超越MABEL的FIH剂量选择:优化第一阶段临床试验 开始剂量,同时保护患者安全
Mineo Matsumoto1, J Ryan Polli2, Suresh Swaminathan3
1Review Division, Pharmaceuticals and Medical Devices Agency (PMDA), Chiyoda- ku, Tokyo, Japan.
Regulatory toxicology and pharmacology : RTP
|February 1, 2026
概括
选择免疫调节剂的最佳首次人体 (FIH) 剂量是具有挑战性的. 这种精细的框架通过整合药理动力学/药理动力学建模和案例研究来提高安全性和疗效,从而提高剂量选择.
科学领域:
- 药理学 药理学是指药理学的学科.
- 免疫学 免疫学 免疫学
- 药物开发 药物开发
背景情况:
- 选择免疫调节剂的首次人体 (FIH) 剂量面临着保守方法的挑战,例如最小预期生物效应水平 (MABEL).
- MABEL优先考虑安全性,但可能导致治疗次的初始剂量,限制患者的益处,并延长剂量升级.
- 现有的方法可能无法完全捕捉免疫调节机制的复杂性.
研究的目的:
- 为完善FIH免疫调节剂剂量选择的综合性框架提出改进.
- 通过行业案例研究来说明这些策略的实际应用.
- 讨论将新兴药物开发概念纳入FIH剂量选择中的问题.
主要方法:
- 完善专家工作组对FIH剂量选择的整合框架.
- 包括修订的决策树和行业案例研究.
- 应用药理动力学/药理动力学 (PK/PD) 建模来评估剂量反应关系.
主要成果:
- 加强的框架允许平衡地考虑免疫调节器的作用机制和风险-益处概况.
- 行业案例研究证明了拟议策略的实际实用性和有效性.
- 该框架支持在早期临床试验中做出更明智的决策.
结论:
- 精细的综合性方法提供了一个强大的战略,以优化FIH免疫调节剂的初始剂量.
- 新兴的概念,如模型信息化药物开发 (MIDD) 和定量系统药理学 (QSP),可以进一步加强FIH剂量选择.
- 最终目标是在早期临床开发中提高患者安全性和治疗疗效之间的平衡.
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