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Ibnidris A, Liaskos N, Eldem E, Gunn A, Streffer J, Gold M, Rea M, Teipel S, Gardiol A, Boccardi M. Facilitating the use of the target product profile in academic research: a systematic review. J Transl Med 2024; 22:693. [PMID: 39075460 PMCID: PMC11288132 DOI: 10.1186/s12967-024-05476-1] [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: 05/13/2024] [Accepted: 07/03/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND The Target Product Profile (TPP) is a tool used in industry to guide development strategies by addressing user needs and fostering effective communication among stakeholders. However, they are not frequently used in academic research, where they may be equally useful. This systematic review aims to extract the features of accessible TPPs, to identify commonalities and facilitate their integration in academic research methodology. METHODS We searched peer-reviewed papers published in English developing TPPs for different products and health conditions in four biomedical databases. Interrater agreement, computed on random abstract and paper sets (Cohen's Kappa; percentage agreement with zero tolerance) was > 0.91. We interviewed experts from industry contexts to gain insight on the process of TPP development, and extracted general and specific features on TPP use and structure. RESULTS 138 papers were eligible for data extraction. Of them, 92% (n = 128) developed a new TPP, with 41.3% (n = 57) focusing on therapeutics. The addressed disease categories were diverse; the largest (47.1%, n = 65) was infectious diseases. Only one TPP was identified for several fields, including global priorities like dementia. Our analyses found that 56.5% of papers (n = 78) was authored by academics, and 57.8% of TPPs (n = 80) featured one threshold level of product performance. The number of TPP features varied widely across and within product types (n = 3-44). Common features included purpose/context of use, shelf life for drug stability and validation aspects. Most papers did not describe the methods used to develop the TPP. We identified aspects to be taken into account to build and report TPPs, as a starting point for more focused initiatives guiding use by academics. DISCUSSION TPPs are used in academic research mostly for infectious diseases and have heterogeneous features. Our extraction of key features and common structures helps to understand the tool and widen its use in academia. This is of particular relevance for areas of notable unmet needs, like dementia. Collaboration between stakeholders is key for innovation. Tools to streamline communication such as TPPs would support the development of products and services in academia as well as industry.
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Affiliation(s)
- Aliaa Ibnidris
- German Center for Neurodegenerative Diseases (DZNE), Rostock-Greifswald site, Gehlsheimer Str. 20, 18147, Rostock, Germany
- Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Nektarios Liaskos
- German Center for Neurodegenerative Diseases (DZNE), Rostock-Greifswald site, Gehlsheimer Str. 20, 18147, Rostock, Germany
- European Infrastructure for Translational Medicine (EATRIS), Amsterdam, The Netherlands
| | - Ece Eldem
- German Center for Neurodegenerative Diseases (DZNE), Rostock-Greifswald site, Gehlsheimer Str. 20, 18147, Rostock, Germany
| | | | - Johannes Streffer
- Reference Center for Biological Markers of Dementia (BIODEM), Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Michael Gold
- AriLex Life Sciences LLC, 780 Elysian Way, Deerfield, IL, 60015, USA
| | | | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock-Greifswald site, Gehlsheimer Str. 20, 18147, Rostock, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University of Medicine Rostock, Rostock, Germany
| | - Alejandra Gardiol
- European Infrastructure for Translational Medicine (EATRIS), Amsterdam, The Netherlands
- Queen Mary University of London, London, UK
| | - Marina Boccardi
- German Center for Neurodegenerative Diseases (DZNE), Rostock-Greifswald site, Gehlsheimer Str. 20, 18147, Rostock, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, University of Medicine Rostock, Rostock, Germany.
