A Refined Developability Classification System.

In 2010, the Developability Classification System (DCS) was proposed. The DCS was designed to close the gap between the biopharmaceutics classification system, which is aimed at guiding regulatory decisions about well-characterized drugs, and the need for early evaluation of drug candidates with respect to their suitability for oral delivery. The DCS applied solubility in fasted state simulated intestinal fluid to estimate intestinal solubility, assessed the compensatory nature of permeability and solubility during oral absorption and provided a way of estimating the critical the particle size at which dissolution becomes rate-limiting to absorption. Building on this framework, a refined developability classification system (rDCS) is now proposed. The rDCS is stratified into standard investigations applied to all candidates, and customized investigations. Standard investigation of solubility and permeability can be performed according to in-house methods, and the results compared with standard data sets of fasted state human intestinal fluid solubility and human effective jejunal permeability, which have been generated specifically for rDCS. Customized investigations are triggered when there is potential for supersaturation/precipitation (weak bases; salts of weak acids) and to assess dissolution versus permeation limited absorption. In addition, the rDCS offers facile visualization of the results, enabling pragmatic comparison of drug candidates and formulation approaches.

How pre-marketing data can be used for predicting the weight of drug interactions in clinical practice.

Unexpected drug interactions have led to the withdrawal of many drugs, raising concern about the gap between what is known at the time of approval and the risk of serious effects in the longer term, particularly in high-risk populations generally excluded from drug development. This is because the majority of drug interaction studies are done using in vitro methods, or in healthy young volunteers who may not reflect the complexity of patients, and the settings in which the drug will be used in clinical practice. Pre-marketing interaction studies should therefore be designed to make information easily accessible and clinically transferable. They should be adequate in terms of sample size, population, comorbidity, phenotyping and/or genotyping, end-points and outcome measures, and conducted in conditions of dose, route and timing of co-administration that reproduce the proposed therapeutic indications of the new drug. Although young volunteers have the advantage of minimizing some confounding effects introduced by diseases or polypharmacy, patients drawn from populations for whom the drug is intended would be more relevant and accurate, providing the studies are feasible and safe.

Stability evaluation of vaccines: WHO approach.

The stability of vaccines has a major impact on the success of immunization programmes worldwide. In line with this, clear definition of the stability characteristics of a vaccine is of critical importance. One of the concerns at country level is whether vaccines will remain potent on its way from the manufacturer, through the distribution channels, to the final users and vaccine recipients. In response to the requests for assistance in defining stability profile of vaccines, the Expert Committee on Biological Standardization (ECBS) in October 2006 agreed that new WHO guidelines be established on stability evaluation of vaccines (http://www.who.int/biologicals/publications/trs/areas/vaccines/stability/en/index.html). This document applies to all vaccines against infectious diseases. The aim of this guideline is to provide the scientific basis and guiding principles for evaluation of vaccine stability for the purpose of clinical trial approval, licensing, and post-licensure monitoring. As part of its initiative to promote use of vaccines of assured quality, WHO emphasizes the role of National Regulatory Authorities (NRAs) and National Control Laboratories (NCLs) in overall vaccine evaluation, including stability assessment. While recognizing that manufacturers are responsible for the quality of the vaccines they produce, compliance with vaccine quality specifications is part of regulatory oversight. This article provides basic information about WHO international standards as well as key definitions and principles for stability evaluation of vaccines that are elaborated in detail in the above mentioned guidance document.

Avaliacao do conhecimento dos medicos ginecologistas/obstetras e pediatras do estado de Sao Paulo (regiao que abrange a DIR IX - 20 municipios) sobre aspectos gerais do uso do fluor / Assessment of the gynecologists/obstetricians and pediatricians' knowledge in Sao Paulo state (a region that encompasses the DIR IX - 20 towns) as for the general aspects of fluor use

Encontra-se no mercado nacional um leque de opcao de suplemento fluoretados indicados pelos fabricantes para gestantes. E assimilando uma nova postura preconizada por entidades cientificas quanto a indicacao e posologia dos compostos fluorados nos propomos avaliar a conduta e o conhecimento de...

Medicamentos huérfanos: propuesta para el establecimiento de un valor de prioridad para su clasificación / Orphan drugs: a proposal for the institution of a priority value for her classification

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A class of phase II designs with three possible outcomes.

In the Phase II design of Fleming (1982, Biometrics 38, 143-151), the possible outcomes are to reject H1:p less than or equal to p1 or to reject H2: p greater than or equal to p2, where p1 less than p2. The design is constrained by specifying that Pr(reject H1[p1) less than or equal to alpha and Pr(reject H2[p2) less than or equal to beta. This can lead to some ambiguity as to the appropriate practical decision at the end of the trial, as the confidence region for p may include a substantial part of the interval between p1 and p2. We propose a class of designs wherein an allowable outcome is not to reject either H1 or H2. An additional constraint is placed on the design by specifying Pr(reject Hj[pm) less than or equal to gamma (j = 1, 2), where p1 less than pm less than p2. This type of design can provide a more realistic basis for decision making following the trial, although traditional values of alpha and/or beta need to be viewed from a somewhat different perspective in order to maintain a reasonable sample size. Some optimal single-stage and sequential multistage designs are presented.

The registration and control of medicines in South Africa: legal issues.

In the provision of health care medicines occupy a central position, both at primary and more advanced levels. Sound medicines have the capability to control and prevent common diseases, and to alleviate suffering. People's confidence in the health services that are provided by the state and by the private sector (as the case may be) is influenced by their knowledge that the medicines that they receive are of good quality and proven efficacy and safety, and that they are continuously available at reasonable cost. A sound national policy for the provision of safe and cost-effective medicines needs to be based on several elements. The most important are: A sound pharmaceutical industry that is able to function in an atmosphere of confidence, with the knowledge that its efforts in support of the public health are understood and respected; and a drug regulatory authority that is trusted for its expertise, independence and integrity. This is as true for a country such as South Africa as it is for a fully industrialised country such as the United States. The regulation and control of medicines in South Africa falls under the aegis of the Medicines Control Council, a statutory body established in accordance with the Medicines and Related Substances Act. In terms of the Act, the council has the mandate to ensure that the medicines available to the South African public are safe, effective, and of high quality, and that their availability is in the public interest. In considering this, the council may take into account only the scientific data available.(ABSTRACT TRUNCATED AT 250 WORDS)