对生物酶替代疗法的剂量选择适用于代谢的先天性错误
Yuen Yi Hon1, Jie Wang2, Henrietta Abodakpi2
1Division of Rare Diseases and Medical Genetics, Office of Rare Diseases, Pediatrics, Urologic and Reproductive Medicine, Office of New Drugs (OND), Center of Drug Evaluation and Research (CDER), Food and Drug Administration (FDA), Silver Spring, Maryland, USA.
Clinical and translational science
|September 22, 2023
概括
在先天性代谢错误 (IEM) 中,酶替代疗法 (ERT) 的有效剂量发现需要早期的体外和动物研究,然后进行强大的临床试验. 关键策略包括定义特定的终点和利用药理动力学生物标志物以获得最佳剂量.
科学领域:
- 生物化学 生物化学
- 药理学 药理学是指药理学的学科.
- 遗传学 是一个遗传学.
背景情况:
- 酶替代疗法 (ERT) 对于治疗代谢天生的错误 (IEM) 是至关重要的.
- 开发用于IEM的新生物产品需要有效的剂量确定策略.
- 第一类ERT在剂量探索方面提出了独特的挑战.
研究的目的:
- 总结来自11个已批准的第一类ERT的剂量确定策略.
- 为IEM未来的生物产品开发提供优化剂量探索的见解.
- 为新型IEM疗法提供有效剂量选择的信息.
主要方法:
- 对11个已批准的第一类ERT中使用的剂量确定方法的审查.
- 从体外研究,动物模型和临床试验中对剂量探索的分析.
- 确定成功选择剂量的关键因素.
主要成果:
- 建议在体外和动物模型中进行早期剂量探索.
- 在早期临床研究中,包括儿科患者群体,找到适当的剂量是至关重要的.
- 疾病特异性终点,药理动力学生物标志物和适当的研究持续时间对于剂量选择至关重要.
结论:
- 优化ERT剂量,考虑患者因素和免疫耐受性策略可能是IEM有效性的必要条件.
- 药理动力学生物标志物的早期开发和利用可以促进临床发展.
- 在IEM治疗中,从临床前研究到临床研究的多阶段剂量确定方法至关重要.
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