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Hauber B, Hand MV, Hancock BC, Zarrella J, Harding L, Ogden-Barker M, Antipas AS, Watt SJ. Patient Acceptability and Preferences for Solid Oral Dosage Form Drug Product Attributes: A Scoping Review. Patient Prefer Adherence 2024; 18:1281-1297. [PMID: 38919378 PMCID: PMC11197953 DOI: 10.2147/ppa.s443213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
Background There is no consistent framework for patient-centric drug product design, despite the common understanding that drug product acceptability and preferences influence adherence and, therefore, drug product effectiveness. The aim of this review was to assess current understanding of patient acceptability and preferences for solid oral dosage form (SODF) drug product attributes, and the potential impact of these attributes on patient behaviors and outcomes. Patients and Methods A scoping review was conducted. Embase, Ovid MEDLINE®, and PubMed® were searched for full-text articles published between January 2013 and May 2023. Following screening and assessment against predefined inclusion criteria, data were analyzed thematically. Results Nineteen studies were included. Four overarching domains of drug product attributes were identified and summarized in a framework: appearance, swallowability, palatability, and handling. Each domain was informed by specific drug product attributes: texture, form, size, shape, color, marking, taste, mouthfeel, and smell. The most frequently studied domains were swallowability and appearance, while the most studied attributes were size, shape, and texture. Smell, marking, and mouthfeel were the least studied attributes. Texture intersected all domains, while form, shape, and size intersected appearance, swallowability, and handling. Swallowability and size appeared to be the key domain and attribute, respectively, to consider when designing drug products. Few studies explored the impact of drug product attributes on behaviors and outcomes. Conclusion While existing studies of drug product attributes have focused on appearance and swallowability, this review highlighted the importance of two less well-understood domains-palatability and handling-in understanding patients' acceptability and preferences for SODF drug products. The framework provides a tool to facilitate patient-centric design of drug products, organizing and categorizing physical drug product attributes into four overarching domains (appearance, swallowability, palatability, and handling), encouraging researchers to comprehensively assess the impact of drug product attributes on patient acceptability, preferences, and outcomes.
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Affiliation(s)
| | - Mark V Hand
- Pfizer Ireland Pharmaceuticals, Ballintaggart, Cork, Ringaskiddy, Ireland
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Aryal S, Blankenship JM, Bachman SL, Hwang S, Zhai Y, Richards JC, Clay I, Lyden K. Patient-centricity in digital measure development: co-evolution of best practice and regulatory guidance. NPJ Digit Med 2024; 7:128. [PMID: 38755349 PMCID: PMC11099175 DOI: 10.1038/s41746-024-01110-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Digital health technologies (DHTs) have the potential to modernize drug development and clinical trial operations by remotely, passively, and continuously collecting ecologically valid evidence that is meaningful to patients' lived experiences. Such evidence holds potential for all drug development stakeholders, including regulatory agencies, as it will help create a stronger evidentiary link between approval of new therapeutics and the ultimate aim of improving patient lives. However, only a very small number of novel digital measures have matured from exploratory usage into regulatory qualification or efficacy endpoints. This shows that despite the clear potential, actually gaining regulatory agreement that a new measure is both fit-for-purpose and delivers value remains a serious challenge. One of the key stumbling blocks for developers has been the requirement to demonstrate that a digital measure is meaningful to patients. This viewpoint aims to examine the co-evolution of regulatory guidance in the United States (U.S.) and best practice for integration of DHTs into the development of clinical outcome assessments. Contextualizing guidance on meaningfulness within the larger shift towards a patient-centric drug development approach, this paper reviews the U.S. Food and Drug Administration (FDA) guidance and existing literature surrounding the development of meaningful digital measures and patient engagement, including the recent examples of rejections by the FDA that further emphasize patient-centricity in digital measures. Finally, this paper highlights remaining hurdles and provides insights into the established frameworks for development and adoption of digital measures in clinical research.
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Affiliation(s)
| | | | | | | | - Yaya Zhai
- VivoSense Inc, Newport Coast, CA, USA
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4
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Furtner D, Hutas G, Tan BJW, Meier R. Journey from an Enabler to a Strategic Leader: Integration of the Medical Affairs Function in ESG Initiatives and Values. Pharmaceut Med 2023; 37:405-416. [PMID: 37464231 PMCID: PMC10587287 DOI: 10.1007/s40290-023-00485-9] [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: 05/27/2023] [Indexed: 07/20/2023]
Abstract
Like most private enterprises, the pharmaceutical industry has deeply rooted environmental, social, and governance (ESG) matters that challenge its long-term sustainability. Overcoming these external challenges requires collaborative and proactive steps as well as procedures guiding the adoption of ESG principles by all internal stakeholders. Environmental challenges such as climate change, and in addition the changes in society, have resulted in the need for governance addressing and coordinating efforts. The core function of medical affairs (MA) is connecting with stakeholders within a company and also between the company and external stakeholders. In this article, we describe the involvement of MA in several aspects of ESG, as a contributor, partner, and implementer. MA has a significant opportunity to emerge as a leading function involved in ESG strategies and their tactical implementation. Although the involvement of MA in the environment pillar of ESG is less, the function can implement changes relating to the conduct of meetings, clinical studies, and the digitalization of medical education via virtual platforms. Due to its patient centricity, MA is tasked to address social determinants of health to improve patients' outcomes. As a linking function within a company and with its external stakeholders, MA can provide proactive input in policy generation and enable effective governance by adherence to standards of accountability, ethics, and compliance, as well as transparency. Championing ESG is a collective responsibility that transcends any single department. It mandates a company-wide commitment. MA represents an essential pivot point in catalyzing the integration of ESG principles within industry, contributing to a healthcare ecosystem that is not merely more sustainable and ethical but also more conducive to patient health and public well-being.
