A Benefit-Risk Analysis Approach to Capture Regulatory Decision-Making: Multiple Myeloma.

A Benefit-Risk Analysis Approach to Capture Regulatory Decision-Making: Multiple Myeloma.
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DOI:
10.1002/cpt.871
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发表时间:
2018-01
影响因子:
6.7
通讯作者:
Woodcock J
Woodcock J
中科院分区:
医学2区
文献类型:
--
作者:
Raju GK;Gurumurthi K;Domike R;Kazandjian D;Landgren O;Blumenthal GM;Farrell A;Pazdur R;Woodcock J

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世界各地的药品监管机构根据定性的获益-风险分析来决定药品的可批准性。在这项工作中,定量获益-风险分析方法捕获了关于治疗多发性骨髓瘤(MM)新药的监管决策。MM评估基于终点,如至疾病进展时间(TTP)、无进展生存期(PFS)和客观缓解率(ORR),与基于总生存期(OS)的获益-风险分析不同。确定并分析了2003年至2016年期间提交给FDA的23项关于MM药物的FDA决定。相对于对照药物(通常为临床试验的对照组),量化获益和风险,以估计中位获益-风险是正还是负。使用ixazomib证明了敏感性分析,以探索不确定度的大小。使用该获益-风险框架,FDA批准决策结果是一致和合乎逻辑的。
Drug regulators around the world make decisions about drug approvability based on qualitative benefit-risk analysis. In this work, a quantitative benefit-risk analysis approach captures regulatory decision-making about new drugs to treat multiple myeloma (MM). MM assessments have been based on endpoints such as time to progression (TTP), progression-free survival (PFS), and objective response rate (ORR) which are different than benefit-risk analysis based on overall survival (OS). Twenty-three FDA decisions on MM drugs submitted to FDA between 2003 and 2016 were identified and analyzed. The benefits and risks were quantified relative to comparators (typically the control arm of the clinical trial) to estimate whether the median benefit-risk was positive or negative. A sensitivity analysis was demonstrated using ixazomib to explore the magnitude of uncertainty. FDA approval decision outcomes were consistent and logical using this benefit-risk framework.
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