基于风险控制理念的口服仿制药一致性评价

安全性、有效性和质量可控性对仿制药的质量至关重要。国内目前采用溶出度实验评价仿制药和原研药的质量一致性。这种仅以"有效"一致性作为标准评价仿制药优劣的方法,明显忽略了对药品内在质量和安全性的评价。本研究基于风险控制的新理念,将仿制药与原研药的有效性、安全性与质量可控性纳入到一致性评价体系,结合仿制药具体品种的剂型、剂量、给药途径、工艺等因素,设定贯穿于药品整个生命周期的高风险因素,然后建立针对性的评估模型,排查仿制药的高危安全性隐患;开展与原研产品杂质谱的对比研究,从物质基础层面揭示仿制药的安全性,并最终改进和提升质量标准;结合前期溶出度工作基础,全面评估仿制品与参比制剂的质量一致性。本项目的实施,为全面评估仿制药的质量一致性,保障人民群众安全合理用药有着十分重要的意义。     

从质量管理角度看药品的一致性评价

目的：探讨实施药品质量一致性评价工作的方法,使一致性评价真正发挥提高仿制药质量水平的作用。方法：基于质量管理的核心理念,从仿制药的原辅料、处方、工艺流程、最终产品和生产线5个方面入手,实现仿制药与原研药过程控制的一致性。结果：我国要全面提高仿制药的质量,开展仿制药与原研药的一致性评价,这对于保障药品安全、有效、质量可控有着十分重要的意义。结论：药品的安全性和有效性一直是公众关注的热点问题。仅通过溶出度试验来判断仿制药的安全有效存在一定的局限性,应当将GMP理念引入一致性评价工作中,全方位地保证仿制药与原研药具有相同的安全性和有效性。     

开展仿制药质量一致性评价的探讨

2012年1月20日,国务院下发的《关于印发国家药品安全“十二五”规划的通知》中要求开展仿制药一致性评价工作。本文概述我国仿制药质量存在的问题及其原因,提出开展一致性评价重点在于多条溶出曲线都要与原研药一致,旨在为进一步开展仿制药一致性评价工作提供建议。     

2017药品一致性评价,为健康护航

2017年4月5日,国家食药监总局公布《仿制药质量和疗效一致性评价品种分类指导意见》,包括原研进口上市品种、原研企业在中国境内生产上市的品种、进口仿制品种、国内仿制品种、改规格、改剂型、改盐基的仿制品种以及国内特有品种等仿制药的一致性评价方法,给出明确意见。回顾药品一致性评价的实施过程,从2012年国家为落实国家药品安...     

仿制药替代潜在最大费用节省研究

目的在仿制药替代背景下,比较原研药和仿制药的价格和采购量,测算仿制药替代的潜在最大费用节省,推动仿制药供应与使用。方法基于陕西省药品招标采购数据,选取2017年12月第一批通过仿制药质量和疗效一致性评价的17个品种(16个品规)药品,对其2017年至2018年的价格、采购量进行分析;采用成本分析法、推测预算法,对采购平台上该通用名、剂型的药品替换为通过仿制药质量和疗效一致性评价单价最低的仿制药,测算年均仿制药替代的潜在最大费用节省。结果价格由高到低依次为原研药、未通过一致性评价的仿制药、通过一致性评价的仿制药;采购量方面,5个品规药品的原研药采购量占比较高,11个品规药品的仿制药采购量占比较高,1个品规药品未发生仿制药替代;对16个品规药品进行仿制药替代后,测算出潜在最大费用节省为3243.63万元。结论仿制药替代可显著节省药品费用,我国的仿制药市场提升空间较大,后续应加快推进仿制药一致性评价和临床使用。     

