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非临床物种对惊厥的敏感性:IQ DruSafe 联盟工作组的一项倡议。

Reprint of: Nonclinical species sensitivity to convulsions: An IQ DruSafe consortium working group initiative.

机构信息

Pfizer Drug Safety R&D, Pfizer, Inc, Groton, CT, USA.

AbbVie Deutschland GmbH & Co. KG, Preclinical Safety, Ludwigshafen, Knollstr 67061, Germany.

出版信息

J Pharmacol Toxicol Methods. 2020 Sep;105:106919. doi: 10.1016/j.vascn.2020.106919. Epub 2020 Sep 30.

Abstract

Clinical development of compounds that carry a convulsion liability is typically limited by safety margins based on the most sensitive nonclinical species. To better understand differences in sensitivity to drug-induced convulsion of commonly used preclinical species, a survey was distributed amongst pharmaceutical companies through an IQ consortium (International Consortium for Innovation and Quality in Pharmaceutical Development) resulting in convulsion-related data on 80 unique compounds from 11 companies. The lowest free drug plasma concentration at which convulsions were observed and the no observed effect level for convulsions were compared between species to determine their relative sensitivity. Additionally, data were collected on other endpoints including use of electroencephalography, premonitory signs, convulsion type, the reason why development was stopped, and the highest development phase reached. The key outcomes were: (1) the dog was most often determined to be the most sensitive species by both non-exposure and exposure-based analyses, (2) there was not a clear sensitivity ranking of other species (NHP, rat and mouse), (3) CNS symptoms were frequently present at exposures that were not associated with convulsions, but no single reliable premonitory indicator of convulsion was identified, and (4) the lack of convulsions in the compounds that were tested in humans in this dataset may suggest that convulsion liability is well mitigated via current drug development strategies.

摘要

通常情况下,具有惊厥副作用风险的化合物的临床开发会受到基于最敏感的非临床物种的安全边际的限制。为了更好地了解常用临床前物种对药物诱导惊厥的敏感性差异,通过 IQ 联盟(国际药物创新和质量联盟)向制药公司分发了一项调查,从 11 家公司的 80 种独特化合物中获得了与惊厥相关的数据。比较了种间观察到惊厥的最低游离药物血浆浓度和无观察到效应水平,以确定它们的相对敏感性。此外,还收集了其他终点的数据,包括使用脑电图、前驱症状、惊厥类型、开发停止的原因以及达到的最高开发阶段。主要结果是:(1)非暴露和基于暴露的分析均表明犬最常被认为是最敏感的物种;(2)其他物种(非人灵长类动物、大鼠和小鼠)没有明确的敏感性排序;(3)CNS 症状经常在与惊厥无关的暴露下出现,但没有确定单一可靠的惊厥前驱指标;(4)在该数据集的人类临床试验化合物中未出现惊厥,这可能表明通过当前的药物开发策略很好地减轻了惊厥风险。

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