This document provides guidance on clinical investigation of medicinal products in pediatric populations. It outlines key issues to consider in pediatric drug development, including:
- Timing of pediatric studies based on disease severity and availability of alternative treatments
- Need for pediatric formulations that allow accurate dosing and enhance compliance
- Types of studies including pharmacokinetics, efficacy, and long-term safety
It also discusses important ethical considerations like informed consent, minimizing risk and distress, and recruitment. The addendum provides approaches to optimize pediatric drug development, such as using existing knowledge, extrapolation, and modelling/simulation to design efficient clinical trials. Special pediatric formulation needs for neonates are also addressed.
Clinical Research Regulation in European Union ShantanuThakre3
The document discusses clinical research regulations in the European Union. It provides information on the aim of the European Medicines Agency (EMA) in regulating clinical trials to protect subjects' rights and safety. It describes the EMA's role in ensuring good clinical practice standards across the European Economic Area. It also summarizes key points of the new Clinical Trials Regulation, including requirements for authorization, informed consent, and conducting trials on vulnerable groups. Finally, it discusses the Clinical Trials Information System that will support application and oversight of trials under the new Regulation.
This document outlines quality system requirements for national pharmaceutical inspection services that conduct GMP inspections of manufacturers and wholesale distributors. It specifies that inspection services must establish a quality manual, administrative structure, documentation control, records management, inspection procedures and resources, internal audits, quality improvement processes, and procedures for handling complaints and recalls. The goal is to achieve consistency in inspection standards across national authorities to facilitate mutual recognition and confidence between inspection services.
The document defines FDA warning letters and describes the process of FDA inspections that can lead to warning letters. It explains that warning letters notify companies of violations found during inspections and investigations. Companies must promptly correct issues and FDA will check that corrections are adequate. The document also describes different types of warning letters for various regulated industries and how to browse existing warning letters on the FDA website.
This presentation is aimed at providing information on automation in the GLP practices in the pharmaceutical industry.
-Standard Operating Procedures.
-Documentation in GALP.
-Logs and Related Forms.
MedWatch is the FDA's program for monitoring the safety of medical products. It allows voluntary reporting of adverse events by the public and healthcare professionals. Reports are collected in a database and monitored by FDA professionals. The FDA uses these reports to identify safety issues, communicate new safety information to the public and healthcare providers, and take regulatory actions like requiring label changes or product recalls when needed. The goal is to help protect public health by ensuring the safety of drugs, medical devices and other medical products.
The document provides information on documentation practices in the pharmaceutical industry. It discusses why documentation is important, defining documentation as written evidence of activities. It states that regulatory bodies prioritize reviewing documents to verify activities. Good documentation practices, including systematic preparation and review of documents, are required to prevent errors and ensure compliance. Documentation provides records, traceability, and audit trails for investigation and review.
Comparison of Clinical Trial Application requirement of India, USA and Europe.Aakashdeep Raval
The document compares the clinical trial application requirements of India, the United States, and Europe. Some key differences include:
- Europe requires approval of a clinical trial application, while the US only requires an investigational new drug application be filed.
- India requires forms, documentation of chemical/toxicology data, and fees to be submitted with the application.
- The US, Europe, and India all require institutional review board or ethics committee approval before starting a trial.
- Reporting and retention of adverse events and trial records differs between the regions' regulations.
REGULATORY REQUIREMENTS FOR ASEAN COUNTRIESVikas Rathee
The document discusses regulatory requirements for drug registration in Asian countries. It provides an overview of the ASEAN Common Technical Dossier (ACTD) format for drug applications across ASEAN countries. It then summarizes requirements for registration in China, South Korea, and with the ASEAN region. For China, it outlines the drug classification system and two-step approval process. For South Korea, it describes the drug classification and approval process including investigational new drug applications. It also provides background on the goals and formation of the ASEAN economic alliance between Southeast Asian countries.
Clinical Research Regulation in European Union ShantanuThakre3
The document discusses clinical research regulations in the European Union. It provides information on the aim of the European Medicines Agency (EMA) in regulating clinical trials to protect subjects' rights and safety. It describes the EMA's role in ensuring good clinical practice standards across the European Economic Area. It also summarizes key points of the new Clinical Trials Regulation, including requirements for authorization, informed consent, and conducting trials on vulnerable groups. Finally, it discusses the Clinical Trials Information System that will support application and oversight of trials under the new Regulation.
This document outlines quality system requirements for national pharmaceutical inspection services that conduct GMP inspections of manufacturers and wholesale distributors. It specifies that inspection services must establish a quality manual, administrative structure, documentation control, records management, inspection procedures and resources, internal audits, quality improvement processes, and procedures for handling complaints and recalls. The goal is to achieve consistency in inspection standards across national authorities to facilitate mutual recognition and confidence between inspection services.
The document defines FDA warning letters and describes the process of FDA inspections that can lead to warning letters. It explains that warning letters notify companies of violations found during inspections and investigations. Companies must promptly correct issues and FDA will check that corrections are adequate. The document also describes different types of warning letters for various regulated industries and how to browse existing warning letters on the FDA website.
This presentation is aimed at providing information on automation in the GLP practices in the pharmaceutical industry.
-Standard Operating Procedures.
-Documentation in GALP.
-Logs and Related Forms.
