Liu Dong-Hua, He Xing-Ling, Ni Shi-Hao, Tang Ya-Qin, Tang Hui-Min, Lu Lu, Yang Zhong-Qi
the First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou 510407, China.
Zhongguo Zhong Yao Za Zhi. 2024 Jan;49(2):565-568. doi: 10.19540/j.cnki.cjcmm.20231113.302.
Traditional Chinese medicine(TCM) preparations in medical institutions, as a unique and important form of preparations in China, have a long history of human use and serve as a bridge between clinical experience prescriptions and new Chinese medicine preparations. The state encourages medical institutions to transform their preparations into new traditional Chinese medicines, emphasizing their role as "incubators". Since the proposal of the traditional Chinese medicine registration and evaluation evidence system with the integration of TCM theory, human use experience(HUE), and clinical experience, the idea of transforming preparations used in medical institutions into new drugs based on HUE has been increasingly valued by drug research and development organizations. In the transformation process, pharmaceutical changes should be concerned from multiple aspects. This paper discusses the pharmaceutical changes and countermeasures based on the transformation of traditional Chinese medicine preparations in medical institutions into new drugs based on HUE from the aspects of excipients, dosage forms, production technology, production scale, packaging materials and containers, production sites, and registration standards. It is emphasized that scientific decisions should be made according to the characteristics and clinical needs of drugs to ensure the stability of drug quality. The impacts of pharmaceutical changes on drug quality should be objectively assessed based on appropriate evaluation indexes and detection methods. The layout should be carried out in advance, and the key pharmaceutical information of the preparations should be kept stable, so as to underpin the transformation of traditional Chinese medicine preparations in medical institutions into new drugs based on HUE.
医疗机构中药制剂作为我国特有的、重要的制剂形式,有着悠久的使用历史,是临床经验方与中药新药制剂之间的桥梁。国家鼓励医疗机构将其制剂转化为中药新药,强调其“孵化器”作用。自提出融合中医理论、人用经验(HUE)和临床经验的中药注册审评证据体系以来,基于人用经验将医疗机构制剂转化为新药的理念日益受到药物研发机构重视。在转化过程中,应从多方面关注药学变更。本文从辅料、剂型、生产工艺、生产规模、包装材料和容器、生产场地及注册标准等方面探讨基于人用经验将医疗机构中药制剂转化为新药过程中的药学变更及应对措施。强调应根据药物特点和临床需求科学决策,确保药品质量稳定。应基于适当的评价指标和检测方法客观评估药学变更对药品质量的影响。应提前布局,保持制剂关键药学信息稳定,为基于人用经验将医疗机构中药制剂转化为新药提供支撑。