The approval center of the State Administration issued the draft for technical r

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The approval center of the State Administration issued the draft for technical requirements for conformity evaluation of quality and efficacy of chemical injection generic drugs (special injection)

Technical requirements for consistency evaluation of quality and efficacy of chemical injection generic drugs (special injection)
November, 2019
Technical requirements for consistency evaluation of quality and efficacy of chemical injection generic drugs (special injection)
Special injection means that compared with ordinary injection, the quality of special injection and the in vivo behavior of its active ingredients are greatly affected by the prescription and process, which may further affect the safety and effectiveness of the preparation in vivo, such as liposome, intravenous milk, microspheres, suspension injection, etc.
 
In principle, the chemical generic drugs for special injections shall meet the requirements of technical requirements for evaluation of consistency of quality and efficacy of generic drugs for chemical injections. This document is a supplement on this basis, aiming to put forward the overall thinking and general principles for the research and development of generic drugs for special injections and provide technical guidance for the research and development of generic drugs for special injections.
I. overall consideration
 
For special injections, due to the complexity of the preparation characteristics, we should take a step-by-step comparative study strategy based on the preparation characteristics and product characteristics. First, we should carry out the pharmaceutical and non clinical comparative study of the test preparation and the reference preparation, then we should carry out the bioequivalence study of human body, and if necessary, we should carry out further clinical study. If the results of pharmaceutical research and / or non clinical research indicate that the test preparation is inconsistent with the reference preparation, the applicant shall carry out the research again after further optimization of the prescription process of the test preparation.
 
2. Pharmaceutical research
 
According to the technical requirements for the consistency evaluation of quality and efficacy of generic drugs for chemical injections, the consistency evaluation of special injections should not only carry out research according to the above technical requirements, but also scientifically design tests according to the characteristics of special injections and the relevant technical requirements of special preparations issued by FDA and EMA. It is suggested to pay attention to the following issues:
(I) prescription process
 
In principle, the formulation should be consistent with the reference preparation. It is suggested to study the type of excipients and CQA of excipients that may affect the behavior of the injection in vivo.
 
The production process of special injections may affect the behavior of the drug in vivo, which needs to be further studied; for special injections produced by aseptic process, special attention should be paid to the aseptic assurance measures and verification of each production step.
 
In principle, the production process and batch size of registered batch and commercial batch shall be consistent. The batch of registered batch samples shall be implemented in accordance with the general requirements for the production scale of registered batch of chemical generic drugs (Trial).
 
(II) quality research
 
The key quality attributes examined may include, but are not limited to, the following: physical and chemical properties (such as properties, viscosity, osmolarity molar concentration, pH / pH value, etc.), zeta potential, particle shape, particle size and distribution (such as D10, D50, D90, etc.), dissolution / release behavior in vitro, dissociation and combination of drugs, drug crystal form and crystal form.
 
In principle, the quality comparison and inspection data of at least three batches of reference preparation samples shall be provided.
 
(III) consideration of human bioequivalence study / clinical trial
 
Human bioequivalence studies and / or clinical trials should be conducted using commercial batches of samples.
 
For specific injection varieties for which FDA or EMA has published guidelines, it is recommended to carry out a comparative study with the reference preparation according to its technical requirements.
III. non clinical research
 
Different from ordinary injections, special injections usually have factors such as drug release process and absorption of body fluid components after entering the body. Therefore, differences in the formulation and process of the test preparation and the reference preparation may lead to changes in pharmacokinetic behavior in the body, resulting in changes in effectiveness and toxicity. However, the in vitro comparative study of pharmacy alone is not enough to fully reflect the test preparation The difference of behavior between the preparation and the reference preparation. Based on the above considerations, before carrying out human bioequivalence study or clinical trial, appropriate animal species and genera should be selected for non clinical pharmacokinetic comparative study, so as to fully indicate the consistency of pharmacokinetic behavior in vivo and / or distribution in pharmacodynamic / toxic targets of the test preparation and the reference preparation.
 
