Regulatory Class - Sept 26 Flashcards

1
Q

Focus of FDA review of NDAs

A

Safe and effective, when used as labeled

Manufacturing consistency - preserve identity, strength, quality, and purity

Must contain substantial evidence from adequate and well-controlled investigations

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2
Q

“Adequate and well-controlled” Studies

A

Clear statement of objectives
Summary of methods of analysis
Study design that permits valid comparison with control
Selection assures subjects have disease/condition
Methods of assignment to minimize bias

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3
Q

Using only foreign clinical data

A

Population must be applicable to US
Done by qualified clinical investigators
FDA is able to validate data

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4
Q

Proprietary name

A

Name used to market the product

Includes: Primary and secondary choices, pronunciation, where it was derived, and pharmacological meaning

Reviewed to minimize risk, and prevent overstate of efficacy or superiority claims

Reviewed as early as end of Phase II; Reviewed 90 days prior to action date (FDA gets 180 days if submitted with IND)

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5
Q

Establishment registration

A

Information used to prepare inspections

Includes listing of all drugs in commercial distribution (if company already produces drugs, just add it to the listing)

Must be done prior to the production of final drug product

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6
Q

Labeler code assignment

A

National drug code (11-digit) provided to US drugs
First 4-5 digits are assigned by FDA - identify the labeler
Remaining digits assigned by manufacturer - identify product codes

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7
Q

Pre-NDA meeting

A

Type B meeting
4-6 months prior to anticipated submission date
Submit request 60 days prior to desired meeting date
Briefing package at least 4 weeks prior to meeting
Present clinical data to be submitted
Discuss format submission

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8
Q

NDA Patent Information

A

Submit information to verify that the sponsor has all the rights necessary to legally manufacture and sell the drug

Includes drug substance, drug product, and method-of-use

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9
Q

Debarment certification

A

Sponsor did not use services of anyone debarred by FDA

Debarred investigators may not receive investigational product

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10
Q

NDA Index

A

First document that should be made in creating the NDA

Use as an outline for the final submission

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11
Q

FDA Form 3454

A

Financial Certification

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12
Q

FDA Form 3455

A

Financial Disclosure

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13
Q

Labeling contents

A

Container / carton labels
Proposed package insert, includes an annotated version (links to special info in the submission) and a final ‘clean’ draft version

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14
Q

Package insert includes highlights of prescribing info:

A
Product names
Boxed warning
Recent major changes
Indication and usage
Dosage and administration
Dosage forms and strengths
Contraindications
Warnings and precautions
Adverse reactions
Drug Interactions
Use in specific population
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15
Q

Package insert - full prescribing info:

A
Includes all topics in the highlights and:
Drug abuse and dependence
Overdosage
Clinical pharmacology
Nonclinical toxicology
Clinical studies
References
How supplied/ storage and handling
Patient counseling info
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16
Q

Boxed Warnings

A

put on products that have a special risk

mainly used to inform physicians

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17
Q

NDA: Clinical Data: Other studies and information section

A

Any clinical info relevant to safety and effectiveness
List of countries where drug is approved
List of countries where drug has been disapproved or withdrawn from marketing

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18
Q

Integrated summary of effectiveness

A

included for each indication
Supports dosage and dose interval recommended in product labeling

Compare and analyze all results from controlled trials; address drug-demographic, drug-drug, and drug-disease interactions; describe any evidence of longterm effectiveness, tolerance, and withdrawal effects

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19
Q

Integrated summary of safety

A

safety data from all sources - including animal data, clinical studies, and foreign marketing experience
Adverse events from all studies

Analysis of clinical lab data, evaluating abnormalities; discussion of drug-drug interactions

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20
Q

Safety update reports

A

New safety data that could affect labeling, contraindications, warnings, precautions, AEs

Submitted 4 months after the initial submission if requested by the FDA

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21
Q

Pediatric use information

A

Requires: Safety and efficacy info; for proposed indications for use; all relevant pediatric populations, dosing and administration info

