Zeitoun Jean-David, Lefèvre Jérémie H, Downing Nicholas S, Bergeron Henri, Ross Joseph S
Sciences Po, Paris, France.
Department of Gastroenterology and Nutrition, Saint-Antoine Hospital, APHP, Paris.
Br J Clin Pharmacol. 2015 Oct;80(4):716-26. doi: 10.1111/bcp.12643. Epub 2015 May 28.
Regulatory review time has been associated with post-market medication safety issues in the United States. Our objective was to evaluate whether regulatory review time and near deadline approval are associated with post-market safety events (PMSEs) for novel medicines approved by the European Medicines Agency (EMA).
We performed a cross-sectional analysis of all novel medicines approved by the EMA through the centralized authorization procedure between 2001 and 2010. PMSEs were defined as withdrawals and communications identified through Dear Healthcare Professional Communications (DHPCs). Regulatory review time was defined as the time that elapsed between the start of the assessment procedure and approval. Near regulatory deadline approval was defined as approval within the 30 days before the EMA's 210 day regulatory deadline.
Among 161 eligible medicines, PMSEs were identified for 49 (30.4%), 44 of which were DHPCs, five of which were withdrawals. Median regulatory review time was 337 days (IQR 276-406) and was not associated with PMSEs (P = 0.57). However, when categorized by regulatory review speed tertile, there were differences in risk of PMSEs, with higher rates among medicines in the middle tertile (25 of 55, 45.4%; P = 0.01). Finally, 26 medicines were approved near the 210 day regulatory deadline, but were not more likely to have PMSEs (38.5% vs. 28.7%; P = 0.32).
Neither faster EMA regulatory review speed nor approval near regulatory deadlines was associated with greater likelihood of PMSEs among recently approved novel medicines.
在美国,监管审查时间与上市后药品安全问题相关。我们的目标是评估监管审查时间和接近截止日期批准是否与欧洲药品管理局(EMA)批准的新型药物的上市后安全事件(PMSE)相关。
我们对2001年至2010年期间通过集中授权程序由EMA批准的所有新型药物进行了横断面分析。PMSE被定义为通过致医疗保健专业人员函件(DHPC)确定的撤市和通报。监管审查时间被定义为评估程序开始至批准之间经过的时间。接近监管截止日期批准被定义为在EMA 210天监管截止日期前30天内批准。
在161种符合条件的药物中,有49种(30.4%)被确定存在PMSE,其中44种是DHPC,5种是撤市。监管审查时间中位数为337天(四分位间距276 - 406),与PMSE无关(P = 0.57)。然而,按监管审查速度三分位数分类时,PMSE风险存在差异,中间三分位数的药物发生率较高(55种中的25种,45.4%;P = 0.01)。最后,26种药物在210天监管截止日期附近获批,但发生PMSE的可能性并不更高(38.5%对28.7%;P = 0.32)。
EMA更快的监管审查速度和接近监管截止日期批准均与近期批准的新型药物发生PMSE的可能性增加无关。