The new drug approvals of 1987, 1988, and 1989: trends in drug development

The new drug approvals of 1987, 1988, and 1989 were analyzed to determine whether there are any emerging trends in the US drug development and review processes. Sixty-four new drugs were approved by the FDA during this period, of which 55 met the Center for the Study of Drug Development's definition of a new chemical entity (NEC). For the 55 NCEs, the mean length of the investigational new drug application (IND) phase (IND filing to NDA submission) was 5.2 years, the new drug application (NDA) phase (NDA submission to approval) was 2.9 years, and the total phase (IND filing to NDA approval) was 8.1 years. Nine of the 55 NCEs were classified by the FDA as 1A (important therapeutic gain), 15 were classified as 1B (modest gain), 29 were classified as 1C (little or no gain), and 2 were classified as 1AA (drugs to treat AIDS and AIDS-related conditions); 10 drugs were granted orphan status. The mean NDA phase for 1A drugs was 2.4 years; 1B drugs, 2.9 years; 1C drugs, 3.1 years; 1AA drugs, 1.4 years; and orphan drugs, 2.5 years. Forty-four of the 55 NCEs (80%) were available in foreign markets before US approval was given, with a mean of 6.5 years of prior marketing. These data are consistent with figures for previous years and suggest little change in the rate of new drug development and review in the United States.     

Trends in drug development: the 1985-86 new drug approvals

New drug approvals in 1985 and 1986 were analyzed to determine whether any new trends have emerged in the US drug development process. Fifty-three new drugs (including three biologic products) were approved during this period; 46 met the Center for the Study of Drug Development's definition of a new chemical entity (NCE). More than 70% of the 46 approvals were granted in the fourth quarter, 50% in December alone. Four were FDA classified as 1A (important therapeutic gain), 24 as 1B (modest gain), and 16 as 1C (little or no gain); two biologics were not classified. Nine drugs were given orphan status. For the 37 non-orphan drugs, the duration of the "development phase" (IND filing to NDA submission) was 5.6 years; the "review phase" (NDA submission to approval) was 2.6 years; and the "total time" (IND filing to NDA approval) was 8.2 years. Review phase for the four 1A drugs was 2.4 years; for the 24 1B drugs, 2.6 years; for the 16 1C drugs, 2.8 years; and for the nine orphan drugs, 2.7 years. Of the 46 drugs, 33 (71.7%) were available in foreign markets prior to US approval with a mean of 5.5 years of prior marketing. Although the total of 46 NCE approvals in 1985 and 1986 represents a two-year high, there has been a dramatic shift towards fourth quarter approvals. Lengths of the development and FDA review phases are in keeping with those values for previous years.     

Current Status of Ind/Nda Regulations

Abstract

In order to improve the investigational drug development process, the efficiency of the Agency's drug approval process and the Agency's dealings with applicants while still maintaining the high level of public health protection, the Food and Drug Administration has undertaken the revision of the current regulations and policies for investigational new drug applications and new drug applications. On October 19, 1982, the FDA published in the Federal Register a proposal for revision of the NDA regulations, and on June 9, 1983, the Agency published a proposal for revision of the IND regulations.

The status of the proposed revisions is discussed along with projections of their impact on the American public, pharmaceutical industry, and the FDA. Since the revised regulations will refer to several guidelines, the status and scope of the guidelines are described. In addition, changes that have already been put into effect prior to finalization of the proposed regulations are described.     

FDA在新药注册审批中的研发激励机制研究

美国是世界上新药研发创新能力最强的国家之一,其中FDA在新药注册审批中实施的一系列激励措施对促进美国的新药研发发挥了重要作用。本文首先研究了FDA在临床试验阶段(IND)和新药上市申请阶段(NDA)阶段采取的不同的激励措施,包括IND备案制、探索性IND研究政策、新药审评付费制度、特定药品快速审评机制等;再从新药审批周期、批准上市的新药的数量和质量、研发资金投入强度、风险控制等几个方面对FDA的激励机制进行了评价,最后就FDA在新药注册审批中的研发激励机制得出对我国的启示。     

Regulatory considerations on the role of general pharmacology studies in the development of therapeutic agents