MedWatch is the FDA's program for monitoring the safety of medical products. It allows voluntary reporting of adverse events by the public and healthcare professionals. Reports are collected in a database and monitored by FDA professionals. The FDA uses these reports to identify safety issues, communicate new safety information to the public and healthcare providers, and take regulatory actions like requiring label changes or product recalls when needed. The goal is to help protect public health by ensuring the safety of drugs, medical devices and other medical products.
The document provides information on documentation practices in the pharmaceutical industry. It discusses why documentation is important, defining documentation as written evidence of activities. It states that regulatory bodies prioritize reviewing documents to verify activities. Good documentation practices, including systematic preparation and review of documents, are required to prevent errors and ensure compliance. Documentation provides records, traceability, and audit trails for investigation and review.
Comparison of Clinical Trial Application requirement of India, USA and Europe.Aakashdeep Raval
The document compares the clinical trial application requirements of India, the United States, and Europe. Some key differences include:
- Europe requires approval of a clinical trial application, while the US only requires an investigational new drug application be filed.
- India requires forms, documentation of chemical/toxicology data, and fees to be submitted with the application.
- The US, Europe, and India all require institutional review board or ethics committee approval before starting a trial.
- Reporting and retention of adverse events and trial records differs between the regions' regulations.
REGULATORY REQUIREMENTS FOR ASEAN COUNTRIESVikas Rathee
The document discusses regulatory requirements for drug registration in Asian countries. It provides an overview of the ASEAN Common Technical Dossier (ACTD) format for drug applications across ASEAN countries. It then summarizes requirements for registration in China, South Korea, and with the ASEAN region. For China, it outlines the drug classification system and two-step approval process. For South Korea, it describes the drug classification and approval process including investigational new drug applications. It also provides background on the goals and formation of the ASEAN economic alliance between Southeast Asian countries.
This document provides guidance on preparing for an FDA pre-approval inspection. It discusses what to expect during an inspection, including that inspectors will review documentation for compliance with quality standards. It stresses the importance of managing the inspection through preparation, including conducting internal audits and training personnel. It also recommends designating an inspection team to guide the process and handle document requests. The overall goal is to demonstrate control over quality issues to avoid delays in approval.
Regulatory requirnment and approval procedure of drugs in japan pptsandeep bansal
this ppt is about all the rules and regulations of drugs in Japan.this ppt contains the PMDA structure, DMF data, IND and NDA procedure, cosmetic regulations, post marketing survelliance etc.
This document discusses Good Automated Laboratory Practices (GALP) which provide guidance for managing automated regulated laboratories. It outlines the importance of standard operating procedures, documentation, logs, training, and concludes that GALP helps streamline laboratory processes and ensures work can be done efficiently within shorter timeframes. Key aspects of GALP covered include security, data management, error handling, change control, archiving, backup and recovery, and hardware maintenance.
This document discusses various post-approval requirements and processes for pharmaceutical drugs, including prior approval supplements, changes being effected in 30 days supplements, annual reports, labeling changes, recalls, FDA inspections, and ISO 31000 risk management standards. It provides details on submission requirements and timelines for different types of post-approval changes, as well as FDA enforcement actions like warning letters, seizures, and injunctions.
Auditing of manufacturing facilities by international regulatory agencies pptTek kaushik
This document discusses auditing of manufacturing facilities by international regulatory agencies. It defines an audit as a systematic, independent and documented process for obtaining evidence and evaluating it objectively. There are three main types of audits: product, process, and system audits. Audits are further classified as internal, external, or regulatory. Regulatory audits are carried out by bodies like the USFDA and MCA to ensure compliance with Good Manufacturing Practices for pharmaceutical production. The purpose of regulatory audits is to build confidence between authorities and facilitate quality systems and global harmonization. The audit process involves notice of inspection, on-site activities like document review and employee interviews, and a final report.
The document outlines regulations regarding informed consent for biomedical research involving human subjects. It states that informed consent must be obtained from all research participants or their legal guardians. Informed consent documents must include key information such as the study's purpose and procedures, risks and discomforts, benefits, confidentiality protections, and participants' rights to withdraw. Researchers have obligations to fully inform participants and respect their autonomy by ensuring participation is voluntary and without coercion. Special procedures are required for vulnerable populations like children.
21CFR 320- BIO AVAILABILITY AND BIO EQUIVALENCE REQUIREMENTSPallavi Christeen
this presentation describes briefly about Bioavailability and Bioequivalence requirements as per US FDA Code of Federal Regulations under title 21 and chapter 320
This document discusses investigational device exemption (IDE) and post marketing surveillance. IDE allows investigational devices to be used in clinical studies to collect safety and effectiveness data, requiring approval by an institutional review board and FDA for significant risk devices. Post marketing surveillance monitors the safety of medical devices after market release using approaches like spontaneous reporting databases and patient registries to identify potential safety issues and provide long-term monitoring of effects. Both are important parts of ensuring device safety during development and after approval.
Post Marketing Requirements/Complaince: PMRs and PMCsDr. Reena Malik
This document discusses post-marketing requirements (PMRs) and post-marketing commitments (PMCs) required of drug sponsors after FDA approval. PMRs are studies required by regulation, while PMCs are studies agreed upon between the sponsor and FDA but not required. Sponsors must periodically report on the status of PMRs and PMCs, with certain details like enrollment required for clinical trials. The FDA provides guidance and websites for sponsors to report and check the status of post-marketing studies.
