欧盟药品注册申请中电子文档递交的应用与实践

为适应信息时代的不断进步和新药研发的高效创新,目前美国FDA、欧盟EMEA 和日本厚生省等国外主流国家的药品注册文件递交和审评已经由纸质版走向了电子化。ICH M2 EWP（Expert Working Group）的eCTD 指导原则提出了制药商向评审机构进行电子提交的标准结构和格式,采用XML（eXtensible Markup Language）对元数据和文档结构进行描述,同时对电子提交物的创建、查阅、生命周期管理及归档等方面做了规范。为顺应时代潮流,中国也开始尝试使用eCTD 格式对化学新药的申请提出了这一要求。天士力推进的第一个欧盟药品注册项目也采用了当下通行的eCTD 文档管理和电子递交（e-Submission）模式,成功通过欧洲电子通道CESP 向荷兰药监部门（CBG-MEB）进行了递交。通过这一项目的应用,结果表明eCTD 电子文档申报不仅能够保障申报信息规范、完整,而且通过这一标准化途径,也有利于实现信息交互与共享,提高注册效率,为欧盟后续评审过程跟踪提供支撑。eCTD 申报模式不仅能够保证注册申报环节规范、便捷,注册材料完整、标准,还能够提高审评效率,节约注册成本,是我国未来药品申报的趋势和方向。     

我国药品注册工作实施eCTD的探讨

目的：为我国药品注册工作实施电子通用技术文档（eCTD）提供参考。方法：介绍eCTD的组成、优势和在全球的实施情况,结合我国实情,从政策、技术层面探讨我国实施eCTD面临的挑战。结果与结论：eCTD在药品注册资料的创建、传输、审阅、检索、存档及文件生命周期管理等方面具备的优势,保证了资料的完整、规范,提高了申报、审评效率,节约了注册成本。但在系统安全性、原辅料与药品注册数据关联、中药制剂注册申报等方面仍需进一步完善,并加强相关专业人才的培养,以加快推进eCTD信息化系统建设和使用。     

我国实施ICH Q系列技术指导原则的策略研究

通过对ICH Q系列指导原则与我国对应技术指导原则的对比研究,分析我国药品注册药学技术要求与ICH药学技术要求的主要差异。通过对公众、专家、企业进行问卷调查,摸清ICH Q系列指导原则在我国的认知和实施基础。在对比研究和问卷调查的基础上,结合ICH的要求,提出了ICH Q系列指导原则在我国实施的建议。     

Utilization of electronic resources in the NDA/BLA regulatory review of bioanalytical data: perspectives from US FDA reviewers

The electronic common technical document (eCTD) format is frequently used in submitting bioanalytical information as part of a new drug application (NDA) or biologics license application (BLA). While the use of the eCTD format has many advantages, the potential for further improvement exists. This review highlights issues that are commonly encountered in reviewing bioanalytical information during the review process. In addition, the authors suggest potential strategies that illustrate how the ability to locate bioanalytical data or information can be enhanced and the summary information can be more consistently organized for a NDA or a BLA that is submitted in an eCTD format.     

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。     

Objectives and organization of the International Conference on Harmonization]

The objective of the International Conference on Harmonization established since 1989 is to allow marketing of new drugs as soon as possible for patient benefit. At the same time harmonization decreases development time by harmonizing the content and the format of the registration file in the three regions: European Union, United States and Japan. ICH is a unique process involving health authorities and industry representatives of the three regions. The Conference which took place in July 1997 was the end of the first step of the process. At the meeting it was decided to pursue this harmonization activity, particularly in initiating a project devoted to the file format (Common Technical Document). The current period will be essentially focused on implementation of the common Guidelines and on their update in relation to scientific progress, the major part of the file now being harmonized in its content.     

我国实施ICH S系列技术指导原则的策略研究

通过对ICH S系列指导原则与我国相应技术指导原则的对比研究,分析我国与ICH在药品注册非临床技术要求方面的主要差异。通过对公众、专家、企业进行问卷调查,摸清ICH S系列指导原则在我国的认知和实施基础。在对比研究和问卷调查的基础上,结合ICH的要求,提出了ICH S系列指导原则在我国实施的建议。     

我国实施ICH M系列技术指导原则的策略研究

通过对ICH M系列指导原则与我国相关技术指导原则的对比研究,分析我国相关技术指导原则与ICH M系列指导原则的主要差异。通过对公众、专家、企业进行问卷调查,摸清了ICHM系列指导原则在我国的认知和实施基础。在对比研究和问卷调查的基础上,结合ICH的要求,提出了ICH M系列指导原则在我国实施的建议。     

我国实施ICH E系列技术指导原则的策略研究

通过对ICH E系列指导原则与我国对应技术指导原则的对比研究,分析我国与ICH在药品注册临床技术要求方面的主要差异。通过对公众、专家、企业进行问卷调查,摸清ICH E系列指导原则在我国的认知和实施基础。在对比研究和问卷调查的基础上,结合ICH的要求,提出ICH E系列指导原则在我国实施的建议。     

