Clinical Safety Statistics, Merck Research Laboratories, RY 34-A318, 126 E Lincoln Ave, Rahway, NJ, 07065-4607, USA.
Global Patient Safety, Eli Lilly and Company, Windlesham, UK.
Ther Innov Regul Sci. 2020 Mar;54(2):447-461. doi: 10.1007/s43441-019-00076-4. Epub 2020 Jan 6.
Notwithstanding successful harmonization efforts, the global regulatory framework governing product safety is complex and continually evolving, as evidenced by additional regional guidance and regulations. In this regulatory review, we provide an overview from both global and regional perspectives. A historical perspective, with a focus on recent developments, enables identification of important long-term trends, such as a shift from single-case medical review of serious adverse events to an interdisciplinary evaluation of aggregate data for the purpose of judging product causality and informing benefit-risk assessments. We will show how these trends lead to opportunities for closer interdisciplinary collaboration, for bridging the gap between preand postmarketing surveillance, and for a more proactive determination of patient populations with a positive benefit-risk profile for product use. We will conclude by pointing to ongoing and future work that seeks to provide specific solutions for ongoing aggregate safety evaluation.
尽管已经进行了成功的协调努力,但全球产品安全监管框架仍然复杂且不断演变,这一点从额外的区域指导方针和法规中可以得到证明。在本次监管审查中,我们从全球和区域角度提供了概述。从历史角度出发,重点关注近期的发展情况,可以确定一些重要的长期趋势,例如,从对严重不良事件的单一案例医学审查转变为对汇总数据的跨学科评估,以判断产品因果关系并为利益风险评估提供信息。我们将展示这些趋势如何为更密切的跨学科合作、缩小上市前和上市后监测之间的差距,以及更积极地确定具有产品使用正利益风险特征的患者群体提供机会。最后,我们将指出正在进行和未来的工作,这些工作旨在为正在进行的汇总安全评估提供具体的解决方案。