International Medical Device Regulators ForumSanthiNori1
The document summarizes the International Medical Device Regulators Forum (IMDRF), which was established in 2011 to accelerate international harmonization of medical device regulations. It provides background on IMDRF's establishment and membership, which includes regulators from 11 countries and regions. The document also discusses IMDRF's relationship to the prior Global Harmonization Task Force (GHTF) and describes IMDRF's management structure, meetings, and current working groups on issues like adverse event terminology and medical device cybersecurity.
The document discusses the inspection of drug distribution channels. It covers the qualifications and attributes of drug inspectors, which include good knowledge of pharmacy laws and regulations, as well as integrity and communication skills. It also describes the organizational aspects of inspectors and different methods of inspection, such as comprehensive, concise, follow-up, and investigative inspections. The objectives of inspecting establishments are to ensure protection of patients, high ethical standards, and compliance with regulations. Special categories of drugs may require a modified inspection procedure.
The document provides guidance for regulatory audits of medical device manufacturers' quality management systems. It discusses the Global Harmonization Task Force (GHTF), which aimed to harmonize medical device regulations internationally. GHTF established 5 study groups, including Study Group 4 which focused on auditing strategies and developed guidance documents. The guidance covers establishing auditing procedures, auditor competencies, and conducting and documenting audits in a harmonized manner. It provides a framework for consistent regulatory audits of medical device quality systems across countries.
The document compares US Drug Master Files (DMFs) and European Union Drug Master Files (EDMFs), which include Certificates of Suitability (CEPs) and Active Substance Master Files (ASMFs). Some key differences include:
- EDMFs allow protection of intellectual property while providing complete information to regulators, whereas DMF submission is optional in the US.
- CEP and ASMF review processes in the EU can include multiple rounds of evaluation and inspections, whereas the FDA only reviews a DMF when referenced in an application.
- EDMF submissions must follow eCTD format and include modules on quality, nonclinical and clinical information, while DMFs can still
Clinical evaluation is the process of assessing clinical data to verify the safety and performance of a medical device for its intended use. It involves three main stages: 1) identifying existing clinical data from literature and reports, 2) appraising individual data sets for sufficiency, and 3) analyzing the overall strength of evidence and conclusions about safety and performance. If existing data is insufficient, new clinical evaluations must be conducted. A clinical evaluation report is prepared when existing data demonstrates conformity with essential requirements.
The document summarizes regulatory considerations for pharmaceuticals in Japan, including manufacturing, packaging, labeling, and post-marketing surveillance. For manufacturing, drugs must be approved by the Ministry of Health, Labor and Welfare and manufacturers must be licensed and follow good manufacturing practices. Packaging and labeling must contain specified information and any changes require relabeling. Post-marketing surveillance involves adverse event reporting, drug reexaminations every few years to reconfirm safety and efficacy, and reevaluations based on current medical knowledge.
Content and format of dossier filling in india sandeep bansal
This document provides an overview of the dossier submission process for drug approval. It discusses the Common Technical Document (CTD) format adopted by the Central Drugs Standard Control Organization of India based on International Conference on Harmonization guidelines. The CTD format organizes the dossier into five modules containing administrative information, quality data, nonclinical studies, clinical studies and references. Compliance with the CTD format and inclusion of all required information is necessary for regulatory approval of new drugs.
The document discusses the regulation of medical devices in the United States. It begins by defining what constitutes a medical device according to the Code of Federal Regulations. It then outlines the key regulatory bodies that oversee medical devices, including the Center for Devices and Radiological Health and the Office of Combination Products. The document provides an overview of the classification system for medical devices and the different regulatory pathways for approval, including 510(k) premarket notification, investigational device exemptions, premarket approval, and humanitarian device exemption. It also summarizes the key requirements and processes for each approval pathway.
This document summarizes the objectives and classification system of the Global Harmonization Task Force (GHTF) for in vitro diagnostic (IVD) medical devices. The GHTF was founded in 1993 to harmonize medical device regulations globally. It aims to facilitate trade while preserving public health. IVD medical devices are classified into 4 risk-based classes (A to D) based on 16 general rules related to device invasiveness, energy use, and disease detection. Class A devices pose the lowest risk while Class D the highest. The classification system aims to ensure regulatory oversight is proportionate to device risk.
Clinical research involves investigating investigational products in human subjects to discover or verify their clinical, pharmacological, and toxic effects. Clinical trials help translate basic scientific research into better ways to prevent, diagnose, or treat disease. Conducting clinical research in pediatric populations requires special considerations due to important developmental differences compared to adults. Key areas of difference include organ maturation, drug absorption, distribution, metabolism, and elimination, which can vary significantly across pediatric age groups from neonates to adolescents. Informed consent from parents or guardians is required. Clinical trials in pediatrics aim to establish safe and effective treatments while minimizing risk.
Transalational Sciences and Clinical Pharmacology in Orphan Drug DevelopmentE. Dennis Bashaw
This document discusses challenges and solutions for developing orphan drugs and implementing precision medicine programs. It notes that orphan drug development faces resource constraints as trials require more patients than rare diseases have. However, using clinical pharmacology tools allows learning from small populations by incorporating biomarkers, modeling, and innovative designs. The future of drug development lies in going beyond traditional trials to involve patients more and continually learn from individual experiences. Quantitative tools during all stages of development can extract maximum knowledge from minimal data to improve understanding, approval chances, and labeling.
This document provides guidance on preparing for an FDA pre-approval inspection. It discusses what to expect during an inspection, including that inspectors will review documentation for compliance with quality standards. It stresses the importance of managing the inspection through preparation, including conducting internal audits and training personnel. It also recommends designating an inspection team to guide the process and handle document requests. The overall goal is to demonstrate control over quality issues to avoid delays in approval.
