinsic activity, the identification of bio-/surrogate markers, as well as dosage form and regimen selection and optimization. At the clinical stage, analytical PK/PD applications include characterization of the dose-concentration-effect/toxicity relationship, evaluation of food, age and gender effects, drug/drug and drug/disease interactions, tolerance development, and inter- and intraindividual variability in response. Predictive PK/PD applications can also involve extrapolation from preclinical data, simulation of drug responses, as well as clinical trial forecasting. Rigorous implementation of the PK/PD concepts in drug product development provides a rationale, scientifically based framework for efficient decision making regarding the selection of potential drug candidates, for maximum information gain from the performed experiments and studies, and for conducting fewer, more focused clinical trials with improved efficiency and cost effectiveness. Thus, PK/PD concepts are believed to play a pivotal role in streamlining the drug development process of the future.     

儿童用药现状浅析

目的保障儿童治疗用药需求,促进临床合理用药。方法分析当前我国儿童用药在研究开发、生产供应、品种规格及临床应用等方面存在的问题,提出改进措施。结果我国儿童用药存在研发能力不足,品种、剂型、规格供应不全,安全用药资料欠缺,临床使用不规范等问题。结论应加大儿童用药研发的政策扶持力度,完善临床用药资料,加强安全用药监管,提高合理用药水平,保证儿童患者用药安全、有效、及时。     

监管科学视角下药品网络销售监督机制探讨

目的:为完善我国药品电子商务政策和药品网络销售监督管理机制提供政策建议。方法:梳理我国药品网络销售政策沿革,基于监管科学视角分析2019年新修订的《药品管理法》和2020年11月发布的《药品网络销售监督管理办法(征求意见稿)》(以下简称《新征求意见稿》)关于网络药品销售监管机制的相关规定,并提出观点。结果与结论:我国药品电子商务经历了4个阶段的发展,目前处于鼓励创新、包容审慎的法律规范新阶段,新修订的《药品管理法》和《新征求意见稿》顺应新时代"互联网+"发展趋势,有条件地放开了网络处方药经营,构筑药品经营发展的新优势和新动能。新的药品网络销售监管机制是监管部门积极顺应社会发展的重要体现,是药品科学监管理念创新的具体实践,同时也为创新药品流通新业态提供了法律保障和政策空间。但是,笔者认为其在处方药的信息与药品广告的关系,网络处方传输与真实性、合法性审核,以及对销售行为和服务行为的概念界定方面还有值得商榷的地方,相关概念和术语应作出一定调整和重新界定。建议将药品网络销售者界定为"药品电子商务经营者"或"药品网络经营者",将药品网络交易第三方平台界定为"药品电子商务平台经营者"或"药品网络交易平台经营者"等。     

药物分子设计的策略：苗头和先导物的品质决定新药的成败

苗头化合物-先导物-候选药物是创制新药的三个重要里程碑，其中候选药物的确定是新药创制的关键环节，将创制过程分成研究和开发两个阶段，并且开发阶段所有环节都取决于候选药物的化学结构，所以决定了临床前和临床研究的命运。候选药物质量的高低又受制于先导化合物的类药性和苗头化合物的品质，苗头化合物演化成先导物是将新药的研究植根于有研发前景的结构上，先导物的优化是将活性化合物转化成候选药物的过程，是在药效、药代、安全性和物化性质等多维空间中的优化操作。本文结合实例讨论了发现苗头、确定先导物、先导物优化和确定候选药物的策略原则。     

药物基因组学在药物研发中的转化与应用

药物安全性和有效性是新药开发和临床用药的核心问题,也是药物基因组学研究的主要内容。目前,已阐明影响药物安全性有效性及个体化差异的首要因素是药物相关生物标记。近年来,药物基因组学各机构正式成立,各发达国家也纷纷出台各种规章,对药物研发中药物基因组学的应用进行规定。药物基因组学在上市药物的评价中已获得巨大的成功,并成功指导了数例肿瘤靶向药物从研发到上市的全过程,缩短了药物开发周期、降低了研究成本及毒副反应。     

The new pre-preclinical paradigm: compound optimization in early and late phase drug discovery

The attrition rates of new chemical entities (NCEs) in preclinical and clinical development are staggeringly high. NCEs are abandoned due to insufficient efficacy, safety issues, and economic reasons. Uncovering drug defects that produce these failures as early as possible in drug discovery would be highly effective in lowing the cost and time of developing therapeutically useful drugs. Unfortunately, there is no single factor that can account for these NCE failures in preclinical and clinical development since factors, such as solubility, pKa, absorption, metabolism, formulation, pharmacokinetics, toxicity and efficacy, to name a few, are all interrelated. In addition, there are many problems in scaling-up drug candidates from the laboratory bench scale to the pilot plant scale. To address the problem of attrition rates of NCEs in preclinical and clinical development and drug scale-up issues, pharmaceutical companies need to reorganize their preclinical departments from a traditional linear approach to a parallel approach. In this review, a strategy is put forth to integrate certain aspects of drug metabolism/pharmacokinetics, toxicology functions and process chemistry into drug discovery. Compound optimization in early and late phase drug discovery occurs by relating factors such as physicochemical properties, in vitro absorption, in vitro metabolism, in vivo pharmacokinetics and drug scale-up issues to efficacy optimization. This pre-preclinical paradigm will improve the success rate of drug candidates entering development.