May be deferred if drug ready for approval before completing pediatric studies or they are delayed until additional safety or effectiveness data are collected

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22
Q

Pediatric use Exceptions for requirement

A

No meaningful therapeutic benefit over existing treatments
Not likely to be used in a substantial number of pediatric patients
Necessary studies are impossible or highly impractical
Evidence suggests drug would be ineffective or unsafe in all pediatric age groups
Orphan drugs

Or is reasonable attempts to produce a pediatric formulation have failed

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23
Q

NDA: Case report form tabulations

A

Must be provided for each patients from all Phase 2 and Phase 3 studies; For each patient from all Phase 1 pharmacology studies, Safety data from all clinical studies

24
Q

NDA: Case report forms (CRFs)

A

For each patient that died

For any patients that withdrew due to an AE

25
Q

Biosimilars

A

generic version of biologics

Not allowed now as the processes are unlikely to be identical, differing in safety, efficacy, and purity.

26
Q

BLA

A

Essentially the same as NDA

Must submit product sample to FDA

Establishment must be inspected by the FDA; process is very significant for biologics

27
Q

NDA Submission Copies

A

Archival copy - complete submission
Review copy - Organized by technical section - includes complete summary with each; for reviewers in each discipline
Field copy - CMC section (include complete summary); for FDA inspectors pre-approval cGMP inspections

28
Q

Abbreviated New Drug Application (ANDA)

A

Generic drug submission
Used for drug products that are the same as a listed drug

Identical: active ingredients, dosage form, strength, route of administration, conditions of use

Does not require human safety and effectiveness information, but does require bioequivalence data

Can start 1 year before the patent expires but ANDA will not be approved until after expiration

29
Q

Parts of an ANDA

A
Application form (FDA Form 356h)
Table of Contents
Reference to listed drug
Conditions of USe
Info to show active ingredient is the same as listed drug
Info to show route of administration, dosage form and strength are the same as listed drug
Bioequivalence to the listed drug
Currently approved labeling for listed drug
Annotated proposed labeling
CMC
Patent Certification
Financial certification ro disclosure
30
Q

Parts of an ANDA: Reference to Listed Drug section

A

Name, dosage form, strength

Identify whether listed drug is entitled to period of marketing exclusivity/patent (Use Orange Book)

31
Q

Orange Book

A

Book of Approved Drug Products with Therapeutic Equivalence Evaluations

32
Q

ANDA proposed labeling

A

Side by side comparison of labeling

Must explain any difference from approved labeling

33
Q

Parts of an ANDA: CMC

A

Master production record (batch records) with description of equipment

Inactive ingredients - identity and characterization
-must demonstrate that inactive ingredients do not affect safety and efficacy

34
Q

CTD Modules

A
  1. Region Specific (administrative and labeling documents)
  2. Summary Overview
    - Quality (CMC)
    - Nonclinical
    - Clinical
  3. Quality (CMC)
  4. Nonclinical Study Reports
  5. Clinical Study Reports
35
Q

Sample eCTD

A

30 day review by FDA

Sample submission evaluated for technical compliance; must contain enough data to be analyzed

36
Q

eCTD

A

Built around a master table of contents, the backbone of the submission

eCTD provides links to specific info in each section, so it’s easier to find documents, standardized

37
Q

FDA Review Process for Marketing Applications

A

Within 60 days, FDA determines whether the NDA/BLA (in writing) may be filed or ANDA (by phone) has been received; broad look for the submission to make sure all components are there (don’t pay fee if not filed)

180-day review period starts on the date of receipt for all types of submissions: usually 10 month review period for NDA/BLA, but 6 months for priority review

90 days in, check with the FDA, start working on any deficiency; informal communications are had for changes are concerns that are not specific

End-of-review conference: held just before the approval decision and discusses any changes required or new information needed