Regulatory requirnment and approval procedure of drugs in japan pptsandeep bansal
this ppt is about all the rules and regulations of drugs in Japan.this ppt contains the PMDA structure, DMF data, IND and NDA procedure, cosmetic regulations, post marketing survelliance etc.
This document discusses Good Automated Laboratory Practices (GALP) which provide guidance for managing automated regulated laboratories. It outlines the importance of standard operating procedures, documentation, logs, training, and concludes that GALP helps streamline laboratory processes and ensures work can be done efficiently within shorter timeframes. Key aspects of GALP covered include security, data management, error handling, change control, archiving, backup and recovery, and hardware maintenance.
This document discusses various post-approval requirements and processes for pharmaceutical drugs, including prior approval supplements, changes being effected in 30 days supplements, annual reports, labeling changes, recalls, FDA inspections, and ISO 31000 risk management standards. It provides details on submission requirements and timelines for different types of post-approval changes, as well as FDA enforcement actions like warning letters, seizures, and injunctions.
Auditing of manufacturing facilities by international regulatory agencies pptTek kaushik
This document discusses auditing of manufacturing facilities by international regulatory agencies. It defines an audit as a systematic, independent and documented process for obtaining evidence and evaluating it objectively. There are three main types of audits: product, process, and system audits. Audits are further classified as internal, external, or regulatory. Regulatory audits are carried out by bodies like the USFDA and MCA to ensure compliance with Good Manufacturing Practices for pharmaceutical production. The purpose of regulatory audits is to build confidence between authorities and facilitate quality systems and global harmonization. The audit process involves notice of inspection, on-site activities like document review and employee interviews, and a final report.
The document outlines regulations regarding informed consent for biomedical research involving human subjects. It states that informed consent must be obtained from all research participants or their legal guardians. Informed consent documents must include key information such as the study's purpose and procedures, risks and discomforts, benefits, confidentiality protections, and participants' rights to withdraw. Researchers have obligations to fully inform participants and respect their autonomy by ensuring participation is voluntary and without coercion. Special procedures are required for vulnerable populations like children.
21CFR 320- BIO AVAILABILITY AND BIO EQUIVALENCE REQUIREMENTSPallavi Christeen
this presentation describes briefly about Bioavailability and Bioequivalence requirements as per US FDA Code of Federal Regulations under title 21 and chapter 320
This document discusses investigational device exemption (IDE) and post marketing surveillance. IDE allows investigational devices to be used in clinical studies to collect safety and effectiveness data, requiring approval by an institutional review board and FDA for significant risk devices. Post marketing surveillance monitors the safety of medical devices after market release using approaches like spontaneous reporting databases and patient registries to identify potential safety issues and provide long-term monitoring of effects. Both are important parts of ensuring device safety during development and after approval.
Post Marketing Requirements/Complaince: PMRs and PMCsDr. Reena Malik
This document discusses post-marketing requirements (PMRs) and post-marketing commitments (PMCs) required of drug sponsors after FDA approval. PMRs are studies required by regulation, while PMCs are studies agreed upon between the sponsor and FDA but not required. Sponsors must periodically report on the status of PMRs and PMCs, with certain details like enrollment required for clinical trials. The FDA provides guidance and websites for sponsors to report and check the status of post-marketing studies.
International Medical Device Regulators ForumSanthiNori1
The document summarizes the International Medical Device Regulators Forum (IMDRF), which was established in 2011 to accelerate international harmonization of medical device regulations. It provides background on IMDRF's establishment and membership, which includes regulators from 11 countries and regions. The document also discusses IMDRF's relationship to the prior Global Harmonization Task Force (GHTF) and describes IMDRF's management structure, meetings, and current working groups on issues like adverse event terminology and medical device cybersecurity.
The document discusses the inspection of drug distribution channels. It covers the qualifications and attributes of drug inspectors, which include good knowledge of pharmacy laws and regulations, as well as integrity and communication skills. It also describes the organizational aspects of inspectors and different methods of inspection, such as comprehensive, concise, follow-up, and investigative inspections. The objectives of inspecting establishments are to ensure protection of patients, high ethical standards, and compliance with regulations. Special categories of drugs may require a modified inspection procedure.
The document provides guidance for regulatory audits of medical device manufacturers' quality management systems. It discusses the Global Harmonization Task Force (GHTF), which aimed to harmonize medical device regulations internationally. GHTF established 5 study groups, including Study Group 4 which focused on auditing strategies and developed guidance documents. The guidance covers establishing auditing procedures, auditor competencies, and conducting and documenting audits in a harmonized manner. It provides a framework for consistent regulatory audits of medical device quality systems across countries.
The document compares US Drug Master Files (DMFs) and European Union Drug Master Files (EDMFs), which include Certificates of Suitability (CEPs) and Active Substance Master Files (ASMFs). Some key differences include:
- EDMFs allow protection of intellectual property while providing complete information to regulators, whereas DMF submission is optional in the US.
- CEP and ASMF review processes in the EU can include multiple rounds of evaluation and inspections, whereas the FDA only reviews a DMF when referenced in an application.
- EDMF submissions must follow eCTD format and include modules on quality, nonclinical and clinical information, while DMFs can still
Clinical evaluation is the process of assessing clinical data to verify the safety and performance of a medical device for its intended use. It involves three main stages: 1) identifying existing clinical data from literature and reports, 2) appraising individual data sets for sufficiency, and 3) analyzing the overall strength of evidence and conclusions about safety and performance. If existing data is insufficient, new clinical evaluations must be conducted. A clinical evaluation report is prepared when existing data demonstrates conformity with essential requirements.
