Center for Biomedical Research, Population Council, New York, New York, USA.
, Bethesda, Maryland, USA.
Andrology. 2024 Oct;12(7):1590-1599. doi: 10.1111/andr.13720. Epub 2024 Aug 2.
Progress in male contraception development faces the challenge of a lack of regulatory precedent and guidelines on the evidence (trial design and primary endpoint) required for marketing approval. Moreover, the development of a male contraceptive is complicated by the fact that the clinical treatment effect; prevention of pregnancy, is not measured in the patient receiving the intervention.
Regulatory precedent and guidelines exist for female hormonal contraceptives but their applicability to male contraceptive products likely varies based on the mode of action and the anticipated pharmacodynamic effects of the product. The unique attributes of male contraceptives, including the frequent delay between the intervention (e.g., vasectomy and hormonal methods) and ultimate contraceptive effect, sperm suppression near azoospermia, and pregnancy prevention need to be addressed.
This article describes the regulatory challenges faced by developers of male contraceptive products and offers proposals, paving the way for the development of both hormonal methods and non-hormonal approaches. Our article intends to suggest the directions but cannot substitute for the advice of regulatory agencies.
男性避孕药的研发进展面临着缺乏监管先例和指导方针的挑战,这些指导方针涉及营销批准所需的证据(试验设计和主要终点)。此外,男性避孕药的研发较为复杂,因为临床治疗效果(避孕效果)无法在接受干预的患者身上进行测量。
针对女性激素类避孕药存在监管先例和指导方针,但这些指导方针可能因产品的作用模式和预期的药效学效果而有所不同。男性避孕药具有独特的属性,包括干预(例如输精管切除术和激素方法)和最终避孕效果之间的频繁延迟、接近无精子症的精子抑制以及避孕效果,这些都需要得到解决。
本文描述了男性避孕药研发者所面临的监管挑战,并提出了建议,为激素方法和非激素方法的开发铺平了道路。本文旨在提出方向,但不能替代监管机构的建议。