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Clinical Trials

Clinical Development – Testing of new investigational compounds in humans is done in stages in order to maximize benefit and minimize harm to patients. All stages of the process are conducted in close communication with the FDA or other appropriate regulatory agencies that have oversight of the final drug approval.

  • Phase I Clinical Trials – First exposure of humans to the Development Compound. These safety studies provide evidence of patients’ tolerance for escalating doses of administered drug and are meant to carefully monitor the appearance of adverse side effects. Trial protocols are often designed to gain insights into the drug’s PK and PD profiles in patients. Any evidence of activity and efficacy are also noted to help guide the selection and treatment of patients in later stage clinical trials.
  • Phase II Clinical Trials – Designed to demonstrate the drug’s effectiveness in the selected patient population, to fine tune final drug dose and administration regimen and to determine appropriate remedies for common adverse side effects that may be encountered. At times, studies are designed as Phase IIA to specifically determine dosing requirements or Phase IIB where efficacy is measured.
  • Phase III Clinical Trials – Large, well controlled studies to demonstrate clear efficacy when drug is administered at optimal dose and regimen. Often conducted in a randomized and blinded fashion, these studies require treatment of a large number of patients in order to demonstrate a statistically significant benefit attributed to the new drug as compared to either standard of care or placebo control. Upon approval of a new drug, Phase III trials are also employed to expand the use of the drug for new indications.
  • Phase IV Clinical Trials – At times requested by the FDA or initiated by the sponsoring company for competitive or marketing reasons, these studies are conducted post launch for surveillance of safety and to support ongoing use of a new drug. Because large numbers of patients in the general population are exposed to the drug for extended periods of time, adverse side effects that are rare or are associated with long term use of the drug may become apparent as a result of these Pharmacovigilance studies.

New Drug Application – Upon completion of the appropriate testing in human clinical trials, a New Drug Application (NDA) is filed with the FDA. The goal of the NDA is to ensure that enough information is provided for the FDA to determine whether the new drug is safe and effective and the benefits outweigh risks associated with its use. In addition, the FDA will determine if the product label and packaging insert are sufficient and appropriate and that the manufacturing process is adequately robust to maintain the new drug’s identity, strength, quality and purity.

NEED – ACCELERATED DEVELOPMENT

LINKS
FDA, Food and Drug Administration http://www.fda.gov/
CEDR, Center for Drug Evaluation and Research http://www.fda.gov/cder/

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