The document summarizes regulatory considerations for pharmaceuticals in Japan, including manufacturing, packaging, labeling, and post-marketing surveillance. For manufacturing, drugs must be approved by the Ministry of Health, Labor and Welfare and manufacturers must be licensed and follow good manufacturing practices. Packaging and labeling must contain specified information and any changes require relabeling. Post-marketing surveillance involves adverse event reporting, drug reexaminations every few years to reconfirm safety and efficacy, and reevaluations based on current medical knowledge.
Content and format of dossier filling in india sandeep bansal
This document provides an overview of the dossier submission process for drug approval. It discusses the Common Technical Document (CTD) format adopted by the Central Drugs Standard Control Organization of India based on International Conference on Harmonization guidelines. The CTD format organizes the dossier into five modules containing administrative information, quality data, nonclinical studies, clinical studies and references. Compliance with the CTD format and inclusion of all required information is necessary for regulatory approval of new drugs.
The document discusses the regulation of medical devices in the United States. It begins by defining what constitutes a medical device according to the Code of Federal Regulations. It then outlines the key regulatory bodies that oversee medical devices, including the Center for Devices and Radiological Health and the Office of Combination Products. The document provides an overview of the classification system for medical devices and the different regulatory pathways for approval, including 510(k) premarket notification, investigational device exemptions, premarket approval, and humanitarian device exemption. It also summarizes the key requirements and processes for each approval pathway.
This document summarizes the objectives and classification system of the Global Harmonization Task Force (GHTF) for in vitro diagnostic (IVD) medical devices. The GHTF was founded in 1993 to harmonize medical device regulations globally. It aims to facilitate trade while preserving public health. IVD medical devices are classified into 4 risk-based classes (A to D) based on 16 general rules related to device invasiveness, energy use, and disease detection. Class A devices pose the lowest risk while Class D the highest. The classification system aims to ensure regulatory oversight is proportionate to device risk.
Clinical research involves investigating investigational products in human subjects to discover or verify their clinical, pharmacological, and toxic effects. Clinical trials help translate basic scientific research into better ways to prevent, diagnose, or treat disease. Conducting clinical research in pediatric populations requires special considerations due to important developmental differences compared to adults. Key areas of difference include organ maturation, drug absorption, distribution, metabolism, and elimination, which can vary significantly across pediatric age groups from neonates to adolescents. Informed consent from parents or guardians is required. Clinical trials in pediatrics aim to establish safe and effective treatments while minimizing risk.
Transalational Sciences and Clinical Pharmacology in Orphan Drug DevelopmentE. Dennis Bashaw
This document discusses challenges and solutions for developing orphan drugs and implementing precision medicine programs. It notes that orphan drug development faces resource constraints as trials require more patients than rare diseases have. However, using clinical pharmacology tools allows learning from small populations by incorporating biomarkers, modeling, and innovative designs. The future of drug development lies in going beyond traditional trials to involve patients more and continually learn from individual experiences. Quantitative tools during all stages of development can extract maximum knowledge from minimal data to improve understanding, approval chances, and labeling.
Pharmacovigilance in Special Populations: Considerations for Pediatric and Ge...ClinosolIndia
Pharmacovigilance is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. When it comes to special populations, such as pediatric and geriatric patients, there are specific considerations that need to be taken into account in pharmacovigilance efforts. Here are some key points regarding pharmacovigilance in these population
This document provides an overview of pharmacovigilance. It defines key terms like drug, adverse event, and pharmacovigilance. It describes the drug development process including preclinical and clinical trials. It explains the need for pharmacovigilance during clinical trials and after marketing to monitor for adverse events. It discusses how pharmacovigilance benefits public health and drug manufacturers by improving drug safety.
Genable Technologies is developing RhoNova, a gene therapy using two AAV vectors, for the treatment of rhodopsin-linked autosomal dominant retinitis pigmentosa (RHO-adRP), a genetic disorder causing progressive vision loss. RhoNova aims to overcome the diversity of over 200 RHO mutations by using RNA interference to destroy mutant RHO mRNA and replacing RHO through a gene resistant to mutations. Proof of concept has been shown in animal models. Orphan drug status has been granted and GMP manufacturing and preclinical toxicology studies are underway to enable clinical trials in 2017.
Definition and scope of Pharmacoepidemiology ABUBAKRANSARI2
In these slides I shared the information of definition and scope of pharmacoepidemiology. Types of studies - cohort studies, cross-sectional studies etc.
This webinar discussed rational use of medicines and antimicrobial stewardship. It covered the importance of rational use approaches and programs within antimicrobial stewardship. The agenda included presentations on rational use of medical products and how to address antimicrobial resistance and rational medicine use. There were also two question and answer sessions to discuss issues raised.
The Role of Pharmacovigilance in Ensuring Drug Safety and EfficacyClinosolIndia
Pharmacovigilance plays a vital role in ensuring drug safety and efficacy throughout the entire lifecycle of a pharmaceutical product. Here are the key aspects of pharmacovigilance in safeguarding public health:
Early Detection of Adverse Drug Reactions (ADRs): Pharmacovigilance systems collect and analyze data on ADRs reported by healthcare professionals and patients. This enables the early detection of potential safety concerns associated with drugs, including known and previously unrecognized adverse effects.
