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患者对美国食品药品监督管理局批准的认知:是教育差距还是价值观差异?

Patient Perceptions of FDA Approval: Gaps in Education or Variation in Values?

作者信息

Ford Paul J, Fox Robert J, Mercer Mary Beth, Cofield Stacey S

机构信息

Neuroethics Program (PJF), Cleveland Clinic; Mellen Center for Multiple Sclerosis (RJF), Cleveland Clinic; Department of Bioethics (MBM), Cleveland Clinic, OH; and Department of Biostatistics (SSC), The University of Alabama at Birmingham.

出版信息

Neurol Clin Pract. 2021 Aug;11(4):273-279. doi: 10.1212/CPJ.0000000000001034.

Abstract

OBJECTIVE

To assess perceptions and opinions about the Food and Drug Administration (FDA) approval process for disease-modifying therapies (DMT) in people living with multiple sclerosis (MS).

METHODS

People living with MS were invited to complete a web-based survey of their perceptions of the FDA role and process for approval of MS medications. The survey asked about the role of the FDA, factors involved in the approval process, which voices should represent those with MS in deliberations about drug approval, and the level of comfort with uncertain safety of newly approved therapies.

RESULTS

Three thousand thirty-three respondents met inclusion criteria for data analysis. Most respondents seemed to understand the role of the FDA, although only half understood a fundamental FDA role: balancing the risks and benefits when considering drug approval. Significant differences were observed in many areas between those who have and have not tried DMTs. Comfort with uncertainty was associated with several factors relating to side effects and benefits believed important for the FDA to consider. Most respondents reported that people who participated in the medication's clinical trial were particularly able to represent people living with MS.

CONCLUSION

Perceptions regarding the FDA and views of who should represent people living with MS varied between those who have and have not tried DMT. There is variability in personal values that should be recognized and taken into account when considering regulatory responsibilities. Interventions are needed to address educational gaps regarding the mission and trustworthiness of the FDA as an oversight body.

摘要

目的

评估多发性硬化症(MS)患者对美国食品药品监督管理局(FDA)批准疾病改善疗法(DMT)流程的看法和意见。

方法

邀请MS患者完成一项基于网络的调查,了解他们对FDA在MS药物批准中的作用和流程的看法。该调查询问了FDA的作用、批准过程中涉及的因素、在药物批准审议中哪些声音应代表MS患者,以及对新批准疗法安全性不确定的接受程度。

结果

3033名受访者符合数据分析的纳入标准。大多数受访者似乎了解FDA的作用,尽管只有一半的人理解FDA的一项基本作用:在考虑药物批准时权衡风险和益处。在是否尝试过DMT的人群之间,许多方面存在显著差异。对不确定性的接受程度与一些与副作用和益处相关的因素有关,这些因素被认为对FDA的考虑很重要。大多数受访者表示,参与药物临床试验的人特别能够代表MS患者。

结论

在是否尝试过DMT的人群中,对FDA的看法以及谁应代表MS患者的观点存在差异。在考虑监管责任时,个人价值观存在差异,应予以认识和考虑。需要采取干预措施来弥补关于FDA作为监管机构的使命和可信度方面的教育差距。

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