PHASES OF CT Flashcards

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1
Q

what do you need to do before CT?

A

sponsor must file an IND with the FDA

  • IND must include results from pre-clinical studies
  • must wait 30 days before starting studies in human
  • INDs must be updated manually
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2
Q

what is the purpose of phase 1?

A

first-in-human study purpose :

  • to determine the metabolic and pharmacologic action (ADME) of the drug in humans
  • asses the adverse effects associated with different doses
  • get an indication of the efficacy of the IP
  • PRIMARY CONCERN : safety and not efficacy of IP
  • permit designing safe, well-controlled, sceintifically sound phase 2?
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3
Q

characteristics of phase 1?

A
  • short duration
  • small group of healthy volunteers
  • very closely monitored
  • not randomized ; everybody receives the active compound
  • often done in special testing facilities
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4
Q

what is randomisation?

A

The process of assigning trial subjects to treatment or control groups using an element of chance to determine the assignments in order to reduce bias
- include control group and treatment groupS

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5
Q

what is stratification?

A

Categorizing subjects into subgroups by

specific characteristics

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6
Q

what is the purpose of Phase 2?

A
  • To determine whether or not the IP demonstrates efficacy for the indication within the safe dose range established in phase I
  • asses the risks and short term adverse effects
  • safety will still be the primary concern
    PHASE IIA : asses dosing requirements
    PHASE IIB : study efficacy
  • dose ranging finding ; establish a min and max effective dose
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7
Q

characteristics of Phase 2?

A
  • rigid and well-controlled studies
  • small patient population ; less than a few hundreds
  • subjects have the targeted disease but no other illnesses
  • consists of double-blind studies using a placebo or comparator drug or both
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8
Q

what is binding?

A

aka masking :
A procedure in which one or more parties to the
trial are kept unaware of the treatment
assignment
SINGLE-BLIND : Subjects being unaware of the treatment assignment
DOUBLE-BLIND : subjects, invs, monitor/CRA being unaware of the assignments

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9
Q

what is control?

A

used as a reference aka comparator
- Active compound : another market drug or diff dose of drug under the study
Placebo : A preparation which is pharmacologically inert but do not have any therapeutic effect

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10
Q

when does phase 3 starts?

A

data generated in phase 1 and 2 must show satisfactory safety profile and have sufficient evidence of efficacy

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11
Q

what is the purpose of phase 3?

A
  • demonstrate the long-term safety and efficacy needed to assess the risk/benefit relationship of the drug and to provide adequate data for the product package insert
  • compare new treatment against standard
    treatment
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12
Q

characteristics of phase 3?

A
  • expanded, randomized, controlled studies
  • large patient populations
  • The patient population represent the types of patients the compound is intended to treat after it is marketed
  • may extend to several years
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13
Q

Phase 3a?

A

Phase 3a : conducted after efficacy of the drug
is demonstrated but prior to regulatory
submission
- patients with targeted disease
- generate additional safety and efficacy data
- may conduct in special patient groups
- provide info needed for the package insert and labelling of the medicine

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14
Q

Phase 3b?

A

conducted after regulatory submission but before approval and launch of drugs
- gather additional safety data, additional indications for the drug or to assess it’s use in special patient populations

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15
Q

when does phase 4 starts?

A

Done after the approval of NDA (Post-Marketing Trial)

- to determine additional information about the safety or efficacy profile of the compound

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16
Q

what is included in phase 4?

A
  • studies required as a condition of approval by the FDA
  • long term safety studies required by FDA
  • studies comparing ip with other marketed drugs
  • studies designed to familiarise physician with the compound
  • provide further detail about the medicine’s efficacy and safety profile
  • diff formulations, dosages, duration of treatment and drug interaction may be evaluated
17
Q

what happens if a marketed medicine is to be evaluated for a new indication?

A

trials will be considered phase 2 trials

18
Q

key things?

A
  • Phase I studies are small safety studies, usually done in healthy volunteers
  • Phase II studies are usually the first studies in patients with the disease or condition of interest
  • Phase III studies are large, comprehensive safety and efficacy trials
  • Phase IIIB studies are those being done during the time the compound is in the FDA review cycle
  • Phase IV studies are done after approval of approval of the compound
19
Q

what is randomized control trials?

A

Are comparative studies with an intervention group and a control group
- most rigorous way of determining whether cause-effect relation exists and the cost effectiveness of a treatment

20
Q

advantages of RCT?

A
  • removes the potential of bias in the allocation of participants to the intervention group or control group
  • the variables and other characteristics of the participants will be evenly balanced between the intervention and control group
  • Validity of statistical tests of significance is
    guaranteed
21
Q

impt features in RCT?

A
  • random allocation to intervention groups
  • All intervention groups are treated identically except for the experimental treatment
  • Patients and trialists should remain unaware of which treatment was given until the study is completed
22
Q

attributes of a proper randomisation scheme?

A
  • Assignment remains unknown to the patient, doctor and the clinic staff until it is needed for treatment initiation
  • future assignments cannot be predicted from past assignment
  • order of allocation is reproducible
  • method of generation is documented
  • method of generations provides clear audit tracking
23
Q

disadvantages of RCT?

A
  • limited by ethical and practical concerns

- more costly and time consuming