Signal Detection and Evaluation: Pharmacovigilance activities involve the systematic identification and evaluation of safety signals, which are indications of potential risks associated with a drug. Signals are assessed by analyzing data from various sources, such as spontaneous reports, clinical trials, literature, and real-world evidence, to determine their clinical significance and inform regulatory action if necessary.
Risk Assessment and Benefit-Risk Evaluation: Pharmacovigilance assesses the balance between the benefits and risks of drugs. The collected data are evaluated to determine whether the benefits of a drug outweigh its risks or if any additional safety measures are required. This information guides regulatory decisions, such as labeling changes, restrictions, or even withdrawal of the drug from the market.
Post-Marketing Surveillance: Pharmacovigilance is crucial in monitoring the safety of drugs after they have been approved and marketed. It involves ongoing surveillance and analysis of real-world data, including ADR reports, electronic health records, and other sources, to identify new or rare adverse effects that may emerge in larger patient populations or specific subgroups.
This document provides an overview of essential drugs and the World Health Organization's (WHO) model list of essential medicines. It discusses the history and definition of essential drugs, as well as the criteria and guidelines for establishing a national essential drugs program. Key points include:
- The concept of essential drugs was developed in 1975 to improve access to necessary medicines in developing countries. The first WHO model list was published in 1977.
- Essential drugs are those that satisfy the health care needs of most of the population and are available at all times. Selection is based on disease prevalence, treatment resources, and financial constraints.
- Establishing a national essential drugs program requires designating a drug authority, developing treatment guidelines and form
Regulatory Affairs is a profession which has developed from the desire of governments to protect public health, by controlling the safety and efficacy of products in areas including pharmaceuticals, veterinary medicines, medical devices, pesticides, agrochemicals, cosmetics and complementary medicines
Regulatory authority and organizations are responsible for effective drug regulation required to ensure the safety, efficacy and quality of drugs, as well as the accuracy and appropriateness of the drug information available to the public.
Discovery/development Team
Nonclinical pharmacology and toxicology Team
Clinical research Team
Regulatory affairs Team
Marketing Team
Legal Team
Management Team
After the successful completion of clinical research, if the drug candidate proven satisfactory to be safe and effective for its intended use, then drug sponsor can submit New Drug Application (NDA) to respective regulatory authority in order to get marketing license and start commercial production.
Regulatory Affairs is a profession which has developed from the desire of governments to protect public health, by controlling the safety and efficacy of products in areas including pharmaceuticals, veterinary medicines, medical devices, pesticides, agrochemicals, cosmetics and complementary medicines.
Biomarkers in Clinical Trials: Enhancing Drug DevelopmentClinosolIndia
Biomarkers play a crucial role in enhancing drug development by providing objective, measurable indicators of biological processes, disease progression, and treatment effects. These indicators can help researchers and pharmaceutical companies make informed decisions at various stages of clinical trials, leading to more efficient and successful drug development. Here's how biomarkers contribute to enhancing drug development in clinical trials:
When designing pediatric research, one size does not fit all. Simply adapting the adult clinical study protocol into its child-sized version will not be enough to gain IRB approval.
Research involving minors must prioritize the rights, safety, and welfare of its young participants, and the FDA has issued substantial regulations to ensure pediatric research is conducted safely and ethically.
This document discusses orphan drugs and rare disease drug development. It outlines the challenges in developing drugs for rare diseases, including small patient populations and lack of knowledge. The role of clinical pharmacology in drug development is described, including use of innovative analyses, trial designs, and knowledge management to help overcome challenges. Clinical pharmacology can point the way by applying lessons from oncology and pediatric drug models to the orphan drug context. Collaboration across different stakeholders is needed to develop safe and effective drugs for rare diseases.
Pharmacoepidemiology is the study of the use and effects of drugs in large populations. It combines clinical pharmacology and epidemiology to study drug use, benefits and risks. Pharmacoepidemiology uses observational studies, experimental studies, and quantitative synthesis to generate and test hypotheses about drug risks and benefits. Common study designs include cohort studies, case-control studies, randomized controlled trials, meta-analyses and decision analyses. Pharmacoepidemiology aims to optimize the benefit-risk balance of drugs.
This document discusses patient involvement at the Medicines Evaluation Board (MEB) in the Netherlands. It makes three key points:
1. The MEB focuses on involving patients throughout the entire life cycle of a medicinal product to ensure the patient perspective is considered. Meetings are held 3-4 times per year and minutes are published online.
2. Strategies for patient involvement at the MEB include having a board member represent the patient perspective, consulting patient organizations on regulatory decisions and guidelines, and creating an online portal for patients.
3. Eliciting individual patient preferences could help identify subgroups with similar preferences to better tailor regulatory decisions and highlight situations where regulator and patient values differ requiring improved communication.
Addressing Data Security and Privacy Concerns in Clinical ResearchClinosolIndia
Data security and privacy are paramount in clinical research, where sensitive and confidential information is collected, stored, and analyzed. Ensuring the protection of research participants' personal and health data is not only an ethical obligation but also a legal requirement. Data breaches or privacy violations can have serious consequences for both research subjects and the organizations involved.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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2. First
Codifiaction
History Date
New Codification
November 2005
E11
Approval by the Steering Committee under Step 2
and release for public consultation.
7
October
1999
E11
E11
Approval by the Steering Committee under Step 4
and recommendation for adoption to the three ICH
regulatory bodies.
