国外已上市连续制造药品的注册审评情况及其启示

目的：借鉴国外已上市连续制造药品的注册审评要点,为我国推进药品连续制造相关监管法规、 技术指南和标准制定等方面提供参考。方法：调查研究全球已上市口服固体制剂连续制造产品在注册过程中的工艺评估及审评情况,结合案例分析和连续制造相关的法规要求,梳理连续工艺产品在注册和审评过程中的关注点。结果与结论：药品连续制造在国外已经有较为成功的应用,监管部门应重视与业界早期沟通,并在审评阶段重点关注批量的定义、工艺验证、技术转移等研究资料。随着ICH Q13的落地实施,建议我国借鉴国外已上市连续制造药品的工艺评估情况并结合相关法规要求,制定符合国情的注册审评指南。     

香港澳门药品注册管理的比较研究

目的：将香港澳门的药品注册管理进行系统的比较研究,为内地药品到港澳上市提供参考。方法：运用文献研究和政策分析法,对港澳地区的药品注册管理体系、药品注册要求以及注册申报程序进行对比分析。结果：港澳的药品注册管理机制不同,香港的药品管理法律体系呈平行管理的特点,对中西药独立监管注册,中药实行中成药注册分类制度,并根据注册组别不同提交不同资料;而澳门的药品法律体系尚未统一,对药品集中注册管理,实行预先登记机制,中药实行中药预先许可制度。结论：内地药品在港澳注册上市,有利于提高内地企业的国际化和药物研发水平;内地企业在港澳申请注册时,应熟悉港澳药品注册管理政策,并与当地经销商合作,积极开展国际多中心临床试验;而提高内地企业药品研发质量,促进三地临床数据互认,有利于实现三地互利共赢的目标。     

药品连续制造全球监管发展现状与思考

目的：在连续制造技术越来越多地应用在药品领域这一背景下,综述相关法规指南从概念探索、 正式发起至发布的发展历程,介绍全球多个采用连续制造技术生产药品获批上市的概况,探讨促进我国业界和监管机构借鉴全球药品连续制造发展经验。方法：通过对比传统的批量制造技术以分析连续制造具有的优势和面临的挑战,结合对全球监管指南制定过程中各监管机构对策的梳理,研究相关共识的发展考量和意义。结果：药品连续制造监管发展已经进入了新的时代,我国相关法规指南的制定和产业技术水平提升需要借鉴全球发展的经验,特别是国际人用药品注册技术协调会及美、欧、日等国家药品监督管理机构或国际组织的现有指南在批定义、工艺验证、稳定性等方面的监管对策,为该新兴技术的监管科学研究提供理论基础。结论：通过对药品连续制造全球监管发展现状的综述和思考,为我国相关法规、技术指南和标准的制定提供参考,并希望为产业发展发挥促进作用。     

我国药品附条件批准程序实施情况及相关思考

目的：对我国药品附条件批准上市相关政策和实施情况进行深入分析和探讨,参考美国与欧盟药品附条件上市政策,对我国附条件批准上市的实施和推进提出建议。方法：通过梳理药品注册管理办法发布后国家药品监督管理局(NMPA)药品附条件批准上市申请审评审批法规政策实施情况,重点围绕当前法规中的准入条件、准入程序、上市后监管要求、撤销情形以及撤销程序进行综述,针对实施过程中发现的问题,借鉴美国食品药品管理局(FDA)药品加速审批(Accelerate Approval)与欧洲药品管理局(EMA)药品附条件批准(Conditional Marketing Authorisation)经验以及对各国附条件政策进行比较分析,探讨我国药品附条件批准上市政策的发展方向。结果与结论：为了加快具有突出价值的临床急需药品上市,缩短新技术临床应用时间,美国与欧盟均设立了相对完备的附条件上市法规政策及程序。我国的附条件批准制度虽然建立时间较短,但有欧美的经验作为参考,结合我国的临床实践和监管需要, 相关法规也在趋于完善。未来,监管部门更多需要考虑的是对程序和技术要求的细化、制度之间的衔接 (如疫苗的紧急使用授权与附条件批准制度),以及加强上市后监管等方面。     

