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日本与美国的孤儿抗癌药物的药物研发滞后及其相关因素比较。

The drug lag and associated factors for orphan anticancer drugs in Japan compared to the United States.

机构信息

Healthcare Policy & CSR, Astellas Pharma Inc., 2-5-1, Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8411, Japan.

Global Regulatory Science, Gifu Pharmaceutical University, 1-25-4, Daigakunishi, Gifu, 501-1196, Japan.

出版信息

Invest New Drugs. 2019 Oct;37(5):1086-1093. doi: 10.1007/s10637-018-0612-y. Epub 2018 May 31.

Abstract

The approval of orphan anticancer drugs in Japan has increased to meet high social demand. Drug lag, namely the approval lag of new drugs, is recognized as a social issue in Japan. We investigated the approval lag and its components, submission lag and review-time lag, between Japan and the United States (US) to reveal whether an approval lag still exists, and to identify potential factors that may contribute to reducing the approval lag. Anticancer drugs approved in Japan between April 2004 and November 2017 were investigated using publicly available information. Results showed that the median approval lag of orphan anticancer drugs in 2016-2017 was 727.0 days (interquartile range, IQR, 310.0-1054.3). The approval lag was significantly correlated with the submission lag (correlation coefficient = 1.00, P < 0.001) but not with the review-time lag (correlation coefficient = -0.16, P = 0.22). The submission lag was significantly longer for orphan anticancer drugs than non-orphan drugs (median, 712.5 days [IQR, 186.0-1448.3] vs. 387.0 days [92.8-1096.0], P = 0.023). External collaboration in drug development was associated with a longer submission lag (coefficient = 762.1, P = 0.017), while breakthrough therapy designation in the US was associated with a shorter submission lag (coefficient = -832.8, P = 0.035). In conclusion, we revealed that an approval lag for orphan anticancer drugs still existed in 2016-2017. A submission lag for orphan anticancer drugs was the main component affecting the approval lag, and was longer than that for non-orphan drugs. External collaboration in drug development may be a potential factor in reducing the submission lag for orphan anticancer drugs.

摘要

在满足高社会需求的情况下,日本已批准更多孤儿抗癌药物。药物延迟,即新药批准的延迟,在日本被认为是一个社会问题。我们调查了日本和美国之间的批准延迟及其组成部分,即提交延迟和审查时间延迟,以揭示是否仍存在批准延迟,并确定可能有助于缩短批准延迟的潜在因素。使用公开可得的信息调查了 2004 年 4 月至 2017 年 11 月期间在日本批准的孤儿抗癌药物。结果表明,2016-2017 年孤儿抗癌药物的中位批准延迟为 727.0 天(四分位距,IQR,310.0-1054.3)。批准延迟与提交延迟显著相关(相关系数= 1.00,P<0.001),但与审查时间延迟无关(相关系数= -0.16,P=0.22)。孤儿抗癌药物的提交延迟明显长于非孤儿药物(中位数,712.5 天 [IQR,186.0-1448.3] 与 387.0 天 [92.8-1096.0],P=0.023)。药物开发中的外部合作与提交延迟较长相关(系数=762.1,P=0.017),而在美国的突破性治疗指定与提交延迟较短相关(系数= -832.8,P=0.035)。总之,我们揭示了 2016-2017 年孤儿抗癌药物仍存在批准延迟。孤儿抗癌药物的提交延迟是影响批准延迟的主要因素,且长于非孤儿药物。药物开发中的外部合作可能是缩短孤儿抗癌药物提交延迟的潜在因素。

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