Authored By: B. V Waghmare

Thursday, October 28, 2010

DRUG RESISTANCE TESTING NEW DRUG DEVELOPMENT (ANTI RETROVIRAL HIV) Protein Binding

D. Protein Binding
Protein binding of an antiviral drug to human serum proteins may result in reduced antiviral activity. The effects of 45 percent to 50 percent human serum on the cell culture antiviral activity of the investigational drug should be evaluated for at least one well-characterized laboratory or clinical isolate, and the serum-adjusted EC50 value should be determined (Data Collection from Dose-Finding Trials). A series of human serum dilutions (e.g., 5 percent, 10 percent, 20 percent, 40 percent) can be used to extrapolate the effect of 100 percent human serum. In addition, an examination of the protein binding effects of α-acid glycoprotein and human serum albumin at physiological concentrations is recommended.


Source:

Drug Resistance Assay and Antiretroviral drug development guidance--->
http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm071173.pdf







IV. NONCLINICAL STUDIES
A. Mechanism of Action
B. Antiviral Activity in Cell Culture
C. Cytotoxicity and Therapeutic Indexes
D. Protein Binding
E. Selection of Drug-Resistant HIV-1 Variants in Cell Culture
1. Genotype
2. Phenotype
F. Cross-Resistance
G. Characterization of Genotypic and Phenotypic Assays
1. Genotypic Assays
2. Phenotypic Assays
V. CLINICAL STUDIES: USE OF RESISTANCE TESTING IN CLINICAL PHASES OF DRUG DEVELOPMENT
A. General Considerations
B. Data Collection
C. Methods and Types of Analyses
1. Baseline Genotype and Virologic Response
2. Development of HIV Mutations
3. Baseline Phenotype and Virologic Response
4. Genotypic and Phenotypic Correlations: Changes in Susceptibility from Baseline
5. Cross-Resistance
6. Additional Analyses
D. Other Considerations
1. Role for Supporting Initial Activity and Dose-Finding Studies
2. Data Collection from Dose-Finding Trials
3. Use of Resistance Data to Establish an Indication
4. Use of Resistance Data for Study Enrollment Criteria, Background Regimen Selection, and Stratification Factors
5. Nonclade B Subtypes
E. Monitoring during Phase 4

REGULATORY REQUIREMENTS FOR SUBMITTING HIV RESISTANCE DATA

SUMMARY



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Last updated : 28-Oct-2010


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