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日本肿瘤药物研发滞后:过去十年是否有所改善?

Oncology drug lag in Japan: has it improved over the last decade?

机构信息

Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo, 108-8641, Japan.

Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan.

出版信息

Int J Clin Oncol. 2023 Nov;28(11):1451-1460. doi: 10.1007/s10147-023-02395-x. Epub 2023 Aug 10.

Abstract

BACKGROUND

Existing studies and statistics on the drug lag between Japan and the United States (US) for anti-cancer drugs indicate that it has decreased, whereas more drugs are left unapproved in Japan. This study aimed to quantify the impact of unapproved drugs on the drug lag.

METHODS

Information on 136 anti-cancer drugs approved in the US between 2011 and 2022 was collected. The approval lag, defined as the number of days from the date of approval in the US to the date of approval in Japan, was calculated for all selected drugs, and the median was calculated using the Kaplan-Meier method. The approval lag for drugs not approved in Japan was treated as censored data. Factors potentially associated with the approval lag were explored using Cox regression analysis.

RESULTS

The median approval lags for the first half-period (2011-2016) and the last half-period (2017-2022) were 961 days (2.6 years) and 1547 days (4.2 years), respectively (Log-rank test: p = 0.0687). The participation of Japan in the global pivotal trial was associated with a shorter approval lag, and new drug applications by non-Japanese companies that did not rank in the global sales top 20 were associated with a longer approval lag.

CONCLUSIONS

Drug lag has not decreased over the last decade. The percentage of pivotal trials for US approval that included Japan has increased but should be further increased in the future. Japan may require a scheme to encourage smaller non-Japanese companies to include Japan in their global clinical development plan.

摘要

背景

已有研究和统计数据表明,日本和美国(US)之间抗癌药物的审批差距在缩小,但仍有更多药物在日本未获得批准。本研究旨在量化未获批药物对审批差距的影响。

方法

收集了 2011 年至 2022 年在美国获批的 136 种抗癌药物的信息。计算所有选定药物的批准滞后时间,定义为从美国批准日期到日本批准日期的天数,并使用 Kaplan-Meier 方法计算中位数。未在日本获批的药物的批准滞后时间被视为删失数据。使用 Cox 回归分析探讨与批准滞后时间相关的潜在因素。

结果

前半段(2011-2016 年)和后半段(2017-2022 年)的中位批准滞后时间分别为 961 天(2.6 年)和 1547 天(4.2 年)(对数秩检验:p=0.0687)。日本参与全球关键性试验与较短的批准滞后时间相关,而未进入全球销售前 20 名的非日本公司的新药申请与较长的批准滞后时间相关。

结论

在过去十年中,药物审批差距并未缩小。包括日本在内的美国批准关键性试验的比例有所增加,但未来应进一步增加。日本可能需要制定一项计划,鼓励规模较小的非日本公司将日本纳入其全球临床开发计划。

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