García-Arieta Alfredo, Gordon John, Gwaza Luther, Merino Virginia, Mangas-Sanjuan Víctor
Área de Farmacocinética y Medicamentos Genéricos, División de Farmacología y Evaluación Clínica, Departamento de Medicamentos de Uso Humano, Agencia Española de Medicamentos y Productos Sanitarios, 28022 Madrid, Spain.
Division of Biopharmaceutics Evaluation, Bureau of Pharmaceutical Sciences, Pharmaceutical Drugs Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada.
Pharmaceutics. 2023 Feb 10;15(2):601. doi: 10.3390/pharmaceutics15020601.
The development of second-entry topical products is hampered by several factors. The excipient composition should be similar to the reference product because excipients may also contribute to efficacy. Conventional pharmacokinetic bioequivalence studies were not considered acceptable because drug concentrations are measured downstream after the site of action. There was no agreed methodology to characterize the microstructure of semisolids, and waivers of therapeutic equivalence studies with clinical endpoints were not possible. Only the vasoconstrictor assay for corticosteroids was accepted as a surrogate. This paper describes the implementation of the European Union's stepwise approach for locally acting products to cutaneous products, discusses the equivalence requirements of the EMA Draft Guideline on the Quality and Equivalence of Topical Products, and compares them with the US Food and Drug Administration recommendations. Step 1 includes the possibility of waivers for simple formulations based on in vitro data only (Q1 + Q2 + Q3 + IVRT). Step 2 includes step 1 requirements plus a kinetic study (TS/IVPT/PKBE) to compare the local availability of complex formulations. Step 3 refers to clinical studies with pharmacodynamic/clinical endpoints. As excipients may affect the local tolerability and efficacy of the products, the similarity of excipient composition is required in all steps, except where clinical endpoints are compared.
二次用药局部用产品的开发受到多种因素的阻碍。辅料组成应与参比产品相似,因为辅料也可能对疗效有贡献。传统的药代动力学生物等效性研究不被认为是可接受的,因为药物浓度是在作用部位下游进行测量的。对于表征半固体的微观结构,尚无公认的方法,且无法豁免具有临床终点的治疗等效性研究。只有皮质类固醇的血管收缩测定法被接受作为替代方法。本文描述了欧盟针对局部作用产品应用于皮肤产品的逐步方法的实施情况,讨论了欧洲药品管理局(EMA)关于局部用产品质量和等效性的指导原则草案中的等效性要求,并将其与美国食品药品监督管理局(FDA)的建议进行了比较。步骤1包括仅基于体外数据(Q1 + Q2 + Q3 + IVRT)对简单制剂豁免的可能性。步骤2包括步骤1的要求加上一项动力学研究(TS/IVPT/PKBE),以比较复杂制剂的局部可获得性。步骤3涉及具有药效学/临床终点的临床研究。由于辅料可能会影响产品的局部耐受性和疗效,因此在所有步骤中都要求辅料组成相似,但在比较临床终点时除外。