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Affiliation(s)
| | - Gabor Hutas
- Astellas Pharma Australia Pty Ltd., Sydney, NSW, Australia
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5
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Oliveira R, Almeida IF. Patient-Centric Design of Topical Dermatological Medicines. Pharmaceuticals (Basel) 2023; 16:ph16040617. [PMID: 37111373 PMCID: PMC10144586 DOI: 10.3390/ph16040617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Topical treatments are essential approaches to skin diseases but are associated with poor adherence. Topical vehicles have the primary purpose of ensuring drug effectiveness (by modulating drug stability and delivery, as well as skin properties) but have a marked impact on treatment outcomes as they influence patient satisfaction and, consequently, adherence to topical treatments. There is also a wide variety of vehicles available for topical formulations, which can complicate the decisions of clinicians regarding the most appropriate treatments for specific skin disorders. One of the possible strategies to improve topical-treatment adherence is the implementation of patient-centric drug-product design. In this process, the patient's needs (e.g., those related to motor impairment), the needs associated with the disease (according to the skin lesions' characteristics), and the patient's preferences are taken into consideration and translated into a target product profile (TPP). Herein, an overview of topical vehicles and their properties is presented, along with a discussion of the patient-centric design of topical dermatological medicines and the proposal of TPPs for some of the most common skin diseases.
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Affiliation(s)
- Rita Oliveira
- FP-BHS-Biomedical and Health Sciences Research Unit, FFP-I3ID-Instituto de Investigação, Inovação e Desenvolvimento, Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Rua Carlos da Maia 296, 4200-150 Porto, Portugal
- UCIBIO-Applied Molecular Biosciences Unit, MedTech, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo de Ferreira 228, 4050-313 Porto, Portugal
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo de Ferreira 228, 4050-313 Porto, Portugal
| | - Isabel F Almeida
- UCIBIO-Applied Molecular Biosciences Unit, MedTech, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo de Ferreira 228, 4050-313 Porto, Portugal
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo de Ferreira 228, 4050-313 Porto, Portugal
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Algorri M, Cauchon NS, Christian T, O'Connell C, Vaidya P. Patient-Centric Product Development: A Summary of Select Regulatory CMC and Device Considerations. J Pharm Sci 2023; 112:922-936. [PMID: 36739904 DOI: 10.1016/j.xphs.2023.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
Patient-centric drug development describes the systematic approach to incorporating the patient's perspectives and preferences into the design, assessment, and production of a therapeutic product. While a patient centric approach can be applied at any stage of the drug development lifecycle, an integrated end-to-end strategy is often most effective to create an optimized product for the patient at the earliest possible timepoint. The importance of patient centricity is well recognized by health authorities and biopharmaceutical organizations which have established toolsets, guidances, and methodologies for incorporating patient input during the clinical stage of development. However, in addition to clinical research, there are other significant aspects of product development that profoundly impact the patient experience. Specifically, chemistry, manufacturing, and control (CMC) and device aspects must also be acknowledged and addressed as part of a cohesive patient-centric development strategy. This review explores current applications and regulatory considerations for patient-centric approaches across the product lifecycle, including R&D, early product development, clinical development, device and combination product development, and post-approval change management. Specific topics of discussion include the contributions of product modality, formulation, and devices to the patient experience; usage of the Quality Target Product Profile (QTPP) as a patient-centered design tool; and post-approval product optimization. Future advancements in regulatory data management and information exchange are also explored as potential enablers of patient engagement which support enhanced communication and interconnectivity between stakeholders. Multidisciplinary collaboration between patients, health authorities, health care providers, and the biopharmaceutical industry is ultimately necessary for ensuring that medicinal products, and their corresponding regulatory processes, take on a patient-first mindset that prioritizes patient needs, values, and preferences.