In contrast to the well-defined regulatory requirements for the conduct of animal toxicology studies, FDA regulations and guidelines for nonclinical pharmacodynamic studies are relatively general and do not require that any specific studies be conducted. General pharmacology studies are conducted to identify actions of a new agent in addition to those associated with the primary therapeutic utility. General pharmacology studies aimed at determining drug effects on cardiovascular, central nervous system, gastrointestinal, respiratory and pulmonary, renal, endocrine and metabolism, autonomic nervous system, and drug-receptor functions were among the types of general pharmacology studies included in a sample of recent investigational new drug application (IND) and new drug application (NDA) submissions. Assessment of drug effects on cardiovascular, autonomic nervous system, and drug-receptor interactions were given the greatest individual importance in identifying drug effects relevant to the assessment of a product's safety at the initial IND stage. At the NDA stage, general pharmacology studies find their greatest value in predicting drug-drug interactions, defining mechanisms of action, characterizing the pharmacological correlates of drug-overdose, identifying dose-limiting effects for the chronic toxicity studies, and associating animal toxicity findings with known pharmacotoxic effects. General pharmacology studies provide valuable information to complement animal toxicity studies for evaluating a drug's potential risk to humans.     

FDA“IND安全性报告的安全性评估指导原则”介绍

美国食品药品管理局（FDA）于2015年12月发布了“IND安全性报告的安全性评估指导原则（草案）”,包括前言、背景、安全评估组织结构、安全性评估实践、前瞻性计划等5个部分。该指导原则为按新药临床研究（IND）开发的人用药物和生物制品IND安全性报告的系统方法提供指导,对IND安全性报告的安全性评估从程序、组织架构、具体操作等方面提供了较为详细的描述。我国目前尚无这类指导原则,了解该指导原则对于新药研究者对临床试验严重不良事件和不良反应的评估和判断有所帮助,简介其主要内容。     

FDA advisory committees and the new drug approval process

To determine the impact of FDA advisory committee review on the approval time of new drug applications (NDAs) approved during the five-year period 1983 through 1987, we compared NDA phase lengths of reviewed new chemical entities (NCEs) with those that were not reviewed and examined the elapsed time from final committee recommendation for approval to NDA approval. Of the 95 drugs approved during the study period that met the Center for the Study of Drug Development's definition of an NCE, 40 (42%) were submitted for review--mean NDA phase length was 36.9 months versus 32.4 months for unreviewed drugs. Reviewed drugs in the neuropharmacologic division had a longer NDA phase, while those in the metabolic/endocrine and oncology/radiopharmaceutical divisions had shorter NDA phases, than unreviewed drugs in those divisions. For NCEs grouped by therapeutic rating, reviewed drugs in each category had longer NDA phases than unreviewed drugs; the difference was largest for 1-B rated drugs. The elapsed time from committee recommendation for approval to NDA approval as a percent of the total NDA phase was greatest for drugs submitted by the metabolic/endocrine division (83.0% of NDA phase) and for drugs rated 1-A (63.2%). Results indicate that advisory committee review is associated with a small overall delay in NDA approval when compared with the regulatory fate of drugs not submitted for review.     

Regulation of the compounding of positron emission tomography drugs.

Controversial aspects of the regulatory framework for compounding drug products used in positron emission tomography (PET) are discussed. The Food and Drug Administration Modernization Act of 1997 (FDAMA), which amends the Federal Food, Drug, and Cosmetic Act (FFDCA), required that FDA establish approval (new drug application [NDA] and abbreviated new drug application [ANDA]) procedures and current good manufacturing practice (CGMP) requirements for PET drugs; this seems to conflict with differentiation between manufacturing and compounding in FFDCA. Compounding by pharmacists is implied in the FDAMA section on PET, but specific mention of "pharmacist" needs to be included. Congress apparently did not intend for compounded PET drugs to be regulated differently from other drugs. Although FDA has waived NDA and ANDA fees for three PET radiopharmaceuticals, revision of FDAMA to exempt PET drug products from regulations placed on manufacturing is needed. Without relief from the current regulations, many academic PET centers are likely to close; this would violate FDAMA's stated intent of making PET available to patients at reasonable cost. Also problematic is FDAMA's prohibition of compounding "regularly or in inordinate amounts" a product that is commercially available; the common PET radiopharmaceutical fludeoxyglucose F 18 injection, for example, is commercially available. A sensible alternative to NDA or ANDA and CGMP requirements would be the enforcement of USP standards for PET drugs by state boards of pharmacy.     

