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上市后的监测创新与药物警戒(第二部分)

Innovation in Post-Launch Surveillance and Pharmaco-Vigilance (Part Two)
课程网址: http://videolectures.net/mitworld_kohane_zariffa_glaser_lutter_ha...  
主讲教师: John Glaser; Névine Zariffa; Isaac Samuel Kohane; Haas Joanna F; Randall Lutter
开课单位: 麻省理工学院
开课时间: 信息不详。欢迎您在右侧留言补充。
课程语种: 英语
中文简介:
这些小组成员描述了他们努力改变药物安全方法的过程,同时承认在涉及药物副作用的麻烦事件发生后需要重新获得公众信任。Né;Vine Zariffa指出,“人类所知的任何临床试验项目都无法帮助预测在广阔的世界中可能发生的每一件事情的每一个实例。”但是,她想,“我们能做些什么更好地将我们在临床试验过程中发现的与现实世界中发生的事情联系起来?”“一个想法:一个生物医学信息中心SWAT小组负责处理FDA药物警报。John Glaser报告说:“整个国家的进展缓慢,但正朝着以电子方式获取患者记录、成像信息,甚至基因组和蛋白质组数据的方向发展。”Partners Healthcare拥有330万人的临床数据存储库,从学术医疗中心到社区医院。这种数据库可以帮助跟踪“一致的药物相互作用”,并在副作用明显时通知有风险的患者。“即使你认为药物审评人会看报纸的账目,如果他们更关注药物安全,审查时间会不会变慢?”答案是否定的,兰德尔·卢特宣称。他说,美国食品和药物管理局并没有放慢审批时间来安抚担忧的公众,也没有牺牲科学来取悦那些渴望药物快速审批的制造商。相反,该机构关心的是,在药物包装上市时得到准确的警告,并提前向公众传播信息。Johanna Haas说,在60年代早期,当沙利度胺的使用与严重的先天畸形有关时,立法导致了安全规则的改变:“公司有责任证明药物应该上市,而不是向FDA证明它不应该上市。”现在,一种后万络模式正在出现,当这种模式下药品生产商正试图追踪大量人群中的细微副作用。唯一的解决办法是建立从最早的临床试验到药物上市的数据库。“你要做的事情会随着时间的推移而发展。您不希望忘记它,并将其塞进临床研究报告中,直到后来它成为公共政策问题时才会被忘记,您会说,“嗯,好奇”。
课程简介: These panelists describe struggling to transform their approach to drug safety, while acknowledging the need to regain public trust after troubling episodes involving drug side effects. Névine Zariffa points out that “no clinical trial program known to man will ever help predict every single instance of everything that might happen in the big, wide world.” But, she wonders, “What can we do better to link up what we discover through the clinical trial process relative to what happens in the real world?” One idea: a Center for Biomedical Information SWAT team to deal with FDA drug alerts. “The whole country is moving slowly, but moving” toward capturing patient records, imaging information, and even genomic and proteomic data electronically, reports John Glaser. Partners HealthCare holds a clinical data repository for 3.3 million people, from academic medical centers to community hospitals. This kind of database may help track “consistent drug interactions” as well as notify patients at risk when a side effect becomes apparent. “Even if you think that drug reviewers look at newspaper accounts, if they focus more on drug safety, wouldn’t that slow review times? The answer is no,” claims Randall Lutter. He says that the FDA has not slowed approval times to appease a worried public, nor has it sacrificed science to please manufacturers eager for rapid drug approval. Rather, the agency’s concerned with getting accurate warnings on drug packages at the time of their launch, and disseminating information earlier to the public. In the early 60s, says Johanna Haas, when the use of Thalidomide was linked to terrible congenital deformities, legislation resulted that transformed the safety rules: “The onus shift(ed) to the company to prove the drug should be marketed, rather than to the FDA to prove it shouldn’t.” Now, a post-Vioxx paradigm is emerging, where drug makers are trying to track subtle side effects in enormous populations. The only answer is to set up databases running from the earliest clinical trials through the drug’s launch. “You take something that’s going to evolve over the course of years. You don’t want it forgotten and tucked into a clinical study report that’s forgotten until it emerges as a public policy issue later on and you say, ‘Hmm, curious.’”
关 键 词: 临床试验程序; 蛋白质组数据电子化; 公共政策问题
课程来源: 视频讲座网
最后编审: 2019-11-22:cwx
阅读次数: 58