This document summarizes the process of drug development from discovery through clinical trials and approval. It discusses the main goals and requirements of each phase of clinical trials: Phase I focuses on safety and dosing in healthy volunteers, Phase II evaluates efficacy and side effects in patients, Phase III tests efficacy versus existing treatments in hundreds to thousands of patients, and Phase IV monitors long-term safety and efficacy after approval and marketing. The overall process from discovery to approval takes 10-15 years and costs over $2 billion on average.
An overview of ICH-GCP guidelines of clinical trials.
Good clinical practice (GCP): a standard for the design , conduct, performance, monitoring, auditing, recording, analyses and reporting of clinical trials that provides assurance that the data and reported results are credible and accurate and that the rights, integrity, and confidentiality of trial subjects are protected.
ICH-GCP is an International Conference on Harmonization Good Clinical Practice.
The guideline was developed with consideration of the current good clinical practices of the European union, Japan, and the United States, as well as those of Australia, Canada, the Nordic countries and the world health organization
Pre-discovery
Understand the disease
Target Identification
Choose a molecule to target with a drug
Target Validation
Test the target and confirm its role in the disease
Drug Discovery
Find a promising molecule (a “lead compound”)
that could become a drug
Roles and Responsibilities in Clinical Trials of Investigator, Study Coordinator, Sponsor, Monitor, a Contract research organization.
The clinical trial, definition, description, Different types of clinical trials, phases of clinical trial.
The clinical trial study team.
Requirements of the clinical trial study team.
Clinical research team role.
GCP- Good clinical practices.
An overview of ICH-GCP guidelines of clinical trials.
Good clinical practice (GCP): a standard for the design , conduct, performance, monitoring, auditing, recording, analyses and reporting of clinical trials that provides assurance that the data and reported results are credible and accurate and that the rights, integrity, and confidentiality of trial subjects are protected.
ICH-GCP is an International Conference on Harmonization Good Clinical Practice.
The guideline was developed with consideration of the current good clinical practices of the European union, Japan, and the United States, as well as those of Australia, Canada, the Nordic countries and the world health organization
Pre-discovery
Understand the disease
Target Identification
Choose a molecule to target with a drug
Target Validation
Test the target and confirm its role in the disease
Drug Discovery
Find a promising molecule (a “lead compound”)
that could become a drug
Roles and Responsibilities in Clinical Trials of Investigator, Study Coordinator, Sponsor, Monitor, a Contract research organization.
The clinical trial, definition, description, Different types of clinical trials, phases of clinical trial.
The clinical trial study team.
Requirements of the clinical trial study team.
Clinical research team role.
GCP- Good clinical practices.
This presentation is a brief overview of ICH-GCP guidelines. Although ICH-GCP is a very vast topic, still this presentation will cover almost all the points. The reader will be able to discuss about the roles and responsibilities of various personnel in clinical trials.
ETHICAL GUIDELINES FOR BIOMEDICAL RESEARCH ON HUMAN PARTICIPANTSjyothibhat21
This presentation highlights the regulations on Ethical requirements for conducting clinical research in India. This is the guiding regulation for the Ethics Committees in India.
The viewers are requested to give their feedback on the utility of the presentation.
Drug discovery and development is and always has been the most exciting part of clinical pharmacology. It is my attempt to compile the basic concepts from various books, articles and online journals. Feel free to comment.
The all the content in this profile is completed by the teachers, students as well as other health care peoples.
thank you, all the respected peoples, for giving the information to complete this presentation.
this information is free to use by anyone.
This presentation is a brief overview of ICH-GCP guidelines. Although ICH-GCP is a very vast topic, still this presentation will cover almost all the points. The reader will be able to discuss about the roles and responsibilities of various personnel in clinical trials.
ETHICAL GUIDELINES FOR BIOMEDICAL RESEARCH ON HUMAN PARTICIPANTSjyothibhat21
This presentation highlights the regulations on Ethical requirements for conducting clinical research in India. This is the guiding regulation for the Ethics Committees in India.