38
Q

Reasons FDA may refuse to file

A

Application is incomplete
Not submitted in required form
Environmental assessment not included
English translations not provided
Non-compliance with GLPs
Non-compliance with IRB or informed consent
Drug contains same active ingredient as marketed drug with exclusivity

39
Q

FDA Advisory Committee Meetings

A

Generally required for all new molecular entities; or when drug is a topic of public interest, controversial matter or a specific expertise is needed

Provide independent, expert advice or product reviews; not FDA and not sponsor related nor participant in study; make recommendations not approvals

Public meeting, recorded and transcribed online, some nondisclosable info not included

40
Q

Info provided for Advisory Committee Meetings

A

Sponsor: presents safety and effectiveness info, discuss postmarketing requirements, or on-going safety monitoring

Sponsor briefing package: info to understand product and its intended use, development program; potential issues or questions for discussion

FDA briefing package: summary of its opinions; concerns regarding product submission; questions for advisory committee

Committee does not have access to marketing submission

41
Q

FDA Response

A

Complete response letter: includes all deficiencies identified in FDA’s review, and recommended actions for approval

Approval letter: approval date = date of letter
-drug cannot be shipped before effective date

42
Q

Resubmission

A

Class 1 - 2-month review period
Class 2 - 6-month review period
Major resubmission - 6-month review period

43
Q

Reasons FDA won’t approve NDA/BLA submissions

A

CMC inadequate to preserve identity, strength, quality, purity, stability and bioavailability
Clinical data does not demonstrate safety
Insufficient evidence of safety or effectiveness
Labeling is false or misleading
Not compliant with cGMPs or GLPs
Inadequate patent information
Sponsor does not permit inspection

44
Q

Reasons FDA won’t approve ANDA submissions

A

CMC inadequate to preserve identity, strength, quality, purity, stability
Didn’t show proposed conditions have been previously approved
Didn’t show API is the same
Didn’t show route of administration, dosage form, or strength is the same
Insufficient info for bioequivalence
Labeling not the same
Inactive ingredients aren’t safe
Drug listed has been withdrawn

45
Q

Reasons for FDA Withdrawal of Approval

A

Imminent hazard to public health
New data show drug is unsafe or not effective
Patent info requested by FDA was not submitted in 30 days
Failure to maintain records or make report
Manufacturing is inadequate
Labeling is false or misleading
Listed drup approval is withdrawn (for generic drug)

46
Q

Grandfathered drug

A

those made prior to 1938

47
Q

Field Copy Certification

A

certifies that the field copy was submitted to the field office is a true copy of the CMC section

48
Q

CMC Section: Samples

A

must include sample to FDA labs for testing and validation of analytical methods

49
Q

Toxicology Information

A

should include info on acute toxicology, multidose toxicology, with reproduction and mutagenicity studues

50
Q

Bioavailability Studies

A

define the rate and extent of absorption relative to a reference dosage form

51
Q

Bioequivalence studies

A

compares pharmaceutical alternatives to establish equivalent extents and rate of absorption

52
Q

Post-Marketing Surveillance

A

After approval, sponsor have to review all adverse drug experiences (ADE) and if serious and unexpected must report it to the FDA within 15 days (FDA Form 3500A - MedWatch)

Periodic ADE Reports - quarterly for the first 3 years and then annually

53
Q

BLA - Analytical Development

A

no single method will capture the full heterogeneity of the compound, so several must be used to characterize a given attribute of the protein

Rationale for method selection must be submitted

54
Q

BLA - Nonclinical evaluation

A

Primary consideration given to the nature of the biological effect and the validity or availability of relevant model systems

Approach and rationale should be discussed

55
Q

BLA - Clinical Development

A

For trial design, consider biological activity of the product, the limits on measurements and assessing efficacy, and the availability of suitable patients

Also consider potential for process-related isoforms to dramatically affect clinical outcomes