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Affiliation(s)
- Marquerita Algorri
- Department of Global Regulatory Affairs and Strategy - CMC, Amgen Inc, Thousand Oaks, CA 91320, USA
| | - Nina S Cauchon
- Department of Global Regulatory Affairs and Strategy - CMC, Amgen Inc, Thousand Oaks, CA 91320, USA.
| | | | - Chelsea O'Connell
- Department of Global Regulatory Affairs and Strategy - Global Regulatory and R&D Policy, Amgen Inc, Thousand Oaks, CA 91320, USA
| | - Pujita Vaidya
- Department of Global Regulatory Affairs and Strategy - Global Regulatory and R&D Policy, Amgen Inc, Thousand Oaks, CA 91320, USA
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Drumond N, Stegemann S. An evaluation of film coating materials and their predicted oro-esophageal gliding performance for solid oral dosage forms. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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8
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Stegemann S, Sheehan L, Rossi A, Barrett A, Paudel A, Crean A, Ruiz F, Bresciani M, Liu F, Shariff Z, Shine M, Schmelzer C, Pense-Lheritier AM. Rational and practical considerations to guide a Target Product Profile for patient-centric drug product development with measurable patient outcomes - A proposed roadmap. Eur J Pharm Biopharm 2022; 177:81-88. [PMID: 35718077 DOI: 10.1016/j.ejpb.2022.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Abstract
The increasing awareness of acceptability and usability of pharmaceutical drug products by the patient as a key quality requirement continues to drive need for integrating patient centric drug product design into the pharmaceutical development process. The complex matrix of multiple drug product related decisions during the early drug development process often limits patient-centric drug product (PCDP) design options in the final commercial drug product development phase. To integrate the specific needs and perspectives of patients into drug development and product design process, a rational approach integrated into the complex development matrix is required from the start and weighs product development decision options accordingly. The aim of this work was to develop a roadmap for PCDP design in a multidisciplinary approach that leads to better usability, adherence and acceptance of the drug by patients via early integration into the development matrix. The proposed rational approach is based upon regulatory requirements and lessons learned from pediatric and geriatric drug development.
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Affiliation(s)
- Sven Stegemann
- Institute for Process and Particle Engineering, Graz University of Technology, Inffeldgasse 13, 8010 Graz, Austria.
| | - Liz Sheehan
- SRL, Office of Technology 2-44, Western Gateway Building, University College Cork, Ireland.
| | - Alessandra Rossi
- Department of Food and Drug, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy.
| | - Andrew Barrett
- Drug Product Design, Pharmaceutical Sciences, Pfizer, Discovery Park House, Ramsgate Road, Sandwich, Kent CT13 9NJ, UK.
| | - Amrit Paudel
- Institute for Process and Particle Engineering, Graz University of Technology, Inffeldgasse 13, 8010 Graz, Austria; Research Center Pharmaceutical Engineering GmbH, Inffeldgasse 13, 8010 Graz, Austria.
| | - Abina Crean
- SSPC Pharmaceutical Research Centre, School of Pharmacy, University College Cork, Cork, Ireland.
| | - Fabrice Ruiz
- ClinSearch, 110 Avenue, Pierre Brossolette, 92240 Malakoff, France.
| | - Massimo Bresciani
- CMAC Technology and Innovation Centre, University of Strathclyde, 99 George Street, Glasgow G1 1RD, UK.
| | - Fang Liu
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, College Lane, Hatfield AL10 9AB, UK.
| | - Zakia Shariff
- School of Pharmacy, Aston University, Birmingham, B4 7ET, UK.
| | - Margarete Shine
- SRL, Office of Technology 2-44, Western Gateway Building, University College Cork, Ireland.
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Wargenau M, Reidemeister S, Klingmann I, Klingmann V. A Composite Endpoint for Acceptability Evaluation of Oral Drug Formulations in the Pediatric Population. Ther Innov Regul Sci 2022; 56:903-909. [PMID: 35471561 PMCID: PMC9492601 DOI: 10.1007/s43441-022-00406-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Abstract
Introduction A medicine’s acceptability is likely to have significant impact on pediatric adherence. The importance is underlined in EMA and FDA guidance on this topic where investigation of acceptability is stated as a regulatory expectation. Demonstrating acceptability can be challenging given there is no globally recognized definition and no standardized testing methodology or assessment criteria. Palatability and swallowability are generally recognized as important elements of acceptability, and this work proposes a definition of acceptability using these elements to give a composite endpoint for acceptability for pediatric subjects across all age ranges. Methods This composite acceptability endpoint is based on validated assessment methods for swallowability and palatability in children of different age groups using different galenic placebo formulations, in line with criteria proposed by EMA for assessing acceptability in children from newborn to 18 years of age. Data from two studies investigating mini-tablets, oblong tablets, orodispersible films, and syrup were analyzed to establish the validity, expediency, and applicability of the suggested composite acceptability assessment tool. Results The new composite endpoint is an efficient and suitable way to distinguish preferences of oral formulations: Mini-tablets and oblong tablets had significantly better acceptability than syrups and orodispersible films. Conclusion Since the suggested acceptability criteria takes both swallowability and palatability into account as composite endpoint, it is highly sensitive to detect acceptability differences between oral formulations. It is a well-defined valid approach, which meets regulatory requirements in an appropriate and comprehensive manner and may in future serve as a pragmatic, standardized method to assess and compare acceptability of pediatric formulations with active substances.
