New Drug Application

Last updated

A new drug application in the 1930s for sulfapyridine to the United States Food and Drug Administration New Drug Application (FDA 148) (8210965141).jpg
A new drug application in the 1930s for sulfapyridine to the United States Food and Drug Administration

The Food and Drug Administration's (FDA) New Drug Application (NDA) is the vehicle in the United States through which drug sponsors formally propose that the FDA approve a new pharmaceutical for sale and marketing. [1] [2] Some 30% or less of initial drug candidates proceed through the entire multi-year process of drug development, concluding with an approved NDA, if successful. [1]

Contents

The goals of the NDA are to provide enough information to permit FDA reviewers to establish the complete history of the candidate drug. [3] Among facts needed for the application are: [2]

Exceptions to this process include voter driven initiatives for medical marijuana [4] in certain states.

Before trials

To legally test the drug on human subjects in the U.S., the maker must first obtain an Investigational New Drug (IND) designation from FDA. [5] This application is based on nonclinical data, typically from a combination of in vivo and in vitro laboratory safety studies, that shows the drug is safe enough to test in humans. [5] Often the "new" drugs that are submitted for approval include new molecular entities [6] or old medications that have been chemically modified to elicit differential pharmacological effects or reduced side effects.

Clinical trials

The legal requirement for approval is "substantial" evidence of effectiveness demonstrated through controlled clinical trials. [7] This standard lies at the heart of the regulatory program for drugs. Data for the submission must come from rigorous clinical trials. [5]

The trials are typically conducted in three phases: [5]

The legal requirements for safety and effectiveness have been interpreted as requiring scientific evidence that the benefits of a drug outweigh the risks and that adequate instructions exist for use, since many drugs have adverse side effects.

Many approved medications for serious illnesses (e.g., cancer) have severe and even life-threatening side effects. Even relatively safe and well understood OTC drugs such as aspirin can be dangerous if used incorrectly.

The actual application

The results of the testing program are codified in an FDA-approved public document that is called the product label, package insert or Full Prescribing Information. [8] The prescribing information is widely available on the web from the FDA, [9] drug manufacturers, and frequently inserted into drug packages. The main purpose of a drug label is to provide healthcare providers and consumers with adequate information and directions for the safe use of the drug.

The documentation required in an NDA is supposed to tell "the drug’s whole story, including what happened during the clinical tests, what the ingredients of the drug are, the results of the animal studies, how the drug behaves in the body, and how it is manufactured, processed and packaged.” [2] Once approval of an NDA is obtained, the new drug can be legally marketed starting that day in the U.S.

Once the application is submitted, the FDA has 60 days to conduct a preliminary review, which assesses whether the NDA is "sufficiently complete to permit a substantive review." If the FDA finds the NDA insufficiently complete, then the FDA rejects the application by sending the applicant a Refuse to File letter, which explains where the application failed to meet requirements. [10] Where the application cannot be granted for substantive reasons, the FDA issues a Complete Response Letter.

Assuming the FDA finds the NDA acceptable, a 74-day letter is published. [11] A standard review implies an FDA decision within about 10 months while a priority review should complete within 6 months. [12]

Requirements for similar products

Biologics, such as vaccines and many recombinant proteins used in medical treatments are generally approved by FDA via a Biologic License Application (BLA), rather than an NDA. The manufacture of biologics is considered to differ fundamentally from that of less complex chemicals, requiring a somewhat different approval process.

Generic drugs that have already been approved via an NDA submitted by another maker are approved via an Abbreviated New Drug Application (ANDA), which does not require all of the clinical trials normally required for a new drug in an NDA. [13] Most biological drugs, including a majority of recombinant proteins are considered ineligible for an ANDA under current US law. [14] However, a handful of biologic medicines, including biosynthetic insulin, growth hormone, glucagon, calcitonin, and hyaluronidase are grandfathered under governance of the Federal Food Drug and Cosmetics Act, because these products were already approved when legislation to regulate biotechnology medicines later passed as part of the Public Health Services Act.

Medications intended for use in animals are submitted to a different center within FDA, the Center for Veterinary Medicine (CVM) in a New Animal Drug Application (NADA). These are also specifically evaluated for their use in food animals and their possible effect on the food from animals treated with the drug.

See also

Related Research Articles

<span class="mw-page-title-main">Food and Drug Administration</span> United States federal agency

The United States Food and Drug Administration is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food safety, tobacco products, caffeine products, dietary supplements, prescription and over-the-counter pharmaceutical drugs (medications), vaccines, biopharmaceuticals, blood transfusions, medical devices, electromagnetic radiation emitting devices (ERED), cosmetics, animal foods & feed and veterinary products.