安徽省中药配方颗粒上市前备案申报资料常见问题分析及建议

目的：研究安徽省中药配方颗粒上市前备案资料审查中发现的常见问题,为中药配方颗粒生产企业提升备案资料质量和加强生产质量管理提供参考。方法：以中药配方颗粒生产企业通过国家药品监督管理局药品业务应用系统提交的上市前备案资料为研究对象,采用汇总归纳的方法对备案资料中发现的常见问题进行分析总结。结果：中药配方颗粒生产企业的上市前备案资料在完整性、生产资质、物料的执行标准、生产工艺、检验、药材基原、药用部位等方面还存在不足和问题。结论：生产企业应深入学习中药配方颗粒监管法规,准确把握上市前备案资料要求,切实履行中药配方颗粒生产和质量保证的主体责任,确保备案资料的真实、完整和可追溯。     

我国药品加快上市注册程序的注册情况分析

目的：对2020年新修订的《药品注册管理办法》颁布前后我国纳入药品加快上市注册程序并已批准上市的药品信息进行分析,为完善我国药品加快上市注册程序提供参考。方法：检索国家药品监督管理局药品审评中心发布的2019-2021年度药品审评报告,对通过优先审评和药品加快上市注册程序而上市的相关药品数据资料进行信息整理和汇总分析。结果：通过药品加快上市注册程序的上市药品数量逐年增多,优先审评审批资源向临床优势药品和创新药品倾斜。结论：药品加快上市注册程序可为临床价值显著的药品提高审批效率,在一定程度上激发制药企业研制热情,但药品加快上市注册审批体系仍需进一步完善配套政策,细化实施要求,加快专业指南出台,鼓励以临床价值为导向的药品的研发创制, 不断提升药品监管部门的服务和监管能力。     

我国体外诊断试剂产品注册管理现状分析

目的：对体外诊断试剂产品中注册管理相关法规和技术文件进行梳理、总结和分析,有利于从业人员和监管人员全面掌握注册制度的关键环节和配套要求,提升体外诊断试剂产品监管的科学性、准确性,提高企业开展相关产品注册的效率和质量。方法：从监督管理变化视角对注册管理办法的产品分类规则、执行标准、临床评价、审查指导原则、特殊审批程序等监管内容进行解读,分析体外诊断试剂行业的前景与面临的问题,阐释修订后的法规在保证体外诊断试剂安全有效、质量可控方面起到的明显成效。结果与结论：通过对体外诊断试剂产品注册管理法规进行修订,实现了对分类规则的调整,解决了部分产品分类与其风险不匹配等问题,完善了产品执行标准,使标准发挥出技术支撑作用,贯彻落实企业主体责任,加大临床试验管理力度,发布审查指导原则,补充特殊审批条件,在保证体外诊断试剂的安全、有效、质量可控方面发挥了显著作用,对我国体外诊断试剂整体行业的发展产生了深远影响。     

新《药品管理法》实施后放射性药品监管法规的变化及对策分析

目的：阐明新修订《中华人民共和国药品管理法》(以下简称《药品管理法》)实施后放射性药品监管法规的主要变化，为放射性药品监管和放射性药品相关企业提供参考。方法：依据《药品注册管理办法》《药品生产监督管理办法》《放射性药品管理办法》以及相关制度的新要求，对影响放射性药品监管的主要变化进行总结和分析。结果与结论：新修订《药品管理法》落实以人为本的理念，加强了对放射性药品全生命周期的监管的同时，调动了放射性药品市场的积极性，促进了上市许可持有人管理能力的提升和主体责任的落实。     

药品上市后变更药学现场检查法规分析

目的：为了使企业更好地理解我国药品上市后变更相关药学现场检查相关法规要求，使其更好地实施药品上市后变更管理及迎接药品监管部门的现场检查。方法：通过梳理我国境内生产药品上市后变更相关的法律法规、通告公告、通知等，对药品上市后变更相关的检查要求进行了分析。结果：总结了注册和监管2个条线共8类检查类型，并分析了相应的检查启动原则、检查实施单位和检查重点等。结论：通过各类上市后变更现场检查的根本是企业应充分地理解法律法规、指导原则的要求，并依据相关要求做好药品的日常管理工作。     

