Holden Arthur L
The International SAE Consortium Ltd, Deerfield, IL, USA.
Drug Discov Today Technol. 2007 Winter;4(2):75-87. doi: 10.1016/j.ddtec.2007.11.003.
The International Serious Adverse Event Consortium (SAEC) is a pharmaceutical industry and FDA led international (501 c3 non-profit) consortium, focused on identifying and validating DNA-variants useful in predicting the risk of drug induced, rare serious adverse events (SAEs). As such, it functions with the explicit purpose of enhancing the 'public good'. Its members are (i) organizations engaged principally in the business of discovering, developing and marketing pharmaceutical products, or (ii) a charitable, governmental, or other non-profit organization with an interest in researching the molecular basis of drug response.Drug-induced, rare SAEs present significant health issues for patients; and pose challenges for the safe use of approved drugs and the development of new drugs. Examples of drug-induced, rare SAEs include hepatotoxicity, QT prolongation, rhabdomyolosis, serious skin rashes (e.g. SJS), edema, acute renal failure, acute hypersensitivity, anemias/neutropenias, excessive weigh gain, retinopathy, vasculitis, among others. The rarity of such drug induced SAEs and the absence of effective government surveillance/research networks, makes it extremely difficult for any one company or research entity to accrue enough SAE cases and controls to conduct effective whole genome studies. Central to the notion of the SAEC is industry, government and health care providers can join forces to make use of a variety of sample and data resources in researching the genetic basis of these events.The purpose of the SAEC is threefold:•To carry out research directed toward the discovery of DNA-variants clinically useful in understanding and predicting the risk of drug induced serious adverse events and similar scientific research.•To ensure the widespread availability of the results of such research to the scientific research community and the public at large for no charge through publication and web-based methods; and•To educate the scientific research and medical communities about issues related to severe adverse drug reactions and about issues related to the Consortium's research.The SAEC was launched in late September of 2007 with the scientific, technical and financial support of eight founding industrial research-funding members (i.e. Abbott, GSK, J & J, Novartis, Pfizer, Roche, Sanofi-Aventis and Wyeth). Additional members are being added as the consortium executes its phase one research program and develops its future plans.The Consortium's will focus initially on two research projects. It will attempt to identify DNA variants associated with drug-induced liver-disease and serious skin rashes [e.g. Stevens-Johnson syndrome ('SJS') and toxic epidermal necrolysis ('TEN')]. These two projects, while important in their own right, will also allow the SAEC to generate initial results in a reasonable time frame (owing to the availability of established case-control DNA sample collections) and build its core operations. Simultaneous with the Phase 1 research activities, the SAEC will plan follow on, hypothesis driven studies (post whole genome association studies) for DILI and SJS and explore the feasibility of whole genome research on additional SAEs. Our long term goal is to discover and validate genetic markers predictive of the major drug induced, rare SAEs and make these available at no cost at the same time, unencumbered by any intellectual property constraints, to all researchers and developers of clinical diagnostics.
国际严重不良事件联盟(SAEC)是一个由制药行业和美国食品药品监督管理局(FDA)牵头的国际性(501 c3非营利性)联盟,专注于识别和验证可用于预测药物诱发的罕见严重不良事件(SAE)风险的DNA变异。因此,它的运作有着明确的目的,即增进“公共利益”。其成员包括:(i)主要从事药品发现、开发和营销业务的组织,或(ii)对研究药物反应的分子基础感兴趣的慈善、政府或其他非营利组织。药物诱发的罕见SAE给患者带来了重大健康问题;对已批准药物的安全使用和新药开发构成了挑战。药物诱发的罕见SAE的例子包括肝毒性、QT间期延长、横纹肌溶解症、严重皮疹(如中毒性表皮坏死松解症)、水肿、急性肾衰竭、急性超敏反应、贫血/中性粒细胞减少症、体重过度增加、视网膜病变、血管炎等。此类药物诱发的SAE罕见,且缺乏有效的政府监测/研究网络,使得任何一家公司或研究机构都极难积累足够的SAE病例和对照来开展有效的全基因组研究。SAEC理念的核心是,行业、政府和医疗服务提供者能够联合起来,利用各种样本和数据资源来研究这些事件的遗传基础。SAEC的目的有三个方面:
•开展旨在发现对理解和预测药物诱发严重不良事件有临床用途的DNA变异以及进行类似科学研究的工作。
•通过出版物和基于网络的方法,确保此类研究结果免费广泛提供给科研界和广大公众;
•就严重药物不良反应相关问题以及联盟研究相关问题对科研界和医学界进行教育。
SAEC于2007年9月下旬在八个创始产业研究资助成员(即雅培、葛兰素史克、强生、诺华、辉瑞、罗氏、赛诺菲 - 安万特和惠氏)的科学、技术和资金支持下成立。随着联盟执行其第一阶段研究计划并制定未来计划,新成员也在不断加入。
该联盟最初将专注于两个研究项目。它将试图识别与药物性肝病和严重皮疹[如史蒂文斯 - 约翰逊综合征(“SJS”)和中毒性表皮坏死松解症(“TEN”)]相关的DNA变异。这两个项目本身很重要,同时也将使SAEC能够在合理的时间框架内产生初步结果(由于有已建立的病例对照DNA样本集)并建立其核心业务。在第一阶段研究活动的同时,SAEC将计划针对药物性肝损伤(DILI)和SJS开展后续的、基于假设的研究(全基因组关联研究之后),并探索对其他SAE进行全基因组研究的可行性。我们的长期目标是发现和验证可预测主要药物诱发的罕见SAE的遗传标记,并将这些标记免费提供给所有临床诊断研究人员和开发者,不受任何知识产权限制。