中国已纳入优先审评审批程序的药品注册情况分析

目的:梳理我国药品优先审评审批(priority review and approval, PRA)制度的发展历程,汇总自2016年2月“食药监药化管[2016]19号文件”发布以来至2022年12月31日我国纳入优先审评审批程序(priority review and approval procedure, PRAP)的药品注册情况,分析制度发展不同阶段纳入PRAP的药品注册品种特征。方法:基于我国已发布的与药品PRA制度相关的法规,梳理该制度在我国的发展历程。采用统计学方法,以国家药品监督管理局药品审评中心网站“纳入优先审评品种名单”栏目中公布的已纳入PRAP的药品注册申请(以受理号计)作为数据来源,对不同阶段纳入PRAP的药品注册数量与品种、药品注册申请事项、药品治疗领域、儿童药品注册数量、罕见病治疗药品注册数量等进行统计分析。结果:我国药品PRA制度已走过了“制度萌芽、解决积压、深化改革”3个阶段,目前进入“创新发展”阶段。截至2022年12月底,共计有1 400个药品注册申请被纳入PRAP,其中原料药112个、药品1 288个(生物制品275个、化学药品1 004个、中药9个...     

国家食品药品监督管理局药品审评中心启动实施《新药注册特殊审批管理规定》推动工作

为保证公众用药的可获得性,促进我国创新性药物的研发,国家食品药品监督管理局药品审评中心按照《药品注册管理办法》的要求,推动实施《新药注册特殊审批管理规定》,制定了技术审评程序、特殊审批资质申请和审批,信息公开内容和方式等实施细则,近日,发布了“特殊审批品种公示信息”、“特殊审批品种单独立卷资料撰写指导建议”、“特殊审批品种沟通交流工作机制实施细则”、“特殊审批品种沟通交流会会议纪要撰写格式”等信息。     

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。     

我国罕见病药物优先审评审批情况简析

该文介绍了目前我国正式纳入优先审评审批的罕见病药物的研发和注册情况。自2016年施行优先审评政策以来，截至2022年第一季度，药品审评中心共正式纳入了137个罕见病药物的优先审评。从2018年开始，从受理到上市的审评时长开始缩短。纳入优先审评的罕见病药物涉及多种分子类型，治疗领域以肿瘤为主，但适应证属于《第一批罕见病目录》的国产药物依然以仿制为主。总体来看，优先审评政策加速了罕见病药物在中国的申报和上市，建议将更多优先审评药物的适应证纳入罕见病目录，并尽快出台罕见病的相关法规、配套出台相应的研发激励政策，促进国内企业投入罕见病创新药的研发，推动我国的自主研发药物上市，以满足罕见病患者的临床需求。     

2020年江苏省药品注册分析报告

2020年江苏省药品注册批准上市品种以及创新药数量保持全国第1,仿制药质量和疗效一致性评价工作走在全国前列。为保证疫情防控期间药品注册审评审批正常进行,江苏省药品监督管理局积极与国家药品监督管理局食品药品审核查验中心联合开展药品注册核查工作,承接任务占全国的1/4以上。按时完成药品再注册,全省常年生产品种占42.6%。稳步推进“放管服”改革,不断深化审评审批制度改革,持续优化营商环境。     

我国药品优先审评审批制度的现状分析

目的 为推动我国优先审评审批制度形成稳定成熟的监管制度提供参考。方法 通过梳理近5年优先审评审批制度的演变及现状,整理归纳了纳入优先审评审批的不同情形,剖析了优先审评审批的范围调整,总结了优先审评审批的任务及占比。结果 同步申报、按与原研质量和疗效一致性完善后重新申报、专利到期和首仿这四类在每年的优先审评审批中比重大并占据了极大的审评资源。在新药品注册管理办法（2020年）实施后将这四类剔除优先审评审批的范围。结论 国家药品监管部门已将优先审评审批的资源向具有临床价值、市场急需的药物聚集。企业能充分利用优先审评审批制度将具有临床价值的药品快速推向市场。     

信息集锦

深化药品审评审批改革鼓励创新国家局日前发布《关于深化药品审评审批改革进一步鼓励创新的意见》,重点从4个方面深化改革、鼓励创新:一是转变创新药审评理念,为创新药物研发营造良好环境。更加注重创新药的临床价值,鼓励有临床需求、具有较好治疗作用、具有自主知识产权的药物研制;更加注重对创新药研发的科学引导,对创新药物注册申请实施早期介入、分阶段指导等措施,对列入国家科技计划重大专项的创新药物注册申请实行加快审评、全程跟踪、重点指导,试行审评工作联系人制度,及时跟踪审评进展。二是调整仿制药审评策略,合理配置审评资源。确定仿制药优先审评领域,属于临床供应不足、市场竞争不充分、影响公众用药可及性和可负担性的药品,儿童用药、罕见病用药和特殊人群用药,以及其他经评估确认为临床急需的药品,实行优先审评;优化审评流程,在仿     

2014至2016年安徽省药品注册现状分析

目的：总结安徽省2014至2016年药品注册情况,为本省的药品研发、申报、审批提供参考。方法：通过梳理药品企业在2014至2106年新药、仿制药、补充申请和再注册申请的情况,对安徽省药品注册申请进行统计分析与评价。结果：近3年,安徽省药品注册申请数量主要集中在药品再注册和补充申请。新药申请中,97%的药品申报临床试验,化学药品占新药申请的90%。仿制药申报品种均为化学药品。结论：安徽省药品注册申报类别分布合理,在生物制品的新药研发上取得进步,中药研发方面有待加强。     

过量重复用药必有危害

国家食品药品监督管理总局（CFDA）网站于9月15日公开《关于公布第一批过度重复药品品种目录的公告》,首批公示了过度重复药品品种目录其中包括已上市药品品种34个（相同活性成分、相同给药途径药品批准文号数量在500个以上）、过度重复申报注册的药品品种16个（相同活性成分、相同给药途径药品注册申请数量在50个以上）,这从一方面凸显出药物低层次重复开发问题非常普遍,另一方面也反映出百姓很容易在品种名称繁复的药品中重复用药、过度用药。     

国家食品药品监督管理总局发布《2013年度食品药品监管统计年报》

2014年12月23日,国家食品药品监督管理总局通过官网发布《2013年度食品药品监管统计年报》。截至2013年底,全国共有原料药和制剂生产企业4875家。2013年全年批准新药临床148件,新药证书4件,批准文号66件,新药证书及批准文号45件（其中：按照《药品注册管理办法》中规定,中药、天然药物注册分类中的1至5类批准生产0个品种,批准临床0个品种;化学药品注册分类中的1.1至1.5类批准生产2个品种,批准临床82个品种;生物制品注册分类中的1类批准生产1个品种,批准临床4个品种）。2013年全年批准按新药申请程序申报的临床申请120件,新药证书0件,生产6件,新药证书及生产32件;批准仿制药临床申请92件,生产申请176件;批准进口药品临床申请251件,批准上市申请17件;批准药品补充申请2055件,备案530件。全国各省局共批准药品补充申请5385件,备案20153件。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.