1
|
Kugener V, Palin K, Salas M, Webster P, Cole A, Price J, Habibi S, Naboulet C, Ely D, Joshi P, Malikova MA. The American Program in Pharmacovigilance (Am2P): a new accredited online training program in pharmacovigilance and pharmacoepidemiology. Ther Adv Drug Saf 2024; 15:20420986241249905. [PMID: 38737826 PMCID: PMC11088298 DOI: 10.1177/20420986241249905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 04/04/2024] [Indexed: 05/14/2024] Open
Affiliation(s)
| | - Karine Palin
- Eu2P Programme, Collège Santé, Université de Bordeaux, Bordeaux, France
| | - Maribel Salas
- Daiichi Sankyo Inc, Tokyo, Japan
- Center for Real-World Effectiveness and Safety of Therapeutics (CREST), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Abimbola Cole
- GSK, Cambridge, MA, USA
- MCPHS University, Boston, MA, USA
| | - John Price
- Independent PV Consultant, Connecticut, USA
- John Price PharmaSolutions LLC, Madison, CT, USA
| | | | - Christa Naboulet
- #PEPiTe santé, Collège Santé – Université de Bordeaux, Bordeaux, France
| | | | | | - Marina A. Malikova
- Surgical Translational Research Operations and Compliance, Department of Surgery, Boston Medical Center, Boston University, Chobanian and Avedisian School of Medicine, 88 East Newton Street, Collamore Building, Boston, MA 02215-1300, USA
| |
Collapse
|
2
|
Adams C, Keller M, Michlitsch JG, Aguayo-Hiraldo P, Chen K, Hossain MZ, Davis A, Park JR, Verneris MR, Gardner RA. Development of a Safety Surveillance Plan for the Academic Medicine Sponsor Performing First-in-Human Cellular Therapy Clinical Trials: A Report from the Consortium for Pediatric Cellular Immunotherapy. Transplant Cell Ther 2024; 30:475-487. [PMID: 38447751 PMCID: PMC11182654 DOI: 10.1016/j.jtct.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/13/2024] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
Pharmacovigilance (PV), also known as drug safety, is the science of risk management involving the detection, assessment, understanding, and prevention of adverse effects related to a medication. This discipline has traditionally focused on the postmarketing period, with less attention to early-phase clinical trials. However, during the immunotherapy and cellular therapy investigational stage, regulatory agencies are increasingly emphasizing the need to identify and characterize safety signals earlier in clinical development as part of a comprehensive safety surveillance plan. Compliance with PV and safety regulations are further heightened as cell and gene therapy (CGT) trials grow in complexity and scope owing to ever-changing and increasingly rigorous regulatory mandates. Based on this changing landscape, a critical aspect of early-phase trials of cellular products where significant safety events are anticipated is to ensure that every effort is made to protect clinical trial participants by maximizing attention to the risk-versus-benefit profile. This includes the development of robust plans for safety surveillance that provide a continual assessment of safety signals to enable safety reporting to regulatory bodies and the Food and Drug Administration, a regular analysis of aggregate safety data, and a plan to communicate safety findings. This report focuses on PV in early-phase clinical trials of first-in-human investigational products sponsored by academic centers in which the availability of PV resources and subject matter experts is limited. To more fully understand the challenges of CGT PV oversight within pediatric academic medical centers conducting early-phase clinical trials, a working group from institutions participating in the Consortium for Pediatric Cellular Immunotherapy composed of faculty and regulatory professionals was convened to compare experiences, identify best practices, and review published literature to identify commonalities and opportunities for alignment. Here we present guidelines on PV planning in early-phase CGT clinical trials occurring in academic medical centers and offer strategies to mitigate risk to trial participants. Standards to address regulatory requirements and governance for safety signal identification and risk assessment are discussed.
Collapse
Affiliation(s)
- Cheri Adams
- Gates Institute, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Michael Keller
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC; GW Cancer Center, George Washington University, Washington, DC
| | | | | | - Karin Chen
- Seattle Children's Hospital, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington
| | | | - Ann Davis
- Seattle Children's Hospital, Seattle, Washington
| | - Julie R Park
- Seattle Children's Hospital, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington; St Jude Children's Research Hospital, Memphis, Tennessee
| | - Michael R Verneris
- Gates Institute, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Rebecca A Gardner
- Seattle Children's Hospital, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington; St Jude Children's Research Hospital, Memphis, Tennessee.
| |
Collapse
|
3
|
Mueller M, Peakin J, Lewis DJ. Practical Considerations for the Implementation and Monitoring of Risk Minimisation Measures for High-Risk Teratogenic Medicines. Pharmaceut Med 2023; 37:439-449. [PMID: 37594662 DOI: 10.1007/s40290-023-00496-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/19/2023]
Abstract
There is considerable societal interest in making medicines more affordable. A critical factor often inadequately considered early in the process of adding drugs to a company's product portfolio is that some products may require additional monitoring and complex, demanding and expensive additional risk minimisation measures (aRMMs). These aRMMs may have a sizeable impact on a company's commitment to that medicinal product throughout the product's entire life cycle. The teratogenic phthalimides were selected as an example of medicines that are recently being genericised and require a substantial commitment in terms of additional monitoring and aRMMs, most notably in the form of pregnancy prevention programmes (PPPs) with controlled distribution systems (CDSs). Implementing PPPs with CDSs is complex and demanding and encompasses all routine activities, aRMMs, local/regional Health Authority (HA) requirements, and commercialisation strategies. Considerations have been summarised that can support decision-making during due diligence processes, implementation and monitoring. Proactive, effective pharmacovigilance requires innovative, sustainable and flexible solutions to maintain high standards across the board. In particular, generic marketing authorisation holders operate with limited resources and may benefit appreciably from the following proposed suggestions and solutions such as early planning and preparation, knowledge-sharing, utilisation of new technologies and implementation of measures beyond HA-mandated requirements.