Investigational drug tracking: phases I-III and NDA submissions--Part II

The author catalogs over 800 investigational drugs/biologicals currently in Phase I, II or III clinical trials or drugs/biologicals submitted to the FDA as new drug applications. Part I of this article appeared in the September issue of Hospital Pharmacy. The list assists in predicting when new drugs will be marketed. The entries include generic/chemical name, investigational drug number, synonyms, trade names, manufacturers, clinical trial status, predicted approval year, indications or drug class, whether the drug has been developed through biotechnology, and references. Entries were gleaned from medical journals, stock market analysis publications, and the Pharmaceutical Manufacturers Association's Medicines in Development Series. The list is alphabetized by the generic/chemical name or investigational drug number and cross-indexed by the trade name and synonyms. The list reflects those drugs which were not FDA approved as of April 15, 1994. Part I concludes with the remaining alphabetical listing by generic/chemical name or investigational drug number.     

Investigational drug tracking: Phases I-III and NDA submissions--Part I

The author catalogs over 800 investigational drugs/biologicals currently in Phase I, II or III clinical trials or drugs/biologicals submitted to the FDA as new drug applications. The list assists in predicting when new drugs will be marketed. The entries include generic/chemical name, investigational drug number, synonyms, trade names, manufacturers, clinical trial status, predicted approval year, indications or drug class, whether the drug has been developed through biotechnology, and references. Entries were gleaned from medical journals, stock market analysis publications, and the Pharmaceutical Manufacturers Association's Medicines in Development Series. The list is alphabetized by the generic/chemical name or investigational drug number and cross-indexed by the trade name and synonyms. The list reflects those drugs which were not FDA approved as of April 15, 1994. Part I includes the trade name and synonym cross-indexes and the beginning of the main alphabetical listing by generic/chemical name or investigational drug number.     

Regulatory aspects of investigational new drugs.

Federal regulations governing the introduction of new drugs in the United States are reviewed. The discussion includes the legislative background, what constitutes a "new drug," drug development, investigational new drugs, new drug applications, pharmacist involvement in clinical trials, the approval process and postmarketing surveillance.     

中药基原鉴定的科学内涵

中药是中国人千百年使用的药品,中药基原鉴定是对中药临床应用的传承性鉴定.药品基原和药材基原具有本质区别.不同版本<中药鉴定学>教材中的中药米源鉴定应该修正为基原鉴定,对其概念、方法和内容应定位在药品上.探讨了中药基原鉴定的定义与范围,分别论述了中药材、中药饮片以及中药复方基原鉴定的内容、方法与基本原理.认为中药的基原具...     

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。     

FDA对研究者在新药和医疗器械临床研究期间安全性报告的要求

上市前药物和医疗器械安全性信息主要来自临床试验,而观察受试者对试验药物和器械反应的是研究者,因此,研究者的不良事件报告至关重要。为帮助研究者确认临床研究期间非预期的安全性信息并遵守安全性报告要求,美国食品药品管理局（FDA）于2021年9月发布了“研究者职责-研究性药物和器械的安全性报告”指导原则（草案）,详细说明了对研究者在IND和IDE研究中向申请人和伦理委员会报告的要求。我国目前还没有类似的指导原则,详细介绍FDA的该指导原则,以期对我国新药和新医疗器械研究者在临床研究期间识别非预期的安全信息并按要求及时报告有帮助并对该方面的监管有所启示。     

新药临床和审批过程中FDA与药品申办者的会议沟通机制

目的对FDA在新药临床和审批过程中与药品申办者的会议沟通机制进行介绍,为我国提供相应的参考。方法查阅FDA的相关法律法规以及一系列的指南文件。结果与结论该会议机制以其法制化、规范化、透明化的特点,确保了新药审评的效率及质量,值得我国借鉴。     

Timing of carcinogenicity studies and predictability of genotoxicity for tumorigenicity in anti-HIV drug development

The timing of carcinogenicity studies in parallel with the clinical development of anti-human immunodeficiency virus (HIV) drugs has been flexible for most cases in the past. This includes postponement of the initiation of the studies and submission of final audited reports to the US Food and Drug Administration (FDA) for a new drug application (NDA) approval. We address this regulatory practice for anti-HIV drugs for which, in the past, there had been no effective treatment. We also examine the correlation of genotoxicity data with carcinogenicity data for the varied subclasses of anti-HIV drugs. We suggest that this regulatory policy regarding the timing of carcinogenicity testing does not compromise the safety standards of FDA's drug evaluation and the approval process. The policy does facilitate availability of these agents to meet the medical needs of the target population. Our analysis on the profile of carcinogenicity findings of anti-HIV drugs shows trends of class effects. Additionally, both carcinogenicity and genotoxicity data show significant correlations, which provide useful insights into issues involving these 2 important areas of toxicological investigations.     