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Affiliation(s)
- Manfred Wargenau
- M.A.R.C.O. GmbH & Co. KG, Institute for Clinical Research and Statistics, Schirmerstrasse 71, 40211, Düsseldorf, Germany
| | - Sibylle Reidemeister
- Novartis Pharma AG, Global Drug Development/Technical Research & Development, Novartis Campus, 4056, Basel, Switzerland
| | - Ingrid Klingmann
- Pharmaplex bv, Avenue Saint-Hubert 51, 1970, Wezembeek-Oppem, Belgium
| | - Viviane Klingmann
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Children's Hospital, Heinrich-Heine-University, Moorenstrasse 5, 40225, Düsseldorf, Germany.
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van Riet-Nales DA, van den Bemt B, van Bodegom D, Cerreta F, Dooley B, Eggenschwyler D, Hirschlérova B, Jansen PAF, Karapinar-Çarkit F, Moran A, Span J, Stegemann S, Sundberg K. Commentary on the EMA reflection paper on the pharmaceutical development of medicines for use in the older population. Br J Clin Pharmacol 2022; 88:1500-1514. [PMID: 35141926 DOI: 10.1111/bcp.15207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022] Open
Abstract
Older people are often affected by impaired organ and bodily functions resulting in multimorbidity and polypharmacy, turning them into the main user group of many medicines. Very often, medicines have not specifically been developed for older people, causing practical medication problems for them like limited availability of easy to swallow formulations, easy to open packaging and dosing instructions for enteral administration. In 2020, the European Medicines Agency (EMA) published a reflection paper 'Pharmaceutical development of medicines for use in the older population', which discusses how the emerging needs of an ageing European population can be addressed by medicines regulation. The paper intends to help industry to better consider the needs of older people during pharmaceutical/clinical medicines development by summarising data on the most relevant topics, providing early suggestions on how to move forward and prompting expert discussions and studies into knowledge gaps. Topics include patient acceptability, (dis)advantages of an administration route, formulation, dosage form, packaging, dosing device and user instruction. While the paper is directed at older people and the pharmaceutical industry, the reflections are also relevant to younger patients with similar disease-related needs and of value to other stakeholders parties, e.g., healthcare professionals, academics, patients and caregivers, as the paper makes clear what can be expected from industry and where collaborative work is needed. This commentary provides an overview of the different steps in the development of the reflection paper, discusses points considered most controversial and/or subject to (multidisciplinary) expert discussions and indicates their value for real world clinical practice.