<span class="mw-page-title-main">Oxaprozin</span> Chemical compound

Oxaprozin, also known as oxaprozinum, is a nonsteroidal anti-inflammatory drug (NSAID), used to relieve the inflammation, swelling, stiffness, and joint pain associated with osteoarthritis and rheumatoid arthritis. Chemically, it is a propionic acid derivative. Safety and efficacy has been established in children over 6 years with juvenile rheumatoid arthritis only, and there is an increased risk of adverse reactions in the elderly population.

An approved drug is a medicinal preparation that has been validated for a therapeutic use by a ruling authority of a government. This process is usually specific by country, unless specified otherwise.

<span class="mw-page-title-main">Drug development</span> Process of bringing a new pharmaceutical drug to the market

Drug development is the process of bringing a new pharmaceutical drug to the market once a lead compound has been identified through the process of drug discovery. It includes preclinical research on microorganisms and animals, filing for regulatory status, such as via the United States Food and Drug Administration for an investigational new drug to initiate clinical trials on humans, and may include the step of obtaining regulatory approval with a new drug application to market the drug. The entire process – from concept through preclinical testing in the laboratory to clinical trial development, including Phase I–III trials – to approved vaccine or drug typically takes more than a decade.

Clinical research is a branch of healthcare science that determines the safety and effectiveness (efficacy) of medications, devices, diagnostic products and treatment regimens intended for human use. These may be used for prevention, treatment, diagnosis or for relieving symptoms of a disease. Clinical research is different from clinical practice. In clinical practice established treatments are used, while in clinical research evidence is collected to establish a treatment.

<span class="mw-page-title-main">Kefauver–Harris Amendment</span>

The U.S. Kefauver–Harris Amendment or "Drug Efficacy Amendment" is a 1962 amendment to the Federal Food, Drug, and Cosmetic Act.

In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. There can be multiple indications to use a procedure or medication. An indication can commonly be confused with the term diagnosis. A diagnosis is the assessment that a particular [medical] condition is present while an indication is a reason for use. The opposite of an indication is a contraindication, a reason to withhold a certain medical treatment because the risks of treatment clearly outweigh the benefits.

<span class="mw-page-title-main">Center for Drug Evaluation and Research</span> US Food and Drug Administration division

The Center for Drug Evaluation and Research is a division of the U.S. Food and Drug Administration (FDA) that monitors most drugs as defined in the Food, Drug, and Cosmetic Act. Some biological products are also legally considered drugs, but they are covered by the Center for Biologics Evaluation and Research. The center reviews applications for brand name, generic, and over the counter pharmaceuticals, manages US current Good Manufacturing Practice (cGMP) regulations for pharmaceutical manufacturing, determines which medications require a medical prescription, monitors advertising of approved medications, and collects and analyzes safety data about pharmaceuticals that are already on the market.

<span class="mw-page-title-main">Prescription Drug User Fee Act</span> Legislation in the United States

The Prescription Drug User Fee Act (PDUFA) was a law passed by the United States Congress in 1992 which allowed the Food and Drug Administration (FDA) to collect fees from drug manufacturers to fund the new drug approval process. The Act provided that the FDA was entitled to collect a substantial application fee from drug manufacturers at the time a New Drug Application (NDA) or Biologics License Application (BLA) was submitted, with those funds designated for use only in Center for Drug Evaluation and Research (CDER) or Center for Biologics Evaluation and Research (CBER) drug approval activities. In order to continue collecting such fees, the FDA is required to meet certain performance benchmarks, primarily related to the speed of certain activities within the NDA review process.

<span class="mw-page-title-main">Food and Drug Administration Amendments Act of 2007</span> US law

President of the United States George W. Bush signed the Food and Drug Administration Amendments Act of 2007 (FDAAA) on September 27, 2007. This law reviewed, expanded, and reaffirmed several existing pieces of legislation regulating the FDA. These changes allow the FDA to perform more comprehensive reviews of potential new drugs and devices. It was sponsored by Reps. Joe Barton and Frank Pallone and passed unanimously by the Senate.

An experimental drug is a medicinal product that has not yet received approval from governmental regulatory authorities for routine use in human or veterinary medicine. A medicinal product may be approved for use in one disease or condition but still be considered experimental for other diseases or conditions.

<span class="mw-page-title-main">Lorcaserin</span> Antiobesity drug

Lorcaserin, marketed under the brand name Belviq, was a weight-loss drug developed by Arena Pharmaceuticals. It reduces appetite by activating a type of serotonin receptor known as the 5-HT2C receptor in a region of the brain called the hypothalamus, which is known to control appetite. It was approved in 2012, and in 2020, it was removed from the market in the United States due to an increased risk of cancer detected in users of Belviq.