19
July
2000
E11
Code History Date
E11 (R1) Endorsement by the ICH Assembly under Step 2 and release for public consultation.
12 October
2016
E11 (R1)
Adoption by the Regulatory Members of the ICH Assembly under Step 4 (document
dated 20 July 2017)
18 August
2017
Current Step 4 version of the E11(R1)
ICH E11(R1) Document History
4. Introduction
o The number of medicinal products currently
labeled for pediatric use is limited.
o It is the goal of this guidance to encourage
and facilitate timely pediatric medicinal
product development internationally.
o The guidance provides an outline of critical
issues in pediatric drug development and
approaches to the safe, efficient, and ethical
study of medicinal products in the pediatric
population.
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6. The decision to proceed with a pediatric development program for a medicinal product, and the nature of that program,
involve consideration of many factors, including:
• The prevalence of the condition to be treated in the pediatric population
• The seriousness of the condition to be treated
• The availability and suitability of alternative treatments for the condition in the pediatric population, including the efficacy
and the adverse event profile (including any unique pediatric safety issues) of those treatments
• Whether the medicinal product is novel or one of a class of compounds with known properties
• Whether there are unique pediatric indications for the medicinal product
• The need for the development of pediatric-specific endpoints
• The age ranges of pediatric patients likely to be treated with the medicinal product
• Unique pediatric (developmental) safety concerns with the medicinal product, including any nonclinical safety
issues
• Potential need for pediatric formulation development
i. Issues When Initiating A Pediatric Medicinal Product
Development Program
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8. “There is a need for
pediatric formulations that
permit accurate dosing and
enhance patient
compliance”
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9. iii. Timing
of Studies
The timing of pediatric studies
will depend on the medicinal
product, the type of disease
being treated, safety
considerations, and the efficacy
and safety of alternative
treatments.
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10. Sr.
No.
Area Timing
Medicinal products for diseases
predominantly or exclusively affecting
pediatric patients
Medicinal Products Intended to Treat
Serious or Life-Threatening Diseases,
Occurring in Both Adults and Pediatric
Patients, for Which There Are
Currently No or Limited Therapeutic
Options
Medicinal Products Intended to
Treat Other Diseases and
Conditions
In this case, the entire development program will be
conducted in the pediatric population except
for initial safety and tolerability data, which will
usually be obtained in adults.
In this case, there is need for relatively urgent and
early initiation of pediatric studies. Medicinal product
development should begin early in the pediatric
population, following assessment of initial safety data
and reasonable evidence of potential benefit.
In this case, although the medicinal product will be used
in pediatric patients, there is less urgency
than in the previous cases and studies would usually
begin at later phases of clinical development
or, if a safety concern exists, even after substantial post
marketing experience in adults.
1
2
3
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11. iv. Types
Of Studies
When a medicinal product is studied in
pediatric patients in one region, the
intrinsic (e.g., pharmacogenetic) and
extrinsic (e.g., diet) factors that could
impact on the extrapolation of data to
other regions should be considered.
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12. Pharmacokinetics
Pharmacokinetic studies in the pediatric population are generally
conducted in patients with the disease.
Dosing recommendations for most medicinal products used in the
pediatric population are usually based on milligram (mg)/kilogram (kg)
body weight up to a maximum adult dose.
For some medications (e.g.,medications with a narrow therapeutic
index ) surface-area-guided dosing may be necessary
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13. Efficacy
• The principles in study design, statistical considerations
and choice of control groups detailed in ICH E6, E9, and
E10 generally apply to pediatric efficacy studies.
• Where efficacy studies are needed, it may be necessary
to develop, validate, and employ different endpoints for
specific age and developmental subgroups.
• In pediatric patients with chronic diseases, the response
to a medicinal product may vary among patients
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14. Safety
• Unintended exposures to medicinal products (accidental ingestions, etc.) may provide
the opportunity to obtain safety and pharmacokinetic information and to maximize
understanding of dose-related side effects.
• Because developing systems may respond differently from matured adult organs, some
adverse events and drug interactions that occur in pediatric patients may not be
identified in adult studies.
• Long-term studies or surveillance data, either while patients are on chronic therapy or
during the posttherapy period, may be needed to determine possible effects on skeletal,
behavioral, cognitive, sexual, and immune maturation and development.
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15. Post-marketing
Information
• The pediatric database is limited at the time of approval.
Therefore, post-marketing surveillance is particularly
important.
• Post-marketing surveillance and/or long-term follow-up
studies may provide safety and/or efficacy information
for subgroups within the pediatric population or
additional information for the entire pediatric
population.
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18. Institutional Review board /
Independent Ethics Committee
• The roles and responsibilities of IRB’s/IEC’s as detailed in
ICH E6 are critical to the protection of study
participants
• There should be IRB/IEC members or experts consulted
by the IRB/IEC who are knowledgeable in pediatric
ethical, clinical, and psychosocial issues.
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19. Consent And Assent
A pediatric subject is legally unable to provide
informed consent. Therefore pediatric study
participants are dependent on their
parent(s)/legal guardian to assume responsibility
for their participation
in clinical studies.
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20. Recruitment
Recruitment of study participants should
occur in a manner free from inappropriate
inducements either to the parent(s)/legal
guardian or the study participant.
An attempt should be made to
include individuals representing
the demographics of the region
and the disease being studied.
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21. Minimizing Risk
Mechanisms should be in
place to ensure that a
study can be rapidly
terminated should an
unexpected hazard be
noted.
