The FDA has published an updated Guidance Agenda – new and revised draft guidances CDER is planning to publish during calendar year 2012. Guidances of particular interest to nonclinical pharmaceutical toxicologists may include:
• Endocrine Disruption Potential of Drugs: Non Clinical Evaluation
• Integrated Summary of Safety
• Food-Effect Bioavailability and Fed Bioequivalence Studies—Bioavailability and Bioequivalence Studies for Orally Administered Drug Products Submitted in New Drug Applications General Consideration
• Providing Regulatory Submissions in Electronic Format – General Considerations
• Providing Regulatory Submissions in Electronic Format – Study Data
• Providing Regulatory Submissions in Electronic Format – Standardized Study Data
Source: U.S. Food and Drug Administration
The objective of a recent survey by Cambridge Health Associates was to identify trends in safety biomarkers and their utilization in drug development. Regardless of company size, recurrent themes for assessing drug safety in early preclinical development were noted.
- Greater knowledge of safety biomarkers improved mechanistic understanding and helped to determine the relevance of nonclinical findings for clinical risk assessment.
- Preclinical inclusion of systems or pathway modeling was deemed important for the selection and interpretation of biomarkers of organ toxicity.
- Physical chemical prediction software or other forms of genetic or developmental and reproductive toxicity (DART) prediction software (e.g., DEREK, M-CASE, Leadscope) were being incorporated into early preclinical development by most companies. All 3 software companies have Cooperative Research and Development Agreements (CRADA) with the FDA.
- For cellular parameter screens, most companies are using image-based multi-parametric approaches of cellular analysis and cytotoxicity at the single-cell and subcellular level (via High Content Analysis [HCA])
- Off-target screening (usually a CEREP panel) was performed by most companies early in preclinical development.
As might be expected to “slow the burn,” smaller companies ran fewer preclinical screens to predict drug safety and performed these screens later in the drug development process. Given that larger companies expect to have this information sooner than later, companies wanting to partner and/or be acquired may consider including more screens for drug safety earlier in their preclinical development programs.
Source: DSEC Drug Safety Executive Blog
An innovative Procedure Cage invented by Dr. Ryoichi Nagata, SNBL USA chairman, is at the center of a comprehensive program designed to significantly raise standards for non-human primate (NHP) care and thereby improve the quality of preclinical data collected.
The Procedure Cage attaches directly to an animal’s home cage allowing animals to enter on their own. This innovation significantly reduces animal stress by eliminating the need for capture-by-hand or use of other restraints, creating a calmer handling environment. In addition, the use of this separate cage for study-related procedures allows the animal to always view their home cage as a “safe place.”
The Procedure Cage is currently being tested at six beta test sites including key pharmaceutical industry, government, and university locations. The results will be presented at the American Association for Laboratory Animal Science (AALAS) National Meeting in Minneapolis on November 4-8, 2012. The Procedure Cage is available exclusively through SNBL USA.
Procedure Cage Demo: Click here
Source: SNBL USA newsletter (18 July 2012)
Pharmacogenomics can play an important role in identifying responders and non-responders to medications, avoiding adverse events, and optimizing drug dose. Drug labels may contain information on genomic biomarkers and can describe:
- Drug exposure and clinical response variability
- Risk for adverse events
- Genotype-specific dosing
- Mechanisms of drug action
- Polymorphic drug target and disposition genes
This resource table lists FDA-approved drugs with pharmacogenomic information / biomarkers in their labels.
Ever wanted to know the ins and outs of almost every drug approved by the Food and Drug Administration since 1939?
By using the Drugs@FDA database, you can search for information about FDA-approved brand name and generic drugs and therapeutic biological products. The database includes most of the drug products approved since 1939 and has drug labels, patient information, approval letters, and other information for most drug products approved since 1998.
Many drug hypersensitivity reactions are HLA-linked, meaning that they will occur much more often or even exclusively in individuals who have certain variants of the HLA gene. A new study elucidates the specific mechanism leading to HLA gene-linked hypersensitivity to the drug abacavir. These findings are applicable to other drugs and related hypersensitivity reactions.
The findings are discussed in the paper “Drug hypersensitivity caused by alteration of the MHC-presented self-peptide repertoire,” published last week in the scientific journal Proceedings of the National Academy of Sciences.
An interview with the authors is published in the Source cited below.
Source: Clinical Toxicology
Transgenic and genetically modified animal models are increasingly being used in the study of disease and for the safety assessment of new compounds. Use of these models enhances understanding of the role that specific genes play in biological pathways. The primary uses of transgenic mouse models in toxicology have mainly been to screen for genotoxicity and carcinogenicity and to understand the mechanisms of toxicity. These mouse models can reliably predict the carcinogenic potential of compounds and significantly reduce the number of false positives. When applied as single assays, however, transgenic models are unable to identify all known human carcinogens. Use of a short-term transgenic mouse assay in combination with a two-year rat chronic study could eliminate the occurrence of false negatives and increase the overall accuracy of detecting carcinogens and non-carcinogens. Additional bonuses for use of transgenic assays include reduced duration, conservative use of animals, and decreased cost relative to a traditional two-year rodent chronic toxicity study.
