All posts by Web Team

4

EMA recommends suspension of medicines due to unreliable studies from Micro Therapeutic Research Labs

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The European Medicines Agency (EMA) has suggested suspending a number of nationally approved medicines for which bioequivalence studies were conducted by Micro Therapeutic Research Labs at two sites in India. Bioequivalence studies are usually the basis for consent of generic medicines. The list of medicines suggested for check can be found here. The deferrals can be lifted once alternative data establishing bioequivalence are provided.

Substitute supporting data have already been provided for several of the medicines studied. Therefore, the CHMP suggested that these medicines can remain on the market. The list of medicines recommended to remain on the market is available here.

The Agency also endorsed that medicines not yet authorized but which are being assessed on the basis of bioequivalence studies from these sites should not be authorized until bioequivalence is verified using alternative data.

Micro Therapeutic Research Labs is a contract research organization (CRO) which conducts the diagnostic and clinical parts of bioequivalence studies, some of which are used to support marketing authorization applications of medicines in the EU.

The review of medicines studied by Micro Therapeutic Research Labs was started after reviews to check amenability with good clinical practice (GCP) by Austrian and Dutch authorities in February 2016. The inspections identified several concerns at the company’s sites regarding misrepresentation of study data and deficiencies in documentation and data handling.

The review, by EMA’s Committee for Medicinal Products for Human Use (CHMP), determined that data from studies conducted at the sites between June 2012 and June 2016 are unreliable and cannot be accepted as a basis for marketing authorization in the EU. However, there is no indication of harm or lack of efficiency of medicines authorized and being assessed in the EU on the basis of studies at the sites.

Some of the medicines which have been suggested for deferral may be of critical importance in certain EU Member States. The CHMP’s approval concerning these medicines will now be sent to the European Commission for a legally binding decision valid throughout the EU.

Date: 24th March 2017

 

EU recommendations for 2017/2018 seasonal flu vaccine composition

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The European Medicines Agency has delivered the European Union (EU) commendations for the influenza virus strains that vaccine companies should include in vaccines for the inhibition of seasonal influenza from autumn 2017.

Every year, EMA’s ad hoc Influenza Working Group issues EU recommendations for the composition of seasonal influenza vaccines on the basis of interpretations by the World Health Organization (WHO). The recommendations for the influenza season 2017/2018 were endorsed by the Agency’s Committee for Medicinal Products for Human Use (CHMP) on 23 March 2017.

Trivalent vaccines for the 2017/2018 season should comprise these three virus strains:

  • an A/Michigan/45/2015 (H1N1)pdm09-like virus;
  • an A/Hong Kong/4801/2014 (H3N2)-like virus;
  • a B/Brisbane/60/2008-like virus.

For quadrivalent vaccines with two influenza B viruses, a B/Phuket/3073/2013-like virus in addition to the strains mentioned above is considered appropriate.

These recommendations also relate to the manufacturing of live mitigated influenza vaccines.

Dated: 24th March 2017

http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2017/03/news_detail_002720.jsp&mid=WC0b01ac058004d5c1

Use of big data to improve human and animal health

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The term big data refers to tremendously large sets of information which involve specific computational tools to enable their examination and exploitation. These data might come from electronic health records from millions of patients, genomics, social media, clinical trials or impulsive adverse reaction reports, to name just a few. The massive volume of data has the potential to contribute suggestively to the way the assistances and risks of medicines are evaluated over their entire lifecycle.

Together with the heads of the national competent authorities in the European Economic Area (EEA), known as Heads of Medicines Agencies (HMA), the European Medicines Agency (EMA) has established a new task force to explore how medicines regulators in the EEA can use big data to provision research, innovation and robust medicines development in order to benefit human and animal health.

The task force, chaired by the Danish Medicines Agency and EMA, is composed of experienced staff from medicines regulatory agencies in the EEA. Their efforts will be complemented on an ad hoc basis by external experts in big data collection analysis.

The group has agreed a number of actions for the next 18 months. These include:

  • planning foundations and features of big data;
  • exploring the potential applicability and influence of big data on medicines regulation and emerging endorsements on necessary changes to regulation, regulatory guidelines or data security requirements;
  • formation of a roadmap for the growth of big data aptitudes for the assessment of applications for marketing authorizations or clinical trials in the national proficient specialists;
  • Teamwork with other regulatory authorities and partners outside the EEA to consider their understandings on big data enterprises.

Dated: 23rd March 2017

http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2017/03/news_detail_002718.jsp&mid=WC0b01ac058004d5c1

Quality Payments: Calculate your SCR usage

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NHS Digital has circulated the Summary Care Record (SCR) usage calculator tool to support community pharmacy contractors in checking and aggregate their SCR usage.

The Quality Payments scheme, which measures each appropriate pharmacy against quality standards and awards points for each one fulfilled will be a key factor in incapacitating the pharmacy cuts.

Use of the Summary Care Record accounts for 10% of Quality Payments points over the year, meaning it could be worth up to £1,280 per pharmacy.

According to NHS England’s quality criteria regulation, pharmacists will need to meet the SCR quality criterion, which entails contractors to be able to validate on the day of the review, a total increase in access to SCR from period one to two.