Investigators should be fully
aware of all relevant preclinical
and clinical toxicity of the
medicinal product.
In designing studies, every
attempt should be made to
minimize the number of
participants and of
Procedures.
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22. Minimizing Distress
Practical considerations should be made to
ensure that participants’ experiences in
clinical studies are positive and to minimize
discomfort and distress.
Repeated invasive procedures
may be painful or frightening.
Studies designed and
conducted by
Personnel knowledgeable and skilled in
dealing with the pediatric population and its
age-appropriate needs, including skill in
performing pediatric procedures
20 of 33
24. Scope and Objective
An approach to the safe,
efficient, and ethical study of
medicinal products in the pediatric
population.
Scope
Objective
To complement and provide
clarification and current regulatory
perspective on topics in pediatric
drug development.
22 of 33
25. Regional differences in some instances limit the ability of health authorities to align requirements for pediatric
product development. To address such differences, timely and efficient drug development requires a common
scientific approach for which the following questions should be considered:
● What is the medical need in one or more pediatric populations that the drug could address?
● Who are the appropriate pediatric populations or subgroups that could be considered?
● What are the knowledge gaps that should be addressed to establish the safe and effective use of the drug?
● What clinical studies and/or methodological approaches could be considered?
● Are there different formulations/dosage forms or delivery devices that will be needed for specific pediatric
subgroups, both to facilitate an optimal dose-finding strategy, and for treatment of pediatric patients in
different subgroups?
A common scientific approach, not common regional requirements, is at the
cornerstone of efficient pediatric drug development
COMMONALITY OF SCIENTIFIC APPROACH FOR PEDIATRIC
DRUG DEVELOPMENT PROGRAMS
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27. Use of Existing Knowledge
• Existing knowledge about a drug under development includes
evidence already or concurrently generated in adult and pediatric
populations with similar or other relevant diseases or conditions.
• Existing knowledge also integrates nonclinical data, data about
related compounds, disease pathophysiology, consideration of the
developmental physiology, and clinical data from the pediatric
population or subgroup.
25 of 33
28. • “Pediatric extrapolation” is defined as an approach to
providing evidence in support of effective and safe use
of drugs in the pediatric population when it can be
assumed that the course of the disease and the
expected response to a medicinal product would be
sufficiently similar in the pediatric and reference (adult
or other pediatric) population.
• Additional pediatric safety data are usually required, as
existing data may only provide some information
about potential safety concerns related to the use of a
drug in the pediatric population
Use of Extrapolation
26 of 33
29. • The usefulness of M&S in pediatric drug development
includes, but is not limited to, clinical trial simulation,
dose selection, choice and optimization of study
design, endpoint selection, and pediatric extrapolation.
• It is particularly critical to consider the maturation of
organ systems with the understanding that data from
older subgroups may not necessarily be informative
for the younger subgroups.
• Risk assessment is a critical part of M&S.
Use Of Modelling and
Simulation
27 of 33
30. Practicalities In The Design And
Execution Of Pediatric Clinical Trials
Outcome
Assessments
• Necessary to develop, validate,
and employ different endpoints
for specific age and
developmental subgroups.
• Standardized measurement,
collection, analysis, and reporting
of outcome assessments are
encouraged to optimize pediatric
drug development.
Feasibilty
• Implementing clinical
trial operational
strategies ,development
of master protocols.
• Adherence to Good
Clinical Practice (ICH E6)
should result in improved
feasibility.
Long – Term
Clinical Aspects
• Long-term effects of drug
treatment in children can include
impacts on development,
growth, and/or maturation of
organ/system function.
• Regular follow-up measurements
should be planned and discussed
with regulatory authorities.
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32. • More than one dosage form of the active pharmaceutical
ingredient (API) and/or strengths may be needed to
cover the range of pediatric populations.
• The setting where the product is likely to be
administered should be considered - For example, long
acting formulations may be beneficial in settings where the
caregiver is not always available (e.g., school, nursery)
• Considerations should include the ease of accurate dose
measurement and the capability to deliver small volumes
of liquids to minimize the risk for dosing errors,
especially in neonates, infants and young children.
Dosage and Administration
30 of 33
33. Excipients
• The use of excipients in pediatric medicines should take into
account factors such as age, weight, maturity, frequency of dosing,
intended duration of treatment, and potential for additional
excipient exposure from commonly co-administered medicines.
• The use of excipients and their quantity in a formulation should
minimize risk and ensure product performance, stability,
palatability, microbial control, and dose uniformity.
• When selecting excipients, one should always consider the
potential impact on absorption and bioavailability of the API.
31 of 33
34. • Taste masking is often needed to improve the
palatability of the API.
• As pediatric drug development can benefit global
populations, the target for taste masking should not only
be focused on ensuring that the preparation does not
taste unpleasant. Ideally, the preparation should have a
neutral taste or a taste with broad cultural acceptance.
• Alternative dose administration strategies should be
considered for pediatric populations who cannot be
accommodated by the intended dosage form (e.g.,
segmenting or crushing tablets, co-administration with
food or liquids)
Palatability and
Acceptaibility
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35. • For neonates, environmental conditions and equipment
used for drug administration (e.g., enteral feeding tubes)
may have an effect on drug delivery and bioavailability.
• Formulation requirements for neonates warrant special
attention, such as its effects on electrolyte, fluid or
nutritional balance.
• Intramuscular preparations should be avoided
• While parenteral formulations may be used in neonates,
it should be considered that their use often necessitates
careful monitoring.
Neonates
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