人用药品注册技术要求国际协调会议关于通用技术文件的协调进展及其启示

本文旨在遵从药品注册技术要求一致化的原则下,对人用药品注册技术要求国际协调会议(ICH)所倡导执行的通用技术文件(CTD)进行比较全面的阐述和理解,详细介绍CTD在ICH6上的进展情况,就美国食品药品监督管理局对CTD的实施过程予以简介和研究,并深入探讨其对于我国药品注册规范等方面的影响和启示。     

Practical issues and observations on the use of foreign clinical data in drug development

The International Conference on Harmonization (ICH) has recently developed the ICH guidelines, which are the common guidelines for regulatory requirements in the ICH regions, i.e., European Union, Japan, and the United States of America. The guidelines have been successively implemented in the ICH regions, and the people involved in drug evaluation in the pharmaceutical industry, such as statisticians and pharmaceutical scientists, have referred to the guidelines during their daily work. Probably one of the most influential ICH guidelines on the drug development process in the ICH regions, especially in Japan, is the ICH-E5 guideline, which is encouraging the pharmaceutical industry to use the mountain of foreign clinical data for the registration of a new drug. In this article, we review the issues concerning the ICH-E5 guideline discussed so far, and discuss some practical issues in applying the guideline, especially the design of the study conducted in a new region. This is called a "bridging study." In addition, we introduce some statistical approaches for evaluating the acceptability of foreign clinical data.     

从定期安全性更新报告过渡到定期受益-风险评价报告：初步经验和挑战

人用药品注册技术要求国际协调会议（ICH）提供了定期安全性更新报告指南（PsuR,ICHE2C（R1））和新的定期受益-风险评价报告指南（PBRER,ICHE2C（R2））。PBRER由PSUR演变而来,实现了从比较传统的获批后药物警戒定期总结报告到现代定期受益-风险评价总结报告的转变,根据累积信息对批准上市产品做出最新的受益-风险评价。通过总结ICHE2CPSUR指南和PBRER指南的主要区别,介绍了某跨国制药公司在由编写PSUR改为编写PBRER的转变过程中所积累的初步经验及其遇到的挑战,讨论了中国在推进药物警戒系统的背景下实行PBRER的可能性。     

ICH M4: the standardized international restration dossier or "C.T.D." (common technical document)]

The ICH E3 guideline "Structure and Content of Clinical Study Reports" has allowed to harmonize the structure and the contents of the study report, as well as the information to be provided in each section. Industry has wished to pursue this process and has asked for an ICH guideline regarding the complete harmonization of the registration dossier, called "C.T.D." or Common Technical Document, for the three parts of the dossier in terms of quality, safety and efficacy. A survey was carried out comparing the documentation to be provided, identifying the differences and potential obstacles to harmonization, and assessing the advantages and disadvantages of the C.T.D. The C.T.D. leading to a single registration dossier should allow pharmaceutical companies and health authorities to make savings in terms of resources (time, money and expertise), to facilitate exchanges through IT systems and to improve communication. The ICH expert groups in charge of the pharmaceutical, pre-clinical and clinical parts of the dossier are expected to start their work in February 1998. By February 2000, it is anticipated that this project will become a valuable tool for the international registration and evaluation of medicines. The C.T.D. should improve the dialogue between industry and authorities with regard to medicines and public health.     

简析化学药品注册分类改革对药品研发的影响

国家食品药品监督管理总局于2016年调整了化学药品注册分类。分析化学药品新旧注册分类中的新药、仿制药概念、内涵以及技术标准的变化。与2007年版法规相比,新法规对新药和仿制药的定义均发生了明显变化,新药的范围缩小,要求更为严格和准确,仿制药的适用范围扩大,在技术标准方面达到国际要求。药品注册制度改革对医药研发产生了深远影响：促使国内医药市场重新洗牌,鼓励企业加大研发和创新力度,加快进入国际市场的步伐。     

Challenges and lessons learned since implementation of the safety pharmacology guidance ICH S7A

The International Conference on Harmonization, Topic S7A guidance (ICH S7A) on safety pharmacology for human pharmaceuticals has been in effect for 3 years in Europe, the United States and Japan. Surveys of the pharmaceutical industry, regulatory agencies and the audience attending the 4th Annual Meeting of the Safety Pharmacology Society have helped identify and address areas of controversy, as well as those challenges that have emerged since implementation of the guidance worldwide. Overall, ICH S7A has been successfully implemented. The guidance provides for "Good Laboratory Practice" compliant "safety pharmacology core battery" of studies that are generally performed prior to first administration to humans. The approach is science-driven and specifies the use of robust and sophisticated in vitro and/or in vivo assays. There are, however, some areas that require further refinement/clarification such as the specifics of study design including the selection of dose/concentration, choice of species, modeling of the temporal pharmacodynamic changes in relation to pharmacokinetic profile of parent drug and major metabolites, use of an appropriate sample size, statistical power analysis as a means of demonstrating the sensitivity of the model system, testing of human-specific metabolites and demonstrating not only the model's sensitivity, but also its specificity for predicting adverse events in humans. There was also discussion of when these studies are needed in relation to the clinical development plan. Representatives from the pharmaceutical industry and regulatory agencies see the implementation of ICH S7A as a major step forward towards identifying the risk to Phase 1 and 2 volunteers and patients. It remains to be seen, however, whether and in what ways the ICH S7A-based strategy will contribute to the modification of the integrated risk assessment during the latter stages of clinical development or once drugs have been introduced to the marketplace.     

