Second Edition Safety Pharmacology in Pharmaceutical Development Approval and Post Marketing Surveillance Second Edition Safety Pharmacology in Pharmaceutical Development Approval and Post Marketing Surveillance Shayne C. Gad Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2012 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20120320 International Standard Book Number-13: 978-1-4398-4568-4 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. 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CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Dedication To Novie Beth— for bringing so much light and joy to this life Contents Preface..................................................................................................................xi About.the.Author..............................................................................................xv Chapter 1 Safety pharmacology: Background, history, issues, and concerns ................................................................................1 1.1. General.versus.safety.pharmacology....................................................2 1.2. History........................................................................................................4 1.3. Reasons.for.poor.predictive.performance.............................................7 1.4. Why.tiers?..................................................................................................8 1.5. Study.designs.and.principles..................................................................9 1.5.1. Selection.of.methodology.and.species....................................9 1.6. Issues........................................................................................................12 1.7. Integral.versus.separate.........................................................................13 1.8. Summary.................................................................................................15 References..........................................................................................................15 Chapter 2 Regulatory requirements: ICH, FDA, EMA, and Japan .....19 2.1. Regulatory.requirements.......................................................................19 References..........................................................................................................23 Chapter 3 Principles of screening and study design ............................25 3.1. Introduction.............................................................................................25 3.2. Characteristics.of.screens......................................................................27 3.3. Uses.of.screens........................................................................................30 3.4. Types.of.screens......................................................................................32 3.5. Criterion:.Development.and.use..........................................................32 3.6. Analysis.of.screening.data....................................................................35 3.6.1. Univariate.data..........................................................................35 3.6.1.1. Control.charts...........................................................35 3.6.1.2. Central.tendency.plots............................................37 3.6.2. Multivariate.data......................................................................38 3.6.2.1. Analog.plot...............................................................39 3.7. Study.design............................................................................................41 vii viii Contents 3.7.1. Animal.model...........................................................................41 3.7.2. Group.size..................................................................................42 3.7.3. Statistical.design.......................................................................42 3.7.3.1. Dose.levels.and.test.concentrations......................42 References..........................................................................................................42 Chapter 4 Cardiovascular system .............................................................45 4.1. Introduction.............................................................................................45 4.2. History......................................................................................................45 4.2.1. Special.case.(and.concern)—QT.prolongation.....................45 4.2.1.1. Regulatory.developments.......................................47 4.2.2. Patch-clamp.studies.using.recombinant.cells. expressing.hERG.channels......................................................57 4.2.3. hERG.protein.expression.system............................................57 4.2.3.1. Relevance.of.hERG.to.QT.prolongation................58 4.2.3.2. Expression.and.recording.systems........................58 4.2.4. Cardiovascular.function.testing.............................................59 4.2.5. Conscious.rodent,.dog,.and.primate.telemetry.studies......64 4.2.5.1. Six-lead.ECG.measurement.in.the. conscious.dog...........................................................64 4.2.6. Systems.for.recording.cardiac.action.potentials..................65 4.2.6.1. Cloned.human.potassium.channels.....................65 4.2.6.2. Cardiac.action.potential.in vitro—Purkinje. fibers..........................................................................65 4.2.6.3. Monophasic.action.potential.in.anesthetized. guinea.pigs................................................................65 4.2.6.4. ECG.by.telemetry.in.conscious.guinea.pigs........65 4.2.6.5. Hemodynamics.and.ECG.in.anesthetized. or.conscious.dogs.or.primates...............................66 4.3. Summary.................................................................................................66 References..........................................................................................................66 Chapter 5 Central nervous system ...........................................................69 5.1. Core.battery.CNS.procedures...............................................................72 5.1.1. General.behavioral.observation.............................................72 5.1.2. Functional.observational.battery...........................................73 5.2. Rat.............................................................................................................74 5.2.1. Observational.assessments.....................................................74 5.2.2. Locomotor.activity....................................................................75 5.2.3. Motor.coordination..................................................................75 5.2.4. Pain.sensitivity..........................................................................76 5.2.5. Convulsive.threshold...............................................................76 5.3. Dog............................................................................................................77 5.3.1. Neurobehavioral.screen...........................................................77
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