日本组合医疗产品监管政策研究

目的： 通过对日本组合医疗产品全生命周期监管有关政策的研究,思考药械组合产品监管应关注的重点问题,以期科学把控风险、落实有效监管。方法：系统介绍日本医药品及医疗器械综合管理机构发布相应管理文件的核心内容,并结合美国、中国的相关政策情况对比分析。结果与结论：可从细化监管政策、做好风险评估和加强国际协调三方面借鉴相关经验,以促进我国药械组合产品行业的创新发展。     

Genomics and the prospects for the discovery of new targets for antibacterial and antifungal agents

The current increase in the number of microbes resistant to antibacterial or antifungal agents represents a potential crisis in human and veterinary medicine. Some believe that we are entering a post-antibiotic era where most antibiotics no longer will be efficacious. Therefore, it is important that new antibiotics be developed. However, because of the potential for cross-resistance, new targets for the discovery of antibiotics are needed particularly where resistance does not currently exist. The results obtained from the sequencing of genomes from pathogenic bacterial and fungal microbes provide an opportunity to ameliorate this problem. Genomic sequence data can be used to identify new genes that could be used as targets for new antibiotic discoveries. Viable new target genes might represent those that are widely distributed among pathogens or that have homologs and are essential for the viability of the organism. Chemical compounds that attack such targets would be expected to have classical antibiotic activities. Less widely distributed genes still could be valuable targets for narrow spectrum antibiotics. While many of these genes will have known or putative functions based on DNA sequence homology, the most interesting genes are the newly discovered genes with unknown functions. In this paper, it is suggested that novel, non-traditional targets also will be found through the analysis of genome sequences: those that are involved in disease pathogenesis and those that are involved in adaptation and growth in infection sites. The advantage of the non-classical targets is that targeting these sites may not result in the same degree of selective pressure that encourages resistance, and these could have a longer therapeutic life time.     

Preparing for the revolution--pharmacogenomics and the clinical lab

Pharmacogenomics seeks to apply the field of genomics to improve the efficacy and safety of therapeutics. Sinmply put, pharmacogenomics is genetic-based testing to determine patient therapy. Interestingly, the clinical lab has rarely been discussed within the context of pharmacogenomics. Since clinical labs fill a key role in drug development it is important that they are included in pharmacogenomic discussions. Currently, clinical labs assist pharmaceutical sponsors in preclinical pharmacogenetic testing. In the future, clinical labs will be looked to for genetic test development and validation, and high-throughput genotyping of patients in clinical trials and routine testing. Clinical labs are an essential link in the chain of pharmacogenomic drug development, a fact which must be recognised by both the labs themselves and the industry as a whole.     

Exercise for the overweight and obese

The development of new phamacological treatments for obesity has been challenging. In part, the lack of early diagnosis, early detection, early intervention and treatment has meant that more cases progress to life-threatening co-morbidities and surgical options. Pharmacological treatment of obesity has been limited. Self medication with drugs of abuse and tobacco has been successful for some patients, but abuse and addiction make this approach quite dangerous. The advent of trendy 'diets du jour' has apparently made obesity and eating disorders more likely rather than less likely. Trials of novel anti-obesity compounds have generally compared the new medication and placebo to a dietary counseling intervention. Interventions for patients who are not obese enough for gastric banding or bariatric surgery are quite similar to those given to alcoholics in the 1970s, "drink less or stop drinking". We need to consume less in a modern life of desk and computer work, driving, and even internet shopping. However, we are driven and reinforced to consume and easily fall prey to television and other cues and messages driving this relationship to eating. This paper, after briefly reviewing the consensus on consumption and exercising suggests that new treatments may be developed by increasing exercise adherence and even increasing the reinforcing value or power of exercise itself. Food, sex, and drugs of abuse are highly valued and reinforced in our brains, so why not exercise?.