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Samenvatting vroege klinische ontwikkeling $5.04   Add to cart

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Samenvatting vroege klinische ontwikkeling

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Dit is een samenvatting over het deel van de vroege klinische ontwikkeling

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  • January 6, 2024
  • 5
  • 2023/2024
  • Summary
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Vroege klinische ontwikkeling
(Dreesen)
Exploratieve/fase 0/microdosis/snuffel studies
 Weinig niet-klinische data nodig  starten tijdens discovery fase
 1 of meerdere GM kandidaten
 Kleine schaal single-cohort studies in mensen
 Meestal in patiënten
 1 site
 Relatief goedkoop
 Flexibel design
 Subtherapeutische exposure  enkel om vroege informatie te hebben over PK, target
attainment, MoA, biomerker en PD  sneller met klinische trials beginnen
 Geen MTD bepalen
 Dosering
o Microdosis studies
 Extrapolatie lineair naar therapeutische dosis  onzekerheid over niet-lineaire
kinetiek  IVIVE nodig voor correctie
 Saturatie van metabole enzymes en/of transporters bij hoge dosis
 Te weinig saturatie van target bij lage dosis  target mediated drug
disposition (TMDD)
 Basis PK en bevestiging metabolisatie
 100 microgram approach: mag in meerdere keren + geen wash-out + single dose
toxiciteitstudie
 500 microgram approach: max 100 per keer + wash-out + repeated dose
toxiciteitstudie nodig
o Subtherapeutische dosis range
 Hogere dosis + geen washout
 Single dose toxiciteit in rodent en non-rodent
o Therapeutische dosis range
 Nog hoger + geen washout
 Meer klinische vereisten
 Analyse (voldoende gevoelig)
o 14C-gelabeld GM met AMS = plasma = invasief
o LC-MS/MS = plasma = invasief
o 11C of 18F-gelabeld GM net PET = niet-invasief (maar blootstelling aan straling)

Fase 1
o Veiligheid, verdraagbaarheid, PK en indien mogelijk PD
1. Risk assessment obv preklinische data (PK, selectiviteit, therapeutisch venster, …)
2. Plan voor klinisch ontwikkeling (advies van experten)

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