新药临床试验期间药物警戒和风险控制研究四:临床试验期间安全性定期报告监管要求研究

目的：比较分析国内外关于临床试验期间安全性定期报告的相关法规和指导原则要求的异同点, 为加强我国试验用新药临床试验期间安全性定期报告的管理提供理论依据。方法：采用文献对比方法, 通过比较ICH、美国、欧盟、中国在临床试验期间安全性定期报告相关法规及指导原则情况,分析各国家/地区对试验用药物临床试验期间安全性报告监管要求的差异。结果与结论：在试验用药物临床试验期间的安全性定期报告方面,我国、FDA、欧盟均提出了明确的监管要求。各国家/地区均接受ICH E2F研发期间安全性更新报告的格式、内容及报告周期的要求,但在区域附件部分,各国家/地区均有各自的特殊要求。     

Study on requirements of bioequivalence for registration of pharmaceutical products in USA,Europe and Canada

The present study was aimed to study the requirements of bioequivalence for the registration of pharmaceutical products in the USA, Europe and Canada. Before going into bioequivalence studies it is essential for the pharmaceutical industry to study the guidelines of bioequivalence for the respective country where the industry wants to market its products and thus enter into generic market. This study reviews the requirements of bioequivalence with study parameters such as study design, fasting or fed state studies, volunteers recruitment, study dose, sampling points, analytical method validation parameters, moieties to be measured in plasma, pharmacokinetic parameters, criteria for bioequivalence, GCP requirements etc, which are needed for the pharmaceutical industry to carry out bioequivalence studies and to file ANDA. Test products and reference products are needed for this study. Test products are usually manufactured by a sponsor and reference products are provided by the government laboratories of the respective countries. Sampling points also vary with respect to the regulatory guidelines of these countries. All these countries follow ICH GCP guidelines. The criterion of bioequivalence for these countries is 90% CI 80–125% for C_max, AUC_t, AUC_0–∞.     

基于消费者视角的成都市社会药房电子处方及远程药学服务实施现状和效果的调查分析

目的:从消费者视角评价社会药房电子处方及远程药学服务试点现状和实施效果,为完善和优化社会药房电子处方及远程药学服务提供参考。方法:随机抽取成都市6个区县、36家药店的264位消费者进行问卷调查,采用SPSS 23.0软件对问卷调查结果进行描述性统计,并基于χ2检验和有序多分类Logistic回归分析比较各种影响因素在消费者满意度中的分布和差异;随机选取接受过该项服务的消费者进行半结构访谈,通过Nvivo 12.0软件进行文本分析以提炼该服务存在的问题。结果:本次研究共向成都市各区消费者发放问卷271份,回收有效问卷264份,有效回收率为97.4%。264名受访者中,有178位(67.9%)对电子处方及远程药学服务有所了解;有197位(74.6%)在药店接受过电子处方及远程药学服务;有202位(76.5%)表示对该项服务有需求,且有63位(23.9%)表示愿意为此服务付费。197位接受过该项服务的受访者中,有163位(82.2%)对使用体验表示满意或十分满意,仅有1位(0.5%)对该项服务表示不满意;其中,等待时间、购药需求的满足程度、工作人员态度、服务平台配置、远程执业医药师的资质和服务质量是主要的满意度影响因素,且该项服务还存在电子处方流转难、服务监管措施不足、医师和药师资质证明不足、文化堕距、服务流程不规范等问题。结论:社会药房电子处方及远程药学服务在技术水平、制度设计和社会认同上仍有所不足,建议相关部门实施鼓励政策,进行技术优化;及时跟进配套政策,加强监管;加大社会宣传和监督,促进社会药房电子处方及远程药学服务不断进益并长效发展。     

从日本药事法的修订谈我国境外药品委托生产

目的:为我国制药企业发展境外药品委托生产提供参考。方法:对比我国和日本等国药品委托生产注册制度,在分析我国药品委托生产现状的基础上,对我国制药企业承接来自日本等国的境外药品委托生产的可行性进行分析。结果与结论:我国政府和制药企业应抓住日本药事法修订的机遇,创造更有利的条件,力争在境外药品委托生产中有所作为。