Source: Life Science Leader
The increased requirement for combined chronic toxicity and fertility assessment of biologics has led to greater use of sexually mature non-human primates. Older animals have different needs compared to the younger, adolescent animals with which we are used to working. In addition, the establishment of sexual maturity requires additional parameter measurements, such as assessment of menstrual cycling, hormone analyses, and seminology. Changes in caging are required to reflect the social hierarchy inherent with the interaction of older primates, especially since subordinate animals mature later than their dominant peers. Provision of complex environmental stimuli also becomes a greater necessity. Due to the increased size and weight of older primates, handling becomes more of a potential source of stress and injury, to both animals and their handlers. Differential criteria for assessment of sexual maturity in primates are discussed.
Source: Developments in Life Sciences
Both pharmaceutical industry and regulatory professionals acknowledge the importance of balancing timely access to new medicines with the need for thorough review of drug safety and efficacy data. A new study, funded by the Pew Charitable Trusts (to be published in the New England Journal of Medicine), reviewed drug approval decisions of the Food and Drug Administration (FDA), the Canadian drug regulator -Health Canada, and the European Medicines Agency (EMA) between 2001 and 2010. Yale and Mayo Clinic researchers studied each regulator’s database of drug approvals to identify novel therapeutics and timing of key regulatory events, thereby allowing regulatory review speed to be calculated. The study found that the FDA approves 80% of all the applications it receives. The median time for novel drug reviews by the FDA was 322 days (10.5 months). That was 45 to 70 days ahead of Europe and Canada, which typically completed their novel drug reviews after 12 and 13 months, respectively. Over the same 10-year time frame, the FDA reviewed 225 novel drug applications, 40 more than Europe and nearly 125 more than Canada. Among novel drugs approved in both the U.S. and Europe, 64% were first approved by the FDA. For novel drugs approved in both the U.S. and Canada, 86% were first approved by the FDA.
Release of study results may be too late to impact upcoming drug user fee Congressional legislation. This legislation will reauthorize user fees the FDA collects from companies that make prescription drugs and medical devices. In return for a 6% increase in user fees, the FDA has already agreed to accelerate novel drug approvals even further. The standing Senate bill (approved by the White House) supports a new user fee for the review of generic drugs and adds provisions that address some challenges of globalization by enhancing the safety of the drug supply chain, increase incentives for the development of new antibiotics, renew and enhance mechanisms to ensure that children’s medicines are appropriately tested and labeled, and that expedite the development and review of certain drugs for treatment of serious or life-threatening diseases and conditions (e.g., by allowing conduct of smaller, shorter clinical trials).
Sources: HuffPost Health, Modern Healthcare.com, R&D Magazine, and The Hill.
Dr. Janet Woodcock (CDER, FDA) stated that for every 10 drugs that enter Phase I clinical trials, only 1 drug is approved. The cost of bringing an innovative drug to market often requires a decade and a billion dollars of investment. The paradigm where pharmaceutical companies invest heavily in research and development yet garner few drug approvals is unsustainable.
Woodcock suggests that academic researchers can contribute better methods and technologies to enable faster/better preclinical and clinical decisions to be made during drug development. Recommendations given include:
- Development of biomarkers that help identify not only safety risks but also identify patients most likely to benefit from a new, targeted therapy
- Greater emphasis on applied science (e.g., drug manufacturing and scale-up enhancements)
- Identification of biochemical pathways causal to disease states
- Identification of proof-of-concept/surrogate endpoints
- Enhanced understanding of how the body handles a drug
- Take a lead on developing orphan drugs, which have historically not been a priority for pharmaceutical companies
- Develop and implement new ways to conduct clinical trials (e.g., use of early biomarker identification to guide patient selection) with the goal of developing faster, better, smaller clinical studies to gain critical information more quickly ( e.g., work being done at Stanford University)
- To extend clinical trials into the community and region surrounding academic medical centers to facilitate patient access, recruitment, and to enhance compliance
The public has a decreased tolerance for risk, as evidenced by increased regulatory requirements for premarket evaluation of drug safety and efficacy. The hope is that academic researchers can drive changes in the required testing paradigms (nonclinical and clinical) to enable faster, better, and cheaper drug approvals.
Sources: Lecture by Dr. Janet Woodcock at the California Institute for Quantitative Biosciences (qb3), UCSF and HealthCanal.com.