The viewers are requested to give their feedback on the utility of the presentation.
Drug discovery and development is and always has been the most exciting part of clinical pharmacology. It is my attempt to compile the basic concepts from various books, articles and online journals. Feel free to comment.
The all the content in this profile is completed by the teachers, students as well as other health care peoples.
thank you, all the respected peoples, for giving the information to complete this presentation.
this information is free to use by anyone.
Typically, researchers discover new drugs through: New insights into a disease process that allow researchers to design a product to stop or reverse the effects of the disease. Many tests of molecular compounds to find possible beneficial effects against any of a large number of diseases.
Ethics in medical sciences research may not always translate into ethical publications.
Ethical violations in conducting medical research always promote unethical scientific publications.
Published research influences other researchers and establishes credibility for individual or journal.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
2. Introduction
• Discovering and developing new treatments for diseases and other medical
conditions is a lengthy and expensive process. Millions of dollars and years of
work is involved in getting a therapeutic product manufactured, tested,
approved and marketed for use of patients. The process of drug development
undergoes following phases:
• Drug discovery: This step involves identification of the compound which have
the potential to be converted into a therapeutic product.
• Preclinical testing: This step validates the safety and biological activity of a
therapeutic compound through in vitro and animal studies.
• Clinical trials: Clinical studies, follow preclinical studies and are designed to
determine the safe and most effective dosages, route of administration,
efficacy (how well the therapeutic compound works) and patient outcomes.
3. Drug discovery
• Identification of targeted chemical moiety. The targeted chemical moiety can be a
receptor, enzyme, gene etc.; which if modified can help to achieve the therapeutic
effect in a given pathology.
• To explore the potential drug candidates which can act on the targeted chemical
moiety and find the lead compound (i.e. the best possible compound out of the
given potential candidates).
• After the identification of lead compound next step is lead compound
optimization, which means altering the chemical structure of lead compound to
increase its stability, selectivity and potency; to produce favorable changes in
pharmacokinetics, and decreasing the adverse effects.
4. Pre-Clinical Development
• It is important to use the right animal model and study design.
Minimum requirements for Preclinical Development are as follows:
• Develop a pharmacological profile of the drug.
• Determine the acute toxicity of the drug in at least two species of animals –
1 rodent & 1 non rodent.
• Conduct short-term toxicity studies ranging from 2 weeks to 3 months,
depending on the proposed duration of use of the therapeutic compound in
the proposed clinical studies.
• Researcher creates this pharmacological and toxicology profile of
drug from:
• in vitro functional assays.
• in vivo PK and PD analysis.
5. Clinical Trials
• According to Sir Austin Bradford Hill Clinical Trials are: carefully and ethically
designed human experimentation with the aim of answering some precisely
framed questions.
• A clinical trial is a prospective biomedical or behavioral research study of human
subjects that is designed to answer specific questions about biomedical or
behavioral interventions (vaccines, drugs, treatments devices, or new ways of
using known drugs treatments or devices).
• Interventional trial is defined as a prospectively planned biomedical or health-
related experiment in humans.
6. • Clinical trial is a systematic investigation in human subjects for evaluating
the safety & efficacy of any new drug.
• Clinical trials are a set of tests in medical research and drug development
that generate safety and efficacy data for health interventions in human
beings.
• Research studies involving people and try to answer scientific questions and
find better ways to prevent, diagnose, or treat disease.
7. Core components of clinical trials
• Involve human subjects.
• Move forward in time.
• Must have a comparison CONTROL group.
• Must have method to measure intervention.
• Focus on unknowns: effect of medication.
• Must be done before medication is part of standard of care.
• Conducted early in the development of therapies.
• Must review existing scientific data & build on that knowledge.
• Test a certain hypothesis.
• Study protocol must be built on sound & ethical science.
• Control for any potential biases – RANDOMIZATION/BLINDING.