Collapse
Affiliation(s)
- Marion Mueller
- Safety Risk Detection and Management, Novartis Pharma AG, Basel, Switzerland.
| | - Joseph Peakin
- Novartis Knowledge Center, Novartis Ireland Limited, Dublin, Ireland
| | - David J Lewis
- Patient Safety and Pharmacovigilance, Global Drug Development, Novartis Pharma GmbH, Wehr, Germany
- Department of Pharmacy, Pharmacology and Postgraduate Medicine, University of Hertfordshire, Hatfield, Hertfordshire, AL10 9AB, UK
| |
Collapse
|
4
|
Rodriguez G, Mancuso J, Lyman GH, Cardoso F, Nahleh Z, Vose JM, Gralow JR, Francisco M, Sherwood S. ASCO Policy Statement on Biosimilar and Interchangeable Products in Oncology. JCO Oncol Pract 2023:OP2200783. [PMID: 37027797 DOI: 10.1200/op.22.00783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
As the voice of cancer care clinicians and the patients they serve, ASCO has taken steps to elevate awareness about biosimilar products and their use in oncology. In 2018, ASCO released its Statement on Biosimilars in Oncology which was subsequently published in the Journal of Clinical Oncology to serve as an educational tool which highlighted and provided guidance on several topical areas surrounding biosimilars. At the time of its publication, the US Food and Drug Administration (FDA) had approved eight biosimilar products for use in the United States, including one product for use as a supportive care agent in the cancer setting and two products for use in the treatment for cancer. This number has risen dramatically (40 approvals), with a total of 22 cancer or cancer-related biosimilar products approved since 2015. Recently, the FDA also approved the four interchangeable biosimilar products for diabetes, certain inflammatory diseases, and certain ophthalmic diseases. Given the current market dynamics and the regulatory landscape, this ASCO manuscript now seeks to propose several policy recommendations across the scope of value, interchangeability, clinician barriers, and patient education and access. This policy statement is intended to guide ASCO's future activities and strategies and serves to affirm our commitment to providing education to the oncology community on the use of biosimilars in the cancer setting.
Collapse
Affiliation(s)
| | - Joan Mancuso
- Independent Breast Cancer Advocate, Philadelphia, PA
| | | | | | | | - Julie M Vose
- University of Nebraska Medical Center/Nebraska Medicine, Omaha, NE
| | | | | | | |
Collapse
|
5
|
Doan T, Lievano F, Scarazzini L, Liebelt K, Jaradeh M, Kantarcioglu B, Fareed J, Jones WK. Development and Implementation of an Online Global Pharmacovigilance Certificate Program During the COVID-19 Pandemic. Clin Appl Thromb Hemost 2022; 28:10760296221115112. [PMID: 35848566 PMCID: PMC9297450 DOI: 10.1177/10760296221115112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Pharmacovigilance plays a lifesaving role in the practice of medicine. In 2021, during the Coronavirus Infectious Disease 2019 (COVID-19) pandemic, Loyola University Chicago launched a graduate-level Pharmacovigilance Certificate Program (PV-CERT) and a pre-professional non-graduate Pharmacovigilance Certificate Course (EPEC-PV), to provide students a comprehensive and contemporary understanding of the principles and practices of pharmacovigilance. Formal training in pharmacovigilance through this course provided a structured understanding of how safety data are generated through clinical trials and from real-world evidence as well as the regulatory environment in which data are monitored and interpreted. Pharmacovigilance training is of critical importance, especially during the COVID-19 pandemic, during which several drugs were re-purposed for the management of various stages of COVID-19 without conventional safety data. Moreover, the safety of currently-used vaccines is of concern in some populations. Although anticoagulants and antithrombotic medications are crucial in the management of COVID-19, a clear pharmacovigilance program on their use in this indication is not established. As the century progresses, new diseases and infectious agents will require novel therapies for which the evaluation of benefits versus risks will be as essential as it has been for the current COVID-19 pandemic. As such, the Loyola course and accompanying programs on pharmacovigilance will play a key role in educating the next generation of professionals in pursuing careers in the development of therapies that ultimately improve patient outcomes while maintaining rigorous safety standards.
Collapse
Affiliation(s)
- Thao Doan
- Pharmacovigilance and Patient Safety, North Chicago, IL, USA
| | - Fabio Lievano
- Pharmacovigilance and Patient Safety, North Chicago, IL, USA
| | | | - Kate Liebelt
- Pharmacovigilance and Patient Safety, North Chicago, IL, USA
| | - Mark Jaradeh
- Department of Molecular Pharmacology and Neuroscience, 25815Loyola University Chicago, Maywood, IL, USA
| | - Bulent Kantarcioglu
- Department of Molecular Pharmacology and Neuroscience, 25815Loyola University Chicago, Maywood, IL, USA
| | - Jawed Fareed
- Department of Molecular Pharmacology and Neuroscience, 25815Loyola University Chicago, Maywood, IL, USA.,Department of Pathology, 25815Loyola University Chicago, Maywood, IL, USA
| | - W Keith Jones
- Department of Molecular Pharmacology and Neuroscience, 25815Loyola University Chicago, Maywood, IL, USA
| |
Collapse
|