For the 28 April 2017 review point, period one is from Monday 27 June 2016 to Sunday 27th November 2016; and period two is from Monday 28 November 2016 to Sunday 30 April 2017.

The calculator will show the number of times a pharmacy has viewed the SCR in period 1 and period 2. And will be updated every Thursday to show the latest figures.

Dated: 10th March 2017

http://www.thepharmacist.co.uk/news/latest-news/quality-payments-calculate-your-scr-usage/

 

European and US regulators agree on mutual acknowledgment of inspections of medicines manufacturers

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Officials in the European Union (EU) and the United States (US) have decided to start assessments of manufacturing sites for human medicines directed in their particular areas on both sides of the Atlantic.

The contract will enable both the EU authorities and the FDA to make better use of their assessment funds to help them to concentrate on other parts of the world where active pharmaceutical ingredients (APIs) and medicines for the EU or US markets are manufactured. This will ensure that patients can rely on the quality, safety and efficacy of all medicines, no matter where they have been produced. Around 40% of finished medicines marketed in the EU come from overseas and 80% of the manufacturers of APIs for medicines available in the EU are located outside the Union.

Each year, national proficient authorities from the EU and the US Food and Drug Administration (FDA) inspect many production sites of medicinal products in the EU, the US and elsewhere in the world, to certify that these sites operate in compliance with good manufacturing practice (GMP). Under the new agreement, EU and US regulators will rely on each other’s assessments in their own areas. In future, the need for an EU authority to inspect a site located in the US, or vice versa, will be partial to remarkable conditions.

In the EU, inspections of manufacturing sites are carried out by national proficient authorities from EU Member States. The European Medicines Agency plays an important role in directing these activities in association with Member States.

The contract is reinforced by strong evidence on both sides of the Atlantic that the EU and the US have comparable regulatory and procedural frameworks for inspections of manufacturers of human medicines. Teams from the European Commission, EU national competent authorities, EMA and the US FDA have been auditing and evaluating the respective managerial systems since May 2014, and have worked closely together to reach this agreement.

The agreement is an extension to the EU-US MRA which was signed in 1998 but is not yet executed. Many provisions of the agreement have already entered into force and others will enter into force on November 1, 2017. By that date, the EU will have completed its valuation of the FDA and the FDA is likely to have accomplished its valuation of at least eight EU Member States, and will be progressively prolonged to all Member States.

Dated:2nd March 2017

 

SGLT2 inhibitors: information on potential risk of toe abstraction to be included in prescribing information

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The European Medicines Agency (EMA) is informing about a potential increased risk of lower limb amputation in patients taking the SGLT2 inhibitors canagliflozin, dapagliflozin and empagliflozin used for type 2 diabetes.

Patients taking these medicines are reminded to check their feet regularly and follow their doctor’s advice on routine precautionary foot care. They should also tell their doctor if they notice any wounds or discoloration, or if their feet are tender or painful.

The review of SGLT2 inhibitors was impelled by an increase in lower limb amputations (mostly affecting the toes) in patients taking canagliflozin in two clinical trials, CANVAS and CANVAS-R. The studies, which are still ongoing, involved patients at high risk of heart problems and matched canagliflozin with placebo (a dummy treatment).

All patients with diabetes (especially those with poorly controlled diabetes and problems with the heart and blood vessels) are at higher risk of infection and ulcers (sores) which can lead to amputations. The mechanism by which canagliflozin may increase the risk of amputation is still unclear.

A rise in lower limb amputations has not been seen in studies with other medicines in the same class, dapagliflozin and empagliflozin. However, data available to date are limited and the risk may also apply to these other medicines.

Further data are anticipated from ongoing studies with canagliflozin, dapagliflozin and empagliflozin.

A warning of the potential increased risk of toe amputation will be included in the recommending information for these medicines. For canagliflozin, the commending information will also list lower limb amputation as an uncommon side effect (occurring in between 1 and 10 patients in 1,000). Doctors may consider stopping treatment with canagliflozin if patients develop significant foot complications such as infection or skin ulcers.

The review of SGLT2 inhibitors was approved out by EMA’s Pharmacovigilance Risk Assessment Committee (PRAC). The PRAC approvals have now been certified by the Committee for Medicinal Products for Human Use (CHMP), and will be sent to the European Commission for a final legally-binding decision valid throughout the EU.

Dated: 24 Feb 2017

http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2017/02/news_detail_002699.jsp&mid=WC0b01ac058004d5c1

First monoclonal antibody in veterinary medicine suggested for a marketing authorization

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At its February meeting, the European Medicines Agency’s (EMA) Committee for Medicinal Products for Veterinary Use (CVMP) suggested the permitting of a marketing authorization in the European Union (EU) for Cytopoint. This is a solution for injection containing the new active substance lokivetmab, the first monoclonal antibody in a veterinary medicine in the EU. It is proposed for the treatment of dogs with atopic dermatitis, a common allergic skin disease.

A monoclonal antibody (mAb) is an immune protein that identifies and impasses to a definite target protein. Lokivetmab is a caninised mAb developed by biotechnology that specifically targets and constrains canine interleukin-31 (IL-31), an immune protein that plays an important role in atopic dermatitis.