8. Various phases of Clinical Trials
• In Phase I trials, small group of healthy people (20-80) the first time to evaluate
its safety, determine a safe dosage range.
• In Phase II trials, group of patients (80 – 300) effective and evaluate its safety.
• In Phase III trials, large group of patients ( 300– 3000) effectiveness, monitor
side effects, compare it to commonly used treatments, and used safely.
• In Phase IV trials, post marketing studies drug’s risks, benefits and optimal
use.
9.
10. Microdosing / Phase 0 study
• Early studies of the pharmacodynamic and pharmacokinetic properties of a
potential drug in humans.
• Microdosing approach could 'accelerate’ drug development without
compromising clinical safety.
• Microdosing helps researchers select better drug candidates for clinical trials
by providing early human PK and bioavailability data.
11. • Advantages
• Less chances of adverse effects , Short duration.
• Less no. of volunteers.
• Reduced cost of development.
• Reduced drug development time.
• Limitations:
• Study mainly based on PK parameters - not efficacy and safety based.
• Agents having different kinetic characteristics between micro dose and full
dose are not evaluated by phase 0 trials.
• Of Limited use for agents having Non linear PKs.
• The laboratory parameters are very limited and expensive, researchers
have to depend on BA/BE labs.
12. Phase I
• First stage of testing in human subjects.
• Designed to assess the safety, tolerability, PK and PD of drug.
• 20-80 healthy volunteers.
• Patients: Anticancer drugs, AIDS therapy.
• Duration: 6-12 months
• No blinding / Open labelled
13. Phase I: Reasons for Using Healthy
Volunteers
• Large numbers available (vs. Patients).
• Rapid recruitment rate.
• Potential risks are considerably reduced.
• Results not confounded by presence of disease variables.
• More homogenous group.
• Greater compliance with Protocol.
• In case of ADR’s Chances of Speedy and Complete recovery are
better Advantages > Disadvantages.
14. Phase I studies: Need
• To make reliable and rapid Prediction of human response, from Preclinical
Data (PD, PK,Toxicity).
• Involves Extrapolation from Animal data to first human exposure.
• Phase I serves as an interface between Preclinical Research and Clinical
Drug development.
• Once Phase I is complete, Human beings become first-choice test species
(Human Guinea- pigs).
15. Phase 1 Basic pre-requisites
• Preclinical data.
• IND application approval by the regulatory authority.
• Protocol approval by the Ethics Committee.
• Informed consent.
• Adherence to Declaration of Helsinki /ICH-GCP guidelines, at the
start as well as from time to time, during the study.
16. Phase I Study/ Clinical trial
• The aim of a Phase I trial is to determine the maximum tolerated
dose (MTD) of the new treatment.
• The MTD is found by escalating the treatment dose until the dose-
limiting toxicity (DLT) is reached.
• Kinds of Phase I
• SAD: single ascending dose studies.
• MAD: multiple ascending dose studies.
• Food Effect: investigates differences in absorption caused by food.
17.
18. Phase II
• Therapeutic ExploratoryTrial.
• 80-300 Subjects.
• To confirm effectiveness, monitor side effects, & further evaluate
safety.
• First in patients (who have the disease that the drug is expected to
treat).
• Duration: 6 months to several years.
19. Phase II: Objectives
• Efficacy in patients (primary objective).
• Safety issues (secondary objective).
• Optimum dose finding.
• Dose efficacy relationship :
• Therapeutic dose regimen
• Duration of therapy
• Frequency of administration
• Therapeutic window
20. Phase II Study/ Clinical trial
• Phase IITypes:
• Phase IIA: Designed to assess dosing requirements.
• Phases IIB: Designed to study efficacy.
21. Phase III
• Therapeutic confirmatory trials.
• Large scale, multicentre, Randomised, Controlled trials .
• Target population: several 100’s to 3000 patients.
• Takes a long time: up to 5 years.
• To establish efficacy of the drug against existing therapy in larger
number of patients, method of usage & to collect safety data.