我国仿制药与原研药的一致性评价

2012年1月,国务院正式印发《国家药品安全"十二五"规划》(以下简称《规划》)《,规划》指出"十二五"期间要大幅提高药品标准和药品质量,包括仿制药的质量。为此,国家食品药品监督管理局(SFDA)根据《规划》的要求,拟对2007年修订的《药品注册管理办法》实施前批准的仿制药,分期、分批与原研药进行质量一致性评价。这是一场由国家部署的逐步提高仿制药质量和坚决淘汰达不到国际标准品种的重大活动,它正在成为制药企业当今直到今后数年的要务之一。上海医药集团、华北制药、     

海南省仿制药一致性评价品种分析与工作进展

仿制药一致性评价是指对已经批准上市的仿制药,按与原研药品质量和疗效一致的原则,分期分批进行的质量评价。为促进海南省仿制药一致性评价工作的顺利开展,通过检索海南省药品注册文号信息系统（琼兰档案管理系统）,梳理了海南省已获批药品中涉及须通过仿制药一致性评价的品种目录以及相关品种在类别、数量、构成等方面的数据,并调研企业面临的困难及工作进展,为海南省涉及一致性评价的相关企业与部门提供参考,为海南省制定生物医药产业创新发展政策提供了数据支持。     

仿制药一致性评价的背景、实施及结局

我国是仿制药大国,开展仿制药质量和疗效一致性评价是国际惯例,也是我国经济、技术水平进步的必然结果。仿制药一致性评价适应国家新政,选择合适终点指标进行研究,目的是提高社会认可、实现仿制药与原研药的真正互换。仿制药一致性评价从简单的体外溶出度试验到系统的药学评价再到生物等效性评价,评价方法正在逐步完善,同时明确化学仿制药参比制剂遴选原则以减少仿制过程中的质量差异。仿制药一致性评价不仅能够提升我国制药行业的整体发展水平,促进医药产业升级和结构调整,同时可以节约医疗费用,保证患者用药安全。     

日本药品品质再评价工程对我国仿制药一致性评价的借鉴

目的 为改进和完善我国仿制药一致性评价工作提供参考。方法 对日本药品品质再评价工程与我国仿制药一致性评价进行比较。结果与结论 加强我国仿制药一致性评价工作,应在进一步完善法律法规体系的基础上,提升相关人员的水平,建立有效的激励机制,制订我国药品品种的橙皮书。     

酒石酸美托洛尔片仿制与原研的溶出度比较

目的：对酒石酸美托洛尔片国产仿制药与原研药进行体外溶出度比较,为质量一致性评价提供依据。方法参照中国药典2010版二部酒石酸美托洛尔片的质量标准,选取50mg规格样品,采用4种不同的溶出介质对国内8家企业生产的仿制药和原研药进行体外溶出行为考察,并采用差异因子f1法、相似因子f2法和直接比较法来评价仿制药与原研药溶出行为的一致性。结果8家仿制药溶出行为参差不齐,按直接比较法只有1家仿制药在四种溶出介质中的溶出曲线均与原研药一致,只在两种或一种溶出介质中的溶出曲线与原研药一致的情况较多。结论国内企业生产的酒石酸美托洛尔片仿制药与原研药存在体外溶出行为不一致性,处方、制剂工艺、辅料的选用方面需要进一步研究,以达到仿制药与原研药体外溶出行为一致性和质量一致性。同时,要结合生物等效性试验,对该品种的国产仿制药和原研药的一致性作出综合的评价。     

Amsacrine evaluation

Amsacrine, an antineoplastic agent currently undergoing clinical trials in the U.S., has been shown to be active against adult and pediatric leukemias, Hodgkin's disease, and non-Hodgkin's lymphomas. Amsacrine is highly bound to plasma proteins and is eliminated primarily via hepatic metabolism. Severe hepatic dysfunction will result in a decreased excretion rate of the drug. The primary side effect is a dose-related suppression of bone marrow function. Other reported toxic effects include mucositis, nausea, vomiting, cardiotoxicity, liver dysfunction, and alopecia. Despite these negative effects, amsacrine appears to have a role in the combination therapy of acute leukemias.     

