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Therapeutic Innovation & Regulatory Science
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Patient recruitment and retention are arguably the greatest challenges to the timely execution of clinical trials. This is particularly true in the case of trials involving biosimilars and those focused on rare diseases. For biosimilars, recruitment success typically hinges on difficulty of access to reimbursement for the originator product and may be hindered by competition from studies with other biosimilars and those with new chemical entities. For rare diseases, recruitment success depends n...
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Over the past 20 years, there has been increasing interest in the use of Bayesian statistical methods for the analysis of clinical trials used to support regulatory decisions. Bayesian methods for the analysis of clinical trials are an attractive option when good prior information is available. Yet, in many cases, prior information is scarce and only tentative or proprietary prior information exists. In these situations, it is necessary to use noninformative type or skeptical-type priors. We und...
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Background Traditional clinical trials are often expensive, inefficient, include selected populations, and can create significant participant burden via travel and other logistical demands. Using new technologies and methodologies to promote a decentralized approach has the potential to improve the efficiency of clinical trials. The Clinical Trials Transformation Initiative (CTTI)—a public–private partnership to improve clinical trials—launched a multi-stakeholder Decentralized Clinical Trials (...
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Clinical guidelines for management of non-valvular atrial fibrillation or venous thromboembolism currently recommend direct oral anticoagulants as the preferred strategy for antithrombotic treatment. As a result, they are increasingly being used as an alternative to conventional therapy. However, they are unlikely to completely replace conventional approaches, due to a number of existing medical challenges. These challenges relate to the uncertainty of optimal dose regimens and the strategy of u...
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Background Research failures are one of the most significant costs associated with the estimated USD2.6 billion price tag and 12-year time frame to bring a drug from discovery to market. The European Commission estimates that USD0 billion are spent every year to develop innovations that have already developed elsewhere, highlighting the exorbitant cost of duplication. The competitive nature of the pharmaceutical industry is such that the voluntary sharing of information is not particularly fo...
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Patient information leaflets (PILs) differ across regulatory jurisdictions—its form and structure are dependent on the regulations it conforms to. Yet, physical or paper-based documents remain to be the most prevalent way of delivering important information to patients. As technology continues to enhance our daily activities, patients are increasingly utilizing digital platforms to facilitate access to relevant product information, hence questioning the continuous viability of physical PILs. Thi...
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Background In the breakthrough therapy designation (BTD) and Sakigake designation programs, rolling submission and close communication between applicants and regulatory authorities enable the timely access of patients to innovative medicines. However, challenges in the quality development, including chemistry, manufacturing, and control (CMC), are expected during the accelerated timeline. This study focused on development with quality by design (QbD) concept, shelf life of drug product, and post...
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Background FDA had been criticized for its slow review of new drugs. Critics complained of a “drug lag” from which US patients suffered when compared to Europeans. Since the advent of PDUFA, however, the FDA has demonstrated a possible slight advantage in review time when compared to the EMA.
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Implementation of the Generic Drug User Fee Amendments (GDUFA I) as part of the Food and Drug Administration Safety and Innovation Act of 2012 (Generic Drug User Fee Amendments. https://www.fda.gov/industry/fda-user-fee-programs/generic-drug-user-fee-amendments) successfully allowed the U.S. Food and Drug Administration (FDA) to modernize review of Abbreviated New Drug Applications (ANDAs) with goal dates. The goal of this study was to assess the success of GDUFA I in decreasing ANDA time to app...
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Randomized controlled clinical trials are the gold standard for evaluating the safety and efficacy of pharmaceutical drugs, but in many cases their costs, duration, limited generalizability, and ethical or technical feasibility have caused some to look for real-world studies as alternatives. On the other hand, real-world data may be much less convincing due to the lack of randomization and the presence of confounding bias. In this article, we propose a statistical roadmap to translate real-world...
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