关于在欧盟确定狭窄治疗指数药物的生物等价性的双向建议
Paulo Paixao1,2, Alfredo Garcia Arieta2,3, Nuno Silva1
1Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-004 Lisboa, Portugal.
Pharmaceutics
|May 25, 2024
概括
一种新的混合方法简化了对狭窄治疗指数 (NTI) 药物的生物等价性 (BE) 的证明. 这种方法可以减少临床试验的样本大小,而不会增加假阳性结果的风险,有利于药物开发.
科学领域:
- 制药科学 制药科学
- 药品监管事务 药品监管事务
- 生物统计学 生物统计学
背景情况:
- 目前欧盟对狭窄治疗指数 (NTI) 药物的生物等价性 (BE) 标准 (90.00-111.11%的几何平均比值置信区间) 提出了挑战.
- 这些标准增加了BE证明的难度,并需要更大的临床试验样本大小,特别是对于具有中高可变性的药物.
研究的目的:
- 评估并提出一种改进的NTI药物的生物等价性评估策略.
- 解决现有的BE方法的局限性,包括与缩放平均BE方法相关的I型错误率的增加.
主要方法:
- 进行模拟研究以评估不同的生物等价性评估策略.
- 拟议的方法涉及混合方法,预先定义固定的接受范围或修改的缩放平均值BE方法.
- 修改的缩放平均值 BE 方法使用针对特定研究设计 (2 × 3 × 3 部分复制) 的调整的一面显著性水平 (α = 0.042) 并省略了较低的接受边界.
主要成果:
- 缩放平均BE方法虽然旨在减少样本大小,但显示出I型错误 (T1E) 的风险增加,特别是在缩放和非缩放方法之间的过渡点附近.
- 通过预先定义评估途径并调整显著性水平,拟议的混合方法有效地控制了T1E.
- 这种混合策略允许与固定方法相比减少样本大小,同时保持统计的严谨性.
结论:
- 混合生物等价性评估策略为NTI药物提供了可行的解决方案.
- 这种方法平衡了减少样本大小的需要和控制I型错误率的关键要求.
- 实施这种混合方法可以简化NTI药物开发的监管过程.
相关概念视频
Bioequivalence: Overview
1.0K
Pharmaceutical equivalents, by definition, are drug products with the same active ingredient in the same quantities, encapsulated in identical dosage forms, and intended for the same administration routes. These pharmaceutical equivalents are deemed bioequivalent if the bioavailability of the active entity in the drug preparations is similar. Moreover, pharmaceutical equivalents demonstrating bioequivalence are also regarded as therapeutically equivalent. This means that when used as directed,...
1.0K
Therapeutic Index
4.2K
The therapeutic index of a drug is a key parameter in pharmacology that quantifies the relative safety of a drug by calculating the ratio between the dose that causes toxicity in half the population (50%) to the dose that proves to be effective for half the population (50%). It provides a spectrum of doses for a particular drug ranging from effective to potentially toxic. To illustrate, consider an anticoagulant agent like warfarin. It possesses a narrow window within its therapeutic index to...
4.2K
Bioavailability: Overview
2.8K
Bioavailability refers to the proportion of an unaltered drug that, after administration, enters the systemic circulation and can be distributed to the desired action site. Factors such as gastrointestinal (GI) absorption and liver biotransformation influence the bioavailability of a drug when it is administered orally. When a drug is administered intravenously, it enters the systemic circulation directly; by definition, its bioavailability is assumed to be 100%. The bioavailability of an...
2.8K
Drug Biotransformation: Overview
2.4K
Pharmaceutical substances known as xenobiotics are predominantly lipophilic and nonionized. This enables them to permeate lipid bilayers, such as cell membranes, and interact with intracellular target receptors. Lipophilic drugs have an advantage in crossing biological barriers and reaching their intended sites of action. However, lipophilic drugs often have a restricted capacity for renal expulsion or elimination from the body. When these drugs enter the kidneys and undergo glomerular...
2.4K
Drug Nomenclature
1.7K
During the development of a new pharmaceutical, the manufacturer initially assigns a code name to the drug. Once approved, the drug receives a United States Adopted Name (USAN)—a generic, nonproprietary designation. Upon being listed in the United States Pharmacopeia, this nonproprietary name becomes the drug's official name. Additionally, the manufacturer assigns a proprietary name or trademark, which serves as the brand name under which the drug is marketed. It is worth noting that...
1.7K
Clinical Trials: Overview
2.9K
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
2.9K