Perioperative dental evaluation

Typically, a patient's intraoral condition is not a chief perioperative concern. The need for proper dental care is often unmet prior to a surgical procedure. Consequently, patients presenting for surgery may possess untreated decayed teeth and/or periodontal disease. These individuals may be harboring a quiescent and potent odontogenic infection. In the perioperative period, the deleterious effects of such an infection can not only compromise surgical outcome, but also magnify treatment and expenses. This article will elaborate on the connection between oral health and systemic disease, and discuss the barriers that exist with improving oral health. It will review pertinent dental nomenclature and anatomy, as well as emphasize the practice and value of a preoperative dental evaluation. Various compromised intraoral conditions are presented among a range of patient populations. The importance of treating an acute odontogenic infection before surgery is also discussed. Healthcare providers who recognize significant perioperative dental conditions can implement effective and preventive actions that can contain costs and achieve optimal patient care.     

Formulation and evaluation of docetaxel nanosuspensions: In-vitro evaluation and cytotoxicity

Objective

The aim of the present study was to formulate the anticancer drug; docetaxel (DOX) as nanoparticles to enhance its biological activity.

Therapeutic evaluation of omeprazole

The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage and administration of omeprazole are reviewed. Omeprazole, a substituted benzimidazole, has a unique site and mechanism of action because it inhibits the proton pump--i.e., hydrogen, potassium adenosine triphosphatase (H+,K+-ATPase)--and consequently blocks the final common step in the gastric acid secretory pathway. Omeprazole inhibits basal and histamine-, gastrin- and pentagastrin-stimulated gastric hydrochloric acid secretion. It produces a dose-dependent reduction in gastric acidity, gastric acid output, and gastric juice volume and has variable effects on pepsin secretion. Omeprazole has no documented effect on esophageal motility or lower esophageal sphincter pressure. Omeprazole is variably absorbed from the gastrointestinal tract, and food appears to decrease the rate, but not the extent, of drug absorption. The drug is approximately 95% bound to plasma proteins and is metabolized to inactive components that are enterohepatically or renally eliminated. Omeprazole is more effective (in most studies) than H2-receptor antagonists in treating duodenal ulcer, at least as effective in treating benign gastric ulcer, and more effective in treating reflux esophagitis. Omeprazole has been used successfully in patients with Zollinger-Ellison syndrome refractory to treatment with H2-receptor antagonists. Gastrointestinal complaints (nausea and diarrhea) are the most commonly reported adverse effects associated with omeprazole therapy. The most frequently reported laboratory abnormality occurring with omeprazole use is elevation of serum aspartate aminotransferase and alanine aminotransferase concentrations. Omeprazole will serve a valuable role in the management of gastrointestinal tract ulcers and hypersecretory conditions.     

Clinical evaluation of fluconazole

Clinical evaluation of fluconazole was performed on 12 cases of mycotic infections (7 cases of Candida esophagitis; one each case of cryptococcal meningitis with AIDS, Candida tropicalis fungemia and disseminated cryptococcosis in kidney transplant patient; 2 cases of Candida pneumonia). Satisfactory responses were obtained except 1 case of Candida pneumonia in which clinical efficacy could not be evaluated. Hiccup was noted in 1 case during the fluconazole treatment. No other adverse reaction was observed. When 150 mg and 200 mg of fluconazole were administered orally to a patient with hemodialysis (HD) after HD on separate occasions, concentrations of the drug in serum at 20 hours after ingestion were 5.9 micrograms/ml and 11.6 micrograms/ml, respectively, and in cerebrospinal fluid (CSF) were 3.5 micrograms/ml and 9.2 micrograms/ml, respectively. Two clinical benefits were obtained in our studies. First, it was possible to treat the AIDS-patient as an outpatient with Candida esophagitis using orally administered fluconazole. Second, it was possible to treat the case of cryptococcal meningitis, in which relapse often occurs, to complete the therapy when the cryptococcal antigen in serum and CSF diminished to an undetectable level and to maintain the therapy preventing relapse without severe adverse effects. Ongoing and future clinical trials will define the specific roles of fluconazole more clearly in the treatment of systemic mycosis.