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Affiliation(s)
- Diana A van Riet-Nales
- Department of Chemical Pharmaceutical Assessments, Medicines Evaluation Board (MEB), Utrecht, Netherlands
| | - Bart van den Bemt
- Department of Pharmacy, Sint Maartenskliniek, Ubbergen, Netherlands.,Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands
| | - David van Bodegom
- Public Health and Primary Care, Leyden Academy on Vitality and Ageing, Leiden, Netherlands.,Department Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Francesca Cerreta
- Scientific Evidence Generation Department, Human Medicines Division, European Medicines Agency, Amsterdam, Netherlands
| | - Brian Dooley
- Quality and Safety of Medicines Department, Human Medicines Division, European Medicines Agency, Amsterdam, Netherlands
| | | | - Blanka Hirschlérova
- Department of Pharmaceutical Assessment of Chemical and Herbal Products, State Institute for Drug Control (SUKL), Prague, Czech Republic
| | - Paul A F Jansen
- Department of Chemical Pharmaceutical Assessments, Medicines Evaluation Board (MEB), Utrecht, Netherlands.,Geriatric Department, University Medical Center, Utrecht, Netherlands.,Expertise Centre Pharmacotherapy in Old Persons (EPHOR), Utrecht, Netherlands
| | | | - Abigail Moran
- Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Jan Span
- Department of Chemical Pharmaceutical Assessments, Medicines Evaluation Board (MEB), Utrecht, Netherlands
| | - Sven Stegemann
- Institute of Process and Particle Engineering, Graz University of Technology, Graz, Austria
| | - Katarina Sundberg
- Department of Pharmaceutics and Biotechnology, Swedish Medical Products Agency (MPA), Uppsala, Sweden
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11
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Drumond N, Stegemann S. Better Medicines for Older Patients: Considerations between Patient Characteristics and Solid Oral Dosage Form Designs to Improve Swallowing Experience. Pharmaceutics 2020; 13:pharmaceutics13010032. [PMID: 33379258 PMCID: PMC7824227 DOI: 10.3390/pharmaceutics13010032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 02/07/2023] Open
Abstract
Oral drug administration provided as solid oral dosage forms (SODF) remains the major route of drug therapy in primary and secondary care. There is clear evidence for a growing number of clinically relevant swallowing issues (e.g., dysphagia) in the older patient population, especially when considering the multimorbid, frail, and polymedicated patients. Swallowing impairments have a negative impact on SODF administration, which leads to poor adherence and inappropriate alterations (e.g., crushing, splitting). Different strategies have been proposed over the years in order to enhance the swallowing experience with SODF, by using conventional administration techniques or applying swallowing aids and devices. Nevertheless, new formulation designs must be considered by implementing a patient centric approach in order to efficiently improve SODF administration by older patient populations. Together with appropriate SODF size reductions, innovative film coating materials that can be applied to SODF and provide swallowing safety and efficacy with little effort being required by the patients are still needed. With that in mind, a literature review was conducted in order to identify the availability of patient centric coating materials claiming to shorten esophageal transit times and improve the overall SODF swallowing experience for older patients. The majority of coating technologies were identified in patent applications, and they mainly included well-known water soluble polymers that are commonly applied into pharmaceutical coatings. Nevertheless, scientific evidence demonstrating the benefits of given SODF coating materials in the concerned patient populations are still very limited. Consequently, the availability for safe, effective, and clinically proven solutions to address the increasing prevalence of swallowing issues in the older patient population is still limited.
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Affiliation(s)
- Nélio Drumond
- Correspondence: (N.D.); (S.S.); Tel.: +49-178-2144689 (N.D.); +49-172-6054869 (S.S.)
| | - Sven Stegemann
- Correspondence: (N.D.); (S.S.); Tel.: +49-178-2144689 (N.D.); +49-172-6054869 (S.S.)
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12
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Stegemann S, van Riet‐Nales D, de Boer A. Demographics in the 2020s-Longevity as a challenge for pharmaceutical drug development, prescribing, dispensing, patient care and quality of life. Br J Clin Pharmacol 2020; 86:1899-1903. [PMID: 32939841 PMCID: PMC7495272 DOI: 10.1111/bcp.14511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/03/2020] [Accepted: 08/05/2020] [Indexed: 12/28/2022] Open
Affiliation(s)
- Sven Stegemann
- Institute of Process and Particle EngineeringGraz University of TechnologyGrazAustria
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13
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Timpe C, Stegemann S, Barrett A, Mujumdar S. Challenges and opportunities to include patient-centric product design in industrial medicines development to improve therapeutic goals. Br J Clin Pharmacol 2020; 86:2020-2027. [PMID: 32441052 DOI: 10.1111/bcp.14388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/09/2023] Open
Abstract
In the past, drug developers in industry chose approaches mainly focusing on the drug product's efficacy, safety and quality according to the level required by regulatory expectations stipulated in guidelines, pharmacopoeia and other regulatory provisions. By putting more focus on the patient perspective, regulatory authorities are currently raising their requirements regarding successful product submissions. The increasing involvement of patients in the product development process (e.g. conduction of human factor use tests, integration of feedback from patient and patient advisory groups into clinical programmes) requires adaptations to the existing and established industrial drug development processes without compromising fast patient access to innovative therapies. This review provides an expert opinion on the emerging challenges and opportunities to implement a patient-centric approach into new drug development programmes. The aim is to better understand the challenge of finding the right balance between bringing innovative drugs fast to the patients and to develop these in parallel in a patient-centric product form as well as why this is an opportunity and how stakeholder parties (e.g. patients, clinicians, pharmacists, caregivers, regulators) can provide support to achieve desired outcomes.
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Affiliation(s)
| | - Sven Stegemann
- TU Graz, Institute for Process and Particle Engineering, Graz, Austria
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