In dogs with this disease, the immune system reacts improperly when the animal comes in contact with allergens found in the environment causing itchy skin. Once the dog’s skin gets damaged by scratching and rubbing, secondary bacterial and yeast infections may develop as well.

The effectiveness of this medicine was assessed in a number of controlled laboratory and clinical studies. The data showed that treatment with Cytopoint reduced itching and the severity of skin disease in dogs receiving the medicine at the proposed dose of 1 mg/kg.

Cytopoint starts working within eight hours after administration and the effect lasts for up to 28 days. It comes in four different dosage forms (10, 20, 30 and 40 mg/ml) for administration to dogs of varying bodyweight.

http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2017/02/news_detail_002696.jsp&mid=WC0b01ac058004d5c1

Dated: 17th Feb 2017

 

Over 1,000 Studies Now Recorded In EU Register Of Post-Authorization Studies

By | UK Pharma | No Comments

The EU PAS Register gives an affluence of information on the safety and value of authorized medicines. It is a cooperatively available podium with information on post authorization research in medicines already marketed in Europe and comprises study etiquettes, study results, related publications and other appropriate and significant information.

The 1,000th study has been uploaded in the European Union (EU) electronic Register of Post-Authorization Studies (EU PAS Register).

The information in the EU PAS Register reduces publication bias[i] (A type of bias that occurs when the outcome of a study influences the decision whether to publish or otherwise allocate it) through improved transparency of medicines research, improves the quality of post-authorization studies by enabling peer-review of protocols and results, simplifies association among stakeholders, and ensures passivity with EU pharmacovigilance legislation necessities.

The majority of studies in the EU PAS register are non-interventional, meaning the assignment of the patient to a therapeutic strategy is not decided in advance by a trial protocol but falls within existing medical practice [ii] (The assignment of the patient to a particular therapeutic strategy in a clinical trial is decided in advance and does not fall within normal clinical practice) and the treatment of the medicine is clearly separated from the decision to include the patient in the study.

These studies complement the evidence generated through the clinical development programme supporting the initial marketing consents of a medicine. They provide valuable perception into the use of a medicine in normal clinical practice and are essential in fully characterizing the safety and effectiveness profile once it is marketed and throughout its life span.

Regulators across the EU boost the registration of all non-interventional post-authorizations studies, regardless of who initiates, manages or finances them. Companies must register all non-interventional post-authorizations safety studies (PASS) forced by regulators. They are stimulated to register PASS requested to obtain further information on a medicine’s safety, or to measure the effectiveness of risk-management measures.

The EU PAS Register was developed through the European Network of Centre for Pharmacoepidemiology and Pharmacovigilance

http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2017/02/news_detail_002692.jsp&mid=WC0b01ac058004d5c1

Supporting high-quality clinical research in children through strengthened international collaboration

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The European Network of Pediatric Research at the European Medicines Agency will hold its ninth annual workshop on 16 May 2017 in London, UK. The main objective of the workshop is to bring important stakeholders together to discuss necessities, hurdles and prospects for high-quality clinical studies in children.

Among the highlights of this year’s workshop are the current struggles to maximize collaboration between the European Union and the United States to facilitate global pediatric trials and medicine developments.

The first day of the workshop will be open to all stakeholders comprising:

  • Patients/parents
  • Organizations,
  • Regulators
  • Enpr-EMA network representatives
  • Academia
  • Clinical investigators and representatives from the pharmaceutical industry for pediatric studies.

Participants will hear about Enpr-EMA’s activities to substitute high-quality research in pediatric medicine and will be invited to share their views on the successes made so far and the way forward.

Registration for the first day of the workshop is open until 28 April 2017.

The second day of the workshop is kept for discussions among the members of Enpr-EMA and the Enpr-EMA organizing group. The organizing group will define significances for 2017-2018 based on the feedback received from stakeholders.

Enpr-EMA was set up to help the conduct of clinical studies in children. It is an umbrella network of 39 national and international networks known for their experience in pediatric research. It acts as a platform for sharing good practices.

Dated :9TH Feb 2017

 

Clinical data for two more medicines now available online

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The European Medicines Agency (EMA) has published clinical data for two further medicines on its clinical data website. This leads to the launch of the website on 20 October 2016 and is in link with the Agency’s policy on the publication of clinical data.

These are the first clinical data published supporting an application that was consequently reserved. The clinical data for Aripiprazole Mylan relate to a withdrawn application for a marketing approval for a generic product to treat schizophrenia, and to stop and treat moderate to severe manic episodes in patients with bipolar I disorder.

Palonosetron Hospira is a generic product designated to stop nausea and vomiting initiated by chemotherapy.

Both medicines have been evaluated mentioning to information available on the effectiveness and protection of their active materials present in the respective sanctioned ‘reference medicines’. For more information on generic medicines see Questions and answers on generic medicines.

In future, the Agency will publicize clinical data publication under this policy on its commercial website on a case-by-case basis only. EMA will continue to highlight the publication of new clinical data on its clinical data website.

 

Dated: 1st Feb 2017