Lu Zhengwu
Clinical Research Department, Abbott Vascular, Santa Clara, CA, USA.
Drug Healthc Patient Saf. 2009;1:35-45. doi: 10.2147/dhps.s7180. Epub 2009 Oct 15.
Risk assessment during clinical product development needs to be conducted in a thorough and rigorous manner. However, it is impossible to identify all safety concerns during controlled clinical trials. Once a product is marketed, there is generally a large increase in the number of patients exposed, including those with comorbid conditions and those being treated with concomitant medications. Therefore, postmarketing safety data collection and clinical risk assessment based on observational data are critical for evaluating and characterizing a product's risk profile and for making informed decisions on risk minimization. Information science promises to deliver effective e-clinical or e-health solutions to realize several core benefits: time savings, high quality, cost reductions, and increased efficiencies with safer and more efficacious medicines. The development and use of standard-based pharmacovigilance system with integration connection to electronic medical records, electronic health records, and clinical data management system holds promise as a tool for enabling early drug safety detections, data mining, results interpretation, assisting in safety decision making, and clinical collaborations among clinical partners or different functional groups. The availability of a publicly accessible global safety database updated on a frequent basis would further enhance detection and communication about safety issues. Due to recent high-profile drug safety problems, the pharmaceutical industry is faced with greater regulatory enforcement and increased accountability demands for the protection and welfare of patients. This changing climate requires biopharmaceutical companies to take a more proactive approach in dealing with drug safety and pharmacovigilance.
临床产品开发过程中的风险评估需要全面、严格地进行。然而,在对照临床试验期间不可能识别出所有安全问题。一旦产品上市,接触产品的患者数量通常会大幅增加,包括患有合并症的患者以及正在接受联合用药治疗的患者。因此,上市后安全数据收集以及基于观察性数据的临床风险评估对于评估和描述产品的风险概况以及就风险最小化做出明智决策至关重要。信息科学有望提供有效的电子临床或电子健康解决方案,以实现几个核心优势:节省时间、提高质量、降低成本以及通过更安全、更有效的药物提高效率。开发和使用与电子病历、电子健康记录以及临床数据管理系统集成连接的基于标准的药物警戒系统,有望成为实现早期药物安全检测、数据挖掘、结果解读、协助安全决策以及临床合作伙伴或不同职能部门之间临床协作的工具。一个可公开访问且频繁更新的全球安全数据库的可用性将进一步加强对安全问题的检测和沟通。由于近期备受瞩目的药物安全问题,制药行业面临更严格的监管执法以及对患者保护和福利的问责要求增加。这种不断变化的形势要求生物制药公司在处理药物安全和药物警戒方面采取更积极主动的方法。