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发表于 2018-11-2 15:36 |只看该作者 |倒序浏览 |打印

Hepatitis B Virus Drug Development: FDA Offers Draft Guidance

Posted 01 November 2018 | By Zachary Brennan
Hepatitis B Virus Drug Development: FDA Offers Draft Guidance

With an aim to assist sponsors looking to develop hepatitis B virus (HBV) treatments, the US Food and Drug Administration (FDA) on Thursday released draft guidance covering the gamut of development stages.

The guidance includes general considerations on nonclinical toxicology and virology studies, early phase clinical development, clinical pharmacology assessments, and phase 3 safety and efficacy trials.

Phase 3 trial design considerations and efficacy endpoints for the development of combination therapies for the treatment of chronic HBV infection are also discussed in the draft. In addition, development considerations for specific subpopulations, such as patients coinfected with hepatitis D virus or human immunodeficiency virus and pediatric HBV-infected patients, are also included.

Under the section on Phase 3 efficacy trial considerations, the draft features a section on other important endpoints, such as assessing progression of liver disease.

“Except for patients with advanced or decompensated cirrhosis, a statistically rigorous evaluation of endpoints of liver progression can be challenging because these events occur infrequently until late in the course of CHB [chronic hepatitis B]. However, treatment effects on these endpoints provide useful clinical information, and trials evaluating them could be used to support an expanded indication or patient population and could be summarized in appropriate sections of the label,” the draft says.

FDA also notes that the development of new HBV therapies is targeted at treatment regimens “of finite duration with low risk of virologic relapse and minimal risk of liver disease progression after the treatment is stopped.”

The draft also includes a section on considerations for antisense oligonucleotides and siRNA investigational drugs.

Other sections of the draft focus on clinical virology considerations, pharmacokinetic/pharmacodynamic considerations and labeling considerations.

Chronic Hepatitis B Virus Infection: Developing Drugs for Treatment: Draft Guidance for Industry

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发表于 2018-11-2 15:36 |只看该作者
乙型肝炎病毒药物开发:FDA提供指南草案

发表于2018年11月1日作者:Zachary Brennan
乙型肝炎病毒药物开发:FDA提供指南草案

美国食品和药物管理局(FDA)周四发布了涵盖各个发展阶段的指南草案,旨在帮助寻求开展乙型肝炎病毒(HBV)治疗的赞助商。

该指南包括对非临床毒理学和病毒学研究,早期临床开发,临床药理学评估和第3阶段安全性和功效试验的一般考虑。

本草案还讨论了用于开发治疗慢性HBV感染的联合疗法的3期试验设计考虑因素和疗效终点。此外,还包括特定亚群的发展考虑因素,例如合并感染丁型肝炎病毒或人类免疫缺陷病毒的患者和儿科HBV感染患者。

根据关于3期疗效试验考虑的部分,该草案以其他重要终点为特色,例如评估肝病的进展。

“除了患有晚期或失代偿性肝硬化的患者,对肝脏进展终点进行统计学上严格的评估可能具有挑战性,因为这些事件很少发生在CHB [慢性乙型肝炎]的晚期。然而,对这些终点的治疗效果提供了有用的临床信息,评估它们的试验可用于支持扩大的适应症或患者人群,并可在标签的适当部分进行总结,“草案说。

FDA还指出,新的HBV疗法的开发针对的是“有限持续时间的病毒复发风险低,治疗停止后肝病进展风险最小的治疗方案”。

该草案还包括关于反义寡核苷酸和siRNA研究药物的考虑的部分。

草案的其他部分侧重于临床病毒学考虑,药代动力学/药效学考虑和标签考虑。

慢性乙型肝炎病毒感染:开发治疗药物:工业指南草案

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发表于 2018-11-2 15:37 |只看该作者

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发表于 2018-11-2 19:38 |只看该作者
不是业内人,FDA真是令人刮目相看,作为一个官僚机构能发布这么前瞻的指导意见,说明非常高效专业。

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发表于 2018-11-2 19:58 |只看该作者
neilhbver 发表于 2018-11-2 19:38
不是业内人,FDA真是令人刮目相看,作为一个官僚机构能发布这么前瞻的指导意见,说明非常高效专业。 ...

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