22. Phase III: Objectives
• To assess overall and relative therapeutic value of the new drug Efficacy,
Safety and Special Properties.
• To determine optimal dosage schedule for use in general.
• The dosage schedule in C.T.’s should be as close as possible to its
anticipated clinical use.
23. Phase III : Prerequisites
• Efficacy and dose schedule defined in Phase II studies.
• No gross ADR’s.
• Long term preclinical safety studies completed.
• ChronicToxicity
• Reproductive toxicity
• Carcinogenicity
• Marketing inputs favorable
• IRB and DCGI approval obtained
24. Phase III studies
• Subtypes
• Phase IIIA: To get sufficient and significant data.
• Prior to NDA
• Generates data on safety and efficacy.
• Phase IIIB: Allows patients to continue the treatment, Label
expansion, additional safety data.
• Phase III B studies are known as "label expansion” to show the drug
works for additional types of patients/diseases beyond the original use
for which the drug was approved for marketing.
• After the NDA but prior to the approval and launch.
• These may supplement or complete the earlier trials or may be directed
to Phase IV trials.
25. NDA: New Drug Application
• NDA Refers to New Drug Application.
• Formal proposal for the FDA/DCGI to approve a new drug for sale.
• Sufficient evidences provided to FDA/DCGI to establish:
• Drug is safe and effective.
• Benefits outweigh the risks.
• Proposed labeling is appropriate.
• NDA contains all of the information gathered during preclinical to
phase III.
• NDA can be thousands of pages long so it can take 1-2 years for FDA to
review.
26. Phase IV Study / Clinical trial
• Harmful effects discovered may result in a drug being no longer sold, or
restricted to certain uses.
• On September 30, 2004, Merck withdraw rofecoxib from the market
because of concerns about increased risk of heart attack and stroke
associated with long-term, high-dosage use.
27. Phase IV: Objectives
• Confirm the efficacy and safety profile in large populations during practice.
• Detect the unknown/rare adverse drug reactions.
• Evaluation of over-dosage.
• Identifications of new indications.
• Dose refinement: Evaluation of new formulations, dosages, durations of
treatment.
• Evaluation in different age groups / types of patients.
• Comparative Benefit-Risk assessment.
• Benefit-Cost assessment (Pharmaco- economics).
• Drug usage in the community.
• Quality Of Life assessment.
28. • Phase IV studies are also known as post marketing surveillance studies.
• Conducted after a product has been marketed.
• Undertaken by the sponsor company and can provide new information
regarding the drug such as:
• A new use for the drug.
• New drug- drug or drug- food interactions.
• Any rare or long-term side effects over a much larger patient population and longer
time period than was possible during the Phase I-III clinical studies.
• Affects produced in specific subgroup of patients (e.g., pregnant women).
29. Primary causes of failure of potential drug
candidate
• Adverse or suboptimal Pharmacokinetic profile, 39%.
• Lack of efficacy, 30%.
• Studies demonstrating animal toxicity, 11%.
• Adverse effects in humans, 10%.
• Commercial reasons, 5%.
• Miscellaneous, 5%.
30. Types of Trials
• Open Label Trial – Both Investigator and Patients knows the full details
of the treatment.
• Single Blind- Investigator knows the details of the treatment but patient
does not.
• Double Blind- Neither investigator nor patients is aware of the
treatment details.
• Triple Blind- Investigator, Patients and statistician are blinded
31. Randomized Controlled Trials (RCT)
• Randomization
• Participants are allocated at random .
• Control
• It may be standard practice (an active comparator), placebo or
no interventions.
• The RCT is one of the simplest and most powerful tools in
clinical research
33. Questions:
• Draw the flowchart of whole Drug development process.
• What is clinical trial? And What are objectives of clinical trial?
• Write the difference between Phase-I and Phase-II of Clinical trial?
• Write in brief about Phase-III and types of Phase-III.
• What is post marketing surveillance? And It’s importance in drug
development?