In view of the fact that only the drug released from the preparation can play an active role in the body, it is recommended to determine the concentration of the loaded drug and the released drug respectively when determining the blood drug concentration.
 
IV. clinical research
 
The clinical study can only be carried out on the basis of the pharmaceutical and non clinical consistency between the test preparation and the reference preparation. In clinical research, we should adopt the step-by-step research strategy. We should first study the bioequivalence of human body and carry out further clinical research if necessary.
(I) study on bioequivalence of human body
 
A study method of bioequivalence of human body was established. General requirements and test design can refer to the technical guidelines for bioequivalence research of chemical generic drugs in human body with pharmacokinetic parameters as the end point evaluation index and the statistical guidelines for bioequivalence research and other relevant guidelines. The specific research suggestions are as follows:
 
Study design: randomized, single dose, crossover study design is usually used. Under special circumstances, a reasonable research design should be selected based on the characteristics of drugs and the population with indications.
 
Subjects: usually healthy subjects. When the selected healthy subjects may face safety risks when participating in the trial, it is recommended to select the patients with the proposed indications of the trial drug.
 
Sample size: the number of selected subjects should make the bioequivalence evaluation have enough statistical effect.
 
Test substance: if the active substance of a special injection has multiple forms at the same time in vivo, the bioequivalence research should fully consider the influence of various forms of drugs on the safety and effectiveness, and select a scientific and reasonable test substance based on the characteristics of drugs. The detection method needs to be fully validated, and has enough discrimination for the target detection substance, and has enough sensitivity for the difference between the test preparation and the reference preparation.
 
Bioequivalence evaluation index: auc0-t, auc0 - ∞, Cmax geometric mean, geometric mean ratio and 90% confidence interval of the test preparation and reference preparation shall be provided. Under special circumstances (such as microspheres, etc.), it may be necessary to add some exposure indicators to observe the early exposure or the exposure in a specific period.
 
Acceptance criteria of bioequivalence: generally, for the main endpoint index, the 90% confidence interval value of the ratio of geometric mean of the above parameters shall not be less than 80.00% and not more than 125.00%.
 
Pre test: before the formal test, the pre test can be carried out in a few subjects to verify the analytical method (including the partition force of the test substance), evaluate the degree of variation, optimize the sampling time, and obtain other relevant information. The data from the pre-test cannot be included in the final statistical analysis.
 
Other:
 
When applying for registration, in addition to meeting the current requirements of relevant application materials, the scientific rationality of relevant key issues shall be fully demonstrated based on product characteristics, including but not limited to test design, subject selection, sample size, test substance, bioequivalence evaluation index, etc.
 
The study on bioequivalence of human body with pharmacodynamic index as the end point evaluation index shall be carried out according to relevant guidelines.
 
In case of special circumstances, it can communicate with the regulatory authority in advance.
(II) randomized controlled clinical trial
 
Whether a randomized controlled clinical trial is necessary or not should be determined based on the characteristics of the drug and the results of previous studies on pharmacy, non clinical and human bioequivalence. If the results of bioequivalence study show that the test preparation is not equivalent to the reference preparation, the applicant shall further optimize the formulation process of the test preparation and carry out a comparative study again.
 
For the following cases (not limited to), it is recommended to carry out a randomized controlled clinical trial to prove the equivalence of the test preparation and the reference preparation:
 
(1) there is no accurate and reliable method for the determination of biological samples, so it is impossible to evaluate the bioequivalence of the test preparation and the reference preparation through the bioequivalence study.
 
(2) the results of bioequivalence study showed that there was a difference between the test preparation and the reference preparation, and it was not sure whether the difference would have a significant impact on the safety and effectiveness of the drug.
 
(3) the correlation between the drug concentration in the systemic circulation and the efficacy or safety is poor, and the human bioequivalence study is not enough to evaluate the efficacy and safety of the test preparation and the reference preparation.
 
It is recommended to communicate with the regulatory authorities in advance about the implementation of clinical trials.