15 January 2017 in Terapevticheskii arkhiv
The number of patients receiving statins increases every year and due to the fact that they should take statins during their lives, the problem of their safety use comes to the forefront. The paper analyzes the safety of using the medications of this group and discusses the diagnosis of myopathies induced by statins and the occurrence of immune-mediated statin myopathies. It considers a personalized approach to prescribing statins, analyzes Russian and foreign experience in using pharmacogenetics to reduce the risk of myopathies, publishes the results of the authors’ experience in clinically introducing pharmacogenetic testing at hospitals, and analyzes the long-term results of determining the polymorphism of the SLCO1B1 gene for the prediction of the risk of adverse events when using statins and estimating patient compliance to prescribed treatment.
28 August 2024 in Regulatory Research and Medicine Evaluation
INTRODUCTION. Irritable bowel syndrome (IBS) is a chronic functional disorder present in over 13% of the population. Despite the wide prevalence of IBS, there is currently a lack of well characterised authorised medicinal products to treat IBS. This situation stems from both poor engagement in the development of such medicinal products and the absence of sound approaches to their regulatory review. The intensification of drug development aimed at improving the safety and efficacy of IBS therapy in the context of the growing common pharmaceutical market of the Eurasian Economic Union (EAEU) requires guidelines for planning and conducting clinical trials of medicinal products for IBS.AIM. This study aimed to evaluate the possibility of using the methodological approaches described in international guidelines for the development of national recommendations for conducting clinical trials of medicinal products for IBS.DISCUSSION. The authors analysed the main provisions of the Guideline on the evaluation of medicinal products for the treatment of IBS by the European Medicines Agency (EMA). The analysis identified the methodological tools, the scope and stages of clinical trials, and the efficacy criteria for each study stage. The authors assessed the specific aspects of diagnosing IBS, which are considered when determining the effectiveness of therapeutic interventions. This review highlighted the need for the harmonisation of national and international methodological approaches to the evaluation of clinical trial results that would ensure more robust results of clinical trial reviews conducted in different countries. The authors determined the considerations for planning exploratory and confirmatory clinical trials, including the selection of endpoints, design, and duration of clinical trials in adults and children, as well as the sex distribution of the trial population.CONCLUSIONS. The EMA’s recommendations may guide the planning of clinical programmes for novel medicinal products for IBS. These recommendations may be applied by experts reviewing clinical trial results, as well as developers creating new medicinal products.