Managing oncology research protocols

Oncology research protocol management is important for the effective execution of clinical trials with oncology patients. Clinical trials explore investigational drug safety, efficacy, and effectiveness. Investigational drugs have not received approval for widespread use and marketing by the Food and Drug Administration (FDA). The National Cancer Institute (NCI) has several branches concerned with investigational drug procurement, distribution, and recordkeeping of investigational cancer chemotherapy agents. Before an investigational drug is approved by the FDA for marketing in the United States, it must undergo several phases of pre-clinical and clinical trials. The Institutional Review Board (IRB) must review and approve clinical trials to ensure that studies meet legal, ethical, and scientific standards. The principal investigator (PI) takes responsibility for the clinical trial. Informed consent must be obtained from subjects before they may participate in clinical trials. The informed consent form is reviewed by the IRB. The investigational drug storage, accountability, ordering, distribution, and drug information dissemination process is improved with a pharmacy-coordinated investigational drug service.     

Therapeutic ratings and end-of-phase II conferences: initiatives to accelerate the availability of important new drugs

To facilitate the availability of important new therapeutic agents, the Food and Drug Administration (FDA) in the mid-1970s began assigning therapeutic ratings to investigational new drugs and holding end-of-phase II conferences with drug sponsors. To determine whether these initiatives are associated with faster approvals, we examined new drug application (NDA) review times of new chemical entities (NCEs) approved during the 12-year period 1978 through 1989. Mean NDA review time for 1A drugs (22.5 months) was 22% shorter than that for 1B drugs (28.7 months), which in turn was 25% shorter than that for 1C drugs (38.4 months). For drugs approved during the recent 4-year period 1986 through 1989, however, the gap between 1A and 1C review times has narrowed considerably from 19 to 9 months. When drugs were grouped by FDA reviewing division, 1A drugs had the shortest mean review time in each division except the Cardio-Renal Division; in that division, 1B drugs had the shortest mean review time. Mean NDA review time for drugs that had end-of-phase II conferences (28.6 months) was 15% shorter than that for drugs without such conferences (33.7 months). These results suggest that NCEs that receive 1A or 1B ratings and are the subject of end-of-phase II conferences benefit by having shorter review times.     

Dendrimers as drugs: discovery and preclinical and clinical development of dendrimer-based microbicides for HIV and STI prevention

Starpharma focuses on the use of dendrimers as drugs in their own right, in contrast to dendrimers as drug delivery vehicles or diagnostics. This contextual review describes how dendrimers offer a unique platform for exploring chemical diversity on the nanoscale and how the production of dendrimer libraries covering a diverse array of macromolecular structures can be used in drug discovery and development. Using Starpharma's work on the prevention of HIV and sexually transmitted infections (STIs) through the development of microbicide candidates as an example, the process from which SPL7013 emerged as a development candidate is described. Following a range of preclinical studies, Starpharma submitted an investigational new drug application (IND) for SPL7013 gel (VivaGel) to the United States Food and Drug Administration (FDA) in June 2003, the first such submission for a dendrimer-based drug. The first clinical trial under this IND was completed in 2004.     

The drug approval process and the information it provides

By law, the commissioner of the Food and Drug Administration (FDA) is responsible for determining whether a new drug is safe and efficacious before it is approved for marketing in the U.S. and for monitoring its use after approval. This paper provides a brief overview of the approval process, in terms of responsibilities of the sponsor in submitting an application for review to the FDA and FDA's responsibilities and organizational procedures for reviewing and approving those applications. A brief history on the legislation regarding the FDA's responsibility in the drug approval area is discussed along with recent regulations, legislation, and FDA initiatives aimed at improving the drug approval process. Specific information that can be released to the public upon request is also discussed. This paper is limited to the regulation of drugs; somewhat different regulations govern the review and regulation of biological products and abbreviated new drug applications.