The following outline is provided as an overview of and topical guide to clinical research:

<span class="mw-page-title-main">Tofacitinib</span> Medication

Tofacitinib, sold under the brand Xeljanz among others, is a medication used to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, polyarticular course juvenile idiopathic arthritis, and ulcerative colitis. It is a janus kinase (JAK) inhibitor, discovered and developed by the National Institutes of Health and Pfizer.

Teprotumumab, sold under the brand name Tepezza, is a medication used to treat adults with thyroid eye disease, a rare condition where the muscles and fatty tissues behind the eye become inflamed, causing the eyes to bulge outwards.

The Food and Drug Administration is a federal agency of the United States, formed in 1930.

<span class="mw-page-title-main">Phases of clinical research</span> Clinical trial stages using human subjects

The phases of clinical research are the stages in which scientists conduct experiments with a health intervention to obtain sufficient evidence for a process considered effective as a medical treatment. For drug development, the clinical phases start with testing for drug safety in a few human subjects, then expand to many study participants to determine if the treatment is effective. Clinical research is conducted on drug candidates, vaccine candidates, new medical devices, and new diagnostic assays.

<span class="mw-page-title-main">Copanlisib</span> Chemical compound

Copanlisib, sold under the brand name Aliqopa, is a medication used for the treatment of adults experiencing relapsed follicular lymphoma who have received at least two prior systemic therapies.

Breakthrough therapy is a United States Food and Drug Administration designation that expedites drug development that was created by Congress under Section 902 of the 9 July 2012 Food and Drug Administration Safety and Innovation Act. The FDA's "breakthrough therapy" designation is not intended to imply that a drug is actually a "breakthrough" or that there is high-quality evidence of treatment efficacy for a particular condition; rather, it allows the FDA to grant priority review to drug candidates if preliminary clinical trials indicate that the therapy may offer substantial treatment advantages over existing options for patients with serious or life-threatening diseases. The FDA has other mechanisms for expediting the review and approval process for promising drugs, including fast track designation, accelerated approval, and priority review.

<span class="mw-page-title-main">Umbralisib</span> Chemical compound

Umbralisib, sold under the brand name Ukoniq, is an anti-cancer medication for the treatment of marginal zone lymphoma (MZL) and follicular lymphoma (FL). It is taken by mouth.

References

  1. 1 2 "The Drug Development Process". U.S. Food and Drug Administration. January 4, 2018. Retrieved May 1, 2018.
  2. 1 2 3 "The Drug Development Process. Step 4: FDA Drug Review". U.S. Food and Drug Administration. January 4, 2018. Retrieved May 1, 2018.
  3. Gad, Shayne Cox (2008). Pharmaceutical Manufacturing Handbook: Production and Processes. John Wiley & Sons. ISBN   9780470259801.
  4. Commissioner, Office of the. "Public Health Focus - FDA and Marijuana". www.fda.gov. Archived from the original on April 28, 2018. Retrieved April 30, 2018.
  5. 1 2 3 4 5 "The Drug Development Process. Step 3: Clinical Research". U.S. Food and Drug Administration. January 4, 2018. Retrieved May 1, 2018.
  6. "The Drug Development Process. Step 1: Discovery and Development". U.S. Food and Drug Administration. January 4, 2018. Retrieved May 1, 2018.
  7. Food, Drug, and Cosmetic Act, Section 505; 21 USC 355]
  8. 21 CFR 201.5: Labeling Requirements for Prescription Drugs and/or Insulin
  9. "Daily Med:Current Medication Information". Archived from the original on November 12, 2008. Retrieved October 10, 2007.
  10. "Merck KGaA Receives Refuse To File Letter From FDA On Cladribine Tablets New Drug Application". medicalnewstoday.com. Archived from the original on March 5, 2010. Retrieved April 30, 2018.
  11. "FINDINGS: Issues and Communication: Independent Evaluation of FDA's First Cycle Review Performance – Final Report". Food and Drug Administration. Archived from the original on March 8, 2010. Retrieved February 23, 2010.
  12. "Cadence Pharmaceuticals Announces Priority Review and Acceptance of NDA Submission for Acetavance for Treatment of Acute Pain and Fever". drugs.com. Archived from the original on July 11, 2017. Retrieved April 30, 2018.
  13. "FDA, CDER Office of Generic Drugs". fda.gov. Archived from the original on May 28, 2009. Retrieved April 30, 2018.
  14. "C&EN: COVER STORY - BEYOND HATCH-WAXMAN". pubs.acs.org. Retrieved April 30, 2018.