Grazie per aver scelto di utilizzare a scopo didattico questo materiale delle Guidelines 2011 libra. Le ricordiamo che questo materiale è di proprietà dell’autore e fornito come supporto didattico per uso personale. Role of industrial research in the development of new drugs Malcolm Johnson GlaxoSmithKline R&D & NHLI,London Key issues in formulating an hypothesis in drug discovery Biology Scientific understanding of disease state? What is the desirable mechanism? Medical Need Medicine Is mechanism acceptable in man? Can it be tested in man? Chemistry What to make? Discovery/Development Strategies • In house research • In-licencing • External collaborations • Collaborative networks • Promote external innovation Drug discovery pipeline Exploratory discovery Disease selection Target identification and selection Drug discovery Lead identification Lead optimization Candidate pre-clinical evaluation Clinical proof of concept Drug discovery pipeline Exploratory discovery Disease selection Target identification Drug discovery Lead Lead identification optimization Candidate Clinical pre-clinical proof of evaluation concept and selection Normal Tissue bioassay Disease Normal Primary Disease Integrative pharmacology Isolated cells Transfection Immunohistochemistry Gene microarray Transgenic models Receptors Enzymes Reporter genes Drug discovery/development pipeline Drug development Drug discovery Disease selection Gene to Function Target function to target to hit Hit to lead Lead optimisation Safety and Phase I Phase II developability Commit Commit to to to disease product target type Commit Tractable hit Candidate First time Proof of selection in man concept Phase III Phase IV Research/development strategy Therapeutic objective Biology Clinical Project team Chemistry Information Drug candidate Exploratory development Full development Clinical trials Regulatory authorities Product licence application Market science How are drugs discovered? Random screening • Chemistry/compound library • Natural products Rational design • Based on natural hormones • Based on existing active drugs • Based on molecular modelling Pre-clinical studies • Purpose - Determine bilogical activity - Assess specificity of action • Types of studies - In vitro studies - In vivo (animal studies) • Study design - Dose-response studies • Success rate - 1 in 1000 compounds tested • Time - Variable. Approximately 3.5 years for successful lead compounds High Throughput Screening 1980:Salmeterol project- 10 compounds/week 2011;100,000 compounds/day: combinatorial chemistry smart screens cloned human receptors 96-well plate format low volumes robotics Future: 10 million /hour: lower costs smaller volumes (pl) • Molecular modelling • Bioinformatics • Proteomics • Genetics • Pharmacogenomics Fluticasone furoate– an ‘enhanced-affinity’ glucocorticoid FP FF Biggadike et al J Med Chem 2008 Vilanterol in receptor Toxicology • Acute • Subacute • Chronic - 2-week studies in 3 or 4 species maximum tolerated dose - 6-month studies in 2 species - 12-month studies in 2 species (rats & dogs) - Oncogenicity studies - 18 months in mice • Fertility and reproductive - 2 years in rats - Fertility, teratology and perinatal and postnatal studies in 2 species • Mutagenicity (rats and rabbits) - In vivo and in vitro tests Phase I clinical trials • Purpose • Type of studies • Study population • Study design • Success rate • Time Determine the primary safety profile and a safe dosage range Pharmacokinetic and pharmacodynamic studies Normal, healthy volunteers (usually male) Single dose escalation or short-term design multiple dose, placebo controlled, in specialised hospital units 1 in 3 1 year Phase III clinical trials • Purpose • Type of studies • Study population • Study design • Success rate • Time Verify effectiveness, closely monitor safety in long-term use, establish optimum dosage Placebo, dose or comparator controlled efficacy and safety 1000 to 3000 patients, more heterogeneous to reflect real patient population Multiple end-point, double-blind, large multi-centre 1 in 3 2 to 4 years New drug development process 12-15 years total 2.5 years Approval Regulatory review Marketing application filed with regulatory authority 3+ years 2+ years 1 + year Phase III clinical studies – extensive clinical studies Phase II clinical studies – efficacy studies Phase I clinical studies – pharmacological profile Regulatory/ethical review committee approval 3+ years Preclinical laboratory and animal toxicology studies IRD NDA Manufacture Clinical trials Process research Volunteer studies Toxicology Patenting Testing Screening New drug development: A major high-risk undertaking Time 12-15 years from discovery to market Cost £900 million Success 1 in 4000 compounds synthesised or 1 in 5 tested in humans reaches the market Return 1 in 3 drugs reaching the market recaptures development costs Mortality Studies COPD: TORCH 6,100 patients studied for 3 years ( Cost 450,000,000 euros; Mortality p=0.052) UPLIFT 6,400 patients studied for 4 years (Cost ?; Mortality p=0.086) External collaborations network Academic Academic Academic centre centre Pharma Clinical R&D centre centre Academic Academic centre centre External collaborations objectives: – Increased product database efficacy/safety support – Extend product profile new claims? – Address competitor claims/issues – Increase number/value of citable publications External Research Collaborations Non-project related: Muscarinic receptor mapping in the airways of COPD patients Role of innate immunity in lung repair in COPD Project related: Effects of Relovair on parasternal muscle and diaphragm in patients with COPD Functional enhancement of corticosteroid action by LABAs GR nuclear translocation Non treatment FP (10-10M) FF (10-10M) 4 hr 30 hr Ito et al, NHLI p38-alpha kinase inhibitor (LosmapimodGW 856553) enhances steroid mediated suppression of IL-8 release in COPD 553-9 553-10 20 * 40 Dex ** 60 80 ** Dex/553-10M Dex/553-9M ** ** p<0.01 compared to Dex alone 100 L/ 55 3 % IL-8 Suppression compared with LPS alone 0 -9 -8 -7 -6 Dex [Log M] Bhavsar et al, NHLI MICA • MRC Industrial Collaboration Award Industry’s contribution can be: Financial (FTEs) or “in kind” Consumables Equipment Resources Project Management % Industrial contribution = industrial costs/total cost Objectives of ECLIPSE • To define clinically relevant COPD subtypes in individuals with GOLD stage II–IV COPD • To define the parameters that predict disease progression over 3 years in the clinically relevant COPD subtypes • To acquire data on biomarkers that correlate with clinically relevant COPD subtypes • To identify novel genetic factors and/or biomarkers that correlate with clinically relevant COPD subtypes SP-D and COPD: Increased SPD Levels Predict Occurrence of At Least One Exacerbation Risk (Odds Ratio) of exacerbation for each 100ng/mL increase in SP-D* 95% CI All patients 1.22 1.07 – 1.39 Upper quartile baseline level only 1.42 1.02 – 1.97 Upper quartile baseline level only, excluding outliers with SP-D >99th percentile (382.7ng/mL) 1.58 1.02 – 2.44 Patients no reporting exacerbation in year prior to enrolment 1.23 1.02 -1.49 * Serum SP-D continuous variable in multivariate model adjusting for sex, percentage predicted FEV1 , reversibility and those taking corticosteroids Lomas DA, et al. Eur Respir J 2009;34:95-102 ECLIPSE/NETT Genome-wide asssociation study identifies BICD1 as a susceptibilty gene for emphysema. • p=5.2x10-7 mild emphysema • p=4.8x10-8 moderate/severe emphysema Kong et al, AJRCCM,2011 IMI Innovative Medicines Initiative: Europe-wide public-private initiative aiming to speed up the development of better and safer medicines for patients. Supports collaborative research projects and builds networks of industrial and academic experts in order to boost pharmaceutical innovation in Europe. CATALYST GSK: Open Bioscience Innovation Campus • INCUBATOR – Small start-up companies • ACCELERATOR - Established companies with possible leads