DRUGS FROM DISCOVERY TO APPROVAL DRUGS FROM DISCOVERY TO APPROVAL Rick Ng, Ph.D. Biopharmaceutical Manufacturing Technology Centre Singapore @W IL EY-LISS A JOHN WILEY &SONS, INC., PUBLICATION Copyright 0 2004 by John Wiley & Sons, Inc. All rights reserved Published by John Wiley & Sons, Inc., Hoboken, New Jersey. Published simultaneously in Canada. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600, or on the web at www.copyright.com. 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RM301.25 .NS 2004 6 IS'. 19-dc22 2003020804 Printed in the United States of America. 10 9 8 7 6 5 4 3 To Cherry, Shaun and Ashleigh CONTENTS PREFACE xi CHAPTER 1 Introduction 1 1.1 Aim of this Book 1 1.2 An Overview of the Drug Discovery and Development 2 Process 1.3 The Pharmaceutical Industry 5 1.4 Economics of Drug Discovery and Development 10 1.5 Trends in Drug Discovery and Development 11 1.6 Further Reading 13 CHAPTER 2 Drug Discovery: Targets and Receptors 15 2.1 Drug Discovery Processes 16 2.2 Medical Needs 16 2.3 Target Identification 18 2.4 Target Validation 25 2.5 Drug Interactions with Targets or Receptors 26 2.6 Enzymes 30 2.7 Receptors and Signal Transduction 32 2.8 Assay Development 39 2.9 Further Reading 40 CHAPTER 3 Drug Discovery: Small Molecule Drugs 43 3.1 Introduction 44 3.2 Irrational Approach 44 3.3 Rational Approach 50 3.4 Antisense Approach 67 3.5 Chiral Drugs 68 3.6 Closing Remarks 70 3.7 Further Reading 73 CHAPTER 4 Discovery: Large Molecule Drugs 75 Drug 4.1 Introduction 76 4.2 Vaccines 77 4.3 Antibodies 85 vii Viii Contents 4.4 Cytokines 92 4.5 Hormones 97 4.6 Gene Therapy 99 4.7 Stem Cells 102 4.8 Further Reading 105 CHAPTER 5 Drug Development and Preclinical Studies 107 5.1 Introduction 108 5.2 Pharmacod ynamics 110 5.3 Pharmacokinetics 115 5.4 Toxicology 127 5.5 Animal Tests, In Vitro Assays and In Silico Methods 130 5.6 Formulations and Delivery Systems 132 5.7 Further Reading 138 CHAPTER 6 Clinical Trial 139 6.1 Definition of Clinical Trial 140 6.2 Ethical Considerations 140 6.3 Clinical Trials 144 6.4 Regulatory Requirements for Clinical Trials 147 6.5 Role of Regulatory Authorities 155 6.6 Gene Therapy Clinical Trial 156 6.7 Further Reading 156 CHAPTER Regulatory Authorities 159 7 7.1 Role of Regulatory Authorities 160 7.2 US Food and Drug Administration 161 7.3 European Agency for the Evaluation of Medicinal 166 Products 7.4 Japan’s Ministry of Health, Labour and Welfare 167 7.5 China’s State Drug Administration 168 7.6 Other Regulatory Authorities 169 7.7 Authorities other than Drug Regulatory Agencies 170 7.8 International Conference on Harmonization 171 7.9 World Health Organization 171 7.10 Pharmaceutical Inspection Cooperation Scheme 17 2 7.11 Further Reading 173 Contents iX CHAPTER 8 Regulatory Applications 175 8.1 Introduction 176 8.2 Food and Drug Administration 176 8.3 European Union 193 8.4 Japan 206 8.5 China 207 8.6 Further Reading 208 CHAPTER 9 Good Manufacturing Practice: Regulatory 211 Requirements 9.1 Introduction 212 9.2 United States 212 9.3 Europe 218 9.4 International Conference on Harmonization 218 9.5 Core Elements of GMP 222 9.6 Selected GMP Systems 232 9.7 The FDA's New cGMP Initiative 243 9.8 Further Reading 245 CHAPTER 10 Good Manufacturing Practice: Drug 247 Manufacturing 10.1 Introduction 248 10.2 GMP Manufacturing 250 10.3 GMP Inspection 252 10.4 Manufacture of Small Molecule APIs 259 10.5 Manufacture of Large Molecule APIs 267 10.6 Finished Dosage Forms 274 10.7 Further Reading 279 CHAPTER 11 Future Perspectives 281 11.1 Past Advances and Future Challenges 281 11.2 Small Molecule Pharmaceutical Drugs 282 11.3 Large Molecule Biopharmaceutical Drugs 285 11.4 Traditional Medicine 285 11.5 Individualized Medicine 287 11.6 Gene Therapy 288 11.7 Cloning and Stem Cells 289 11.8 Old Age Diseases and Aging 291 X Confenfs 11.9 Lifestyle Drugs 293 11.10 Performance-Enhancing Drugs 294 11.11 Chemical and Biological Terrorism 295 11.12 Transgenic Animal and Plants 297 11.13 Regulatory Issues 298 11.14 Intellectual Property Rights 299 11.15 Concluding Remarks 301 11.16 Further Reading 302 APPENDIX 1 History of Drug Discovery and Development 305 Al.l Early History of Medicine 305 A1.2 Drug Discovery and Development in the Middle Ages 308 A1.3 Foundation of Current Drug Discovery and 308 Development A1.4 Beginnings of Modern Pharmaceutical Industry 309 A1.5 Evolution of Drug Products 310 A1.6 Further Reading 311 APPENDIX 2 Cells, Nucleic Acids, Genes and Proteins 313 A2.1 Cells 313 A2.2 Nucleic Acids 315 A2.3 Genes and Proteins 321 A2.4 Further Reading 326 APPENDIX 3 Selected Drugs and Their Mechanisms of Action 327 APPENDIX 4 Pharmacology/Toxicology Review Format 329 ACRONYMS 335 GLOSSARY 339 INDEX 347 PREFACE This book is written as a basic framework to introduce the concepts and processes from drug discovery to marketing approval by regulatory authorities. It is particularly suitable for undergraduates pursuing courses in medicine, pharmacy, science and life sciences. Professionals in the pharmaceutical industry will find this book useful as a quick reference guide. There are eleven chapters: Chapter 1 provides a snapshot about the drug discovery and development processes, as well as the current status in the pharmaceutical industry. Chapter 2 describes the all-important steps in identifying disease targets and receptors for drug interaction and intervention. Chapter 3 explains the current technologies and methodologies for discovering new small molecule drugs. Chapter introduces the various large molecule drugs and the 4 methods for discovering and developing them. Chapter 5 summarizes the steps for drug development and preclinical tests. Chapter 6 details the processes and conduct of clinical trials with due respect for safety, risks and benefits. Chapter 7 describes the major drug regulatory authorities in selected countries such as the United States, European Union, Japan, China and some international organizations. Chapter 8 shows the basic procedures for applications to regulatory authorities for clinical trials and drug marketing approvals. Chapter 9 discusses the regulatory requirements for drug manufacture, with selected examples. Chapter 10 demonstrates the controls required to manufacture drugs that meet the regulatory requirements. Chapter 11 gives perspectives about the future events for drug discovery and development. Some background concepts are introduced in four appendices together with acronyms and glossary. xi
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