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美国食品和药物管理局孤儿产品临床试验资助:对结果的评估及其对罕见病产品开发的影响。

FDA orphan products clinical trial grants: assessment of outcomes and impact on rare disease product development.

机构信息

US Food and Drug Administration, Office of the Commissioner, Office of Orphan Products Development, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA.

出版信息

Orphanet J Rare Dis. 2020 Sep 3;15(1):234. doi: 10.1186/s13023-020-01514-5.

Abstract

BACKGROUND

The Office of Orphan Products Development (OOPD) of the United States (U.S.) Food and Drug Administration (FDA) has awarded over 700 grants to conduct clinical trials of medicals products for rare diseases since 1983, leading to over 70 marketing approvals. However, despite recent progress in rare disease product development, thousands of rare diseases still have no approved treatments. An assessment of this clinical trial grants program was undertaken to provide an in-depth analysis of the characteristics and outcomes of the program. Results of this analysis will be used to inform future goals of the program, as well as internal data collection to continue to maximize the program's impact in supporting rare disease product development.

RESULTS

Between fiscal years 2007-2011, OOPD funded 85 clinical trial grants. These grants spanned 18 therapeutic areas, included all pre-approval phases (Phases 1-3), and approximately 75% of the grants studied small molecule drugs. Nine (11%) product approvals, of seven drugs and two devices, were at least partially supported by grants funded within this 5-year timeframe. Four of the seven drugs approved were new molecular entities (NMEs). The average time from funding to approval was seven years. We also found a suggested association between collaboration with multiple types of stakeholders and the success of grants, where we defined success as either positive or negative study findings or a future marketing approval.

CONCLUSIONS

The clinical trials funded by OOPD provided valuable information for future product development, and there were a notable number of approvals that occurred using the support of the grants program. There was a suggested association between collaboration and successful outcomes. Efficient and innovative trial designs and collaboration among stakeholders appear vital to continue to effectively bring products to rare disease patients. Ongoing program assessments will ensure that the funding continues to be used to optimally meet the treatment needs of the rare disease community.

摘要

背景

自 1983 年以来,美国(U.S.)食品和药物管理局(FDA)的孤儿产品开发办公室(OOPD)已授予 700 多项开展医学产品临床试验的赠款,从而促成了 70 多项营销批准。然而,尽管近年来罕见病产品的开发取得了一些进展,但仍有成千上万的罕见病没有获得批准的治疗方法。对这一临床试验赠款计划进行了评估,以便对该计划的特点和结果进行深入分析。该分析的结果将用于为该计划的未来目标提供信息,并对内部数据进行收集,以继续最大限度地发挥该计划在支持罕见病产品开发方面的作用。

结果

在 2007 年至 2011 年的财政年度,OOPD 资助了 85 项临床试验赠款。这些赠款涵盖了 18 个治疗领域,包括所有的预批准阶段(第 1 至 3 阶段),且约 75%的研究赠款涉及小分子药物。在这 5 年的时间框架内,至少有 7 种药物和 2 种器械获得了批准,其中有 9 种(11%)产品批准是由获得的赠款部分支持的。在获得批准的 7 种药物中,有 4 种是新分子实体(NMEs)。从资助到批准的平均时间为 7 年。我们还发现,与多种类型的利益相关者合作与赠款的成功之间存在一定的关联,我们将成功定义为积极或消极的研究结果或未来的营销批准。

结论

OOPD 资助的临床试验为未来的产品开发提供了有价值的信息,并且有相当数量的批准是利用赠款计划获得的。合作与成功结果之间存在一定的关联。高效和创新的试验设计以及利益相关者之间的合作对于继续为罕见病患者有效地提供产品似乎至关重要。正在进行的计划评估将确保资金继续被用于最佳满足罕见病社区的治疗需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cd/7469294/6da7d01127fa/13023_2020_1514_Fig1_HTML.jpg

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