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对于QT评估的暴露建议是否得到满足?
Tsubasa Wakabayashi1,2, Mamoru Narukawa1
1Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo, Japan.
Journal of clinical pharmacology
|January 9, 2025
概括
许多药物在早期研究中未能达到高临床暴露 (HCE),这可能会延迟开发. 优化早期研究设计以实现双重治疗暴露对于满足监管要求和避免 QT 途径研究失败至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床发展 临床发展
- 监管科学 监管科学
背景情况:
- 监管机构建议高临床暴露 (HCE) 进行彻底的QT (TQT) 研究.
- 问答5.1路径建议作为一种替代方法,对度校正的QT (C-QTc) 分析进行双倍的HCE边际.
研究的目的:
- 评估当前监管建议对药物暴露边际的影响.
- 评估2015年以来在日本批准的新活性物质的TQT研究和C-QTc分析中HCE的实现情况.
主要方法:
- 对日本批准的166种新活性物质的暴露率分析.
- 在传统的TQT研究和C-QTc分析中检查HCE成就.
- 在单次上升剂量 (SAD) 和多次上升剂量 (MAD) 研究中对HCE目标进行Cmax的评估.
主要成果:
- 28.3%的TQT研究和50.0%的C-QTc分析不符合HCE要求.
- 51.1%的SAD研究和47.7%的MAD研究未能达到HCE.
- 很大一部分物质在临床早期没有达到建议的暴露水平.
结论:
- 目前的早期临床研究设计往往无法确保足够的药物暴露.
- 需要一个剂量上升的策略,以双重治疗暴露为目标,以满足HCE的建议.
- 优化早期研究设计可以防止TQT研究豁免失败和开发延迟.
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