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DMD 药物上市许可被欧盟撤销,但仍在欧洲多国持续销售

首页 > 资讯 > DMD 药物上市许可被欧盟撤销,但仍在欧洲多国持续销售

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DMD 药物上市许可被欧盟撤销,但仍在欧洲多国持续销售
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笔记

2025-07-29

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*Translarna包装

近日外媒报道,PTC Therapeutics的杜氏肌营养不良(Duchenne Muscular Dystrophy,DMD)治疗药物Translarna(ataluren)的欧盟有条件上市许可(Conditional Marketing Authorization,CMA)于2025年3月被正式撤销,但仍在部分欧洲市场持续供应。这一罕见情形引发广泛关注。

Translarna历经坎坷。该药于2014年8月首次获得欧盟CMA,基于一项包含174名患者的II期临床试验,数据显示患者在六分钟步行测试中步行距离有所改善。2017年,PTC同意开展III期安慰剂对照试验(Study 041)以续签CMA。然而Study 041未能在六个月的治疗期内证明Translarna与安慰剂相比具有统计学显著差异。2023年,EMA的人用药品委员会(CHMP)建议撤销CMA,PTC请求重新审查未果。随后,欧盟委员会罕见地未遵循CHMP的建议,要求EMA重新审视其科学评估,考虑欧盟成员国专家提出的科学问题以及新的真实世界证据。但CHMP还是在2024年10月维持其决定,欧盟委员会随后于2025年3月发布关于CMA撤销的实施决定。

但Translarna在欧洲的故事并未结束。根据PTC首席执行官Matthew Klein在2025年6月的高盛医疗保健会议上所述,Translarna的现状“史无前例”(unprecedented)。欧盟成员国首次援引2001/83/EC指令中的条款,以确保患者能够继续获得这种已被撤销CMA的治疗药物。

具体而言,一些国家通过2001/83/EC指令第117(3)条规定的国家层面机制,决定继续提供Translarna的商业供应。该条款允许在“特殊情况下,在过渡期间,允许已接受该药品治疗的患者继续使用该药品”。意大利药品管理局(AIFA)确认,其依据该指令的第5(1)条继续支持Translarna。第5(1)条本质上允许“特定患者”使用,规定成员国可以根据现行立法,为满足特殊需求,由授权医疗专业人员决定且以个人患者直接责任的方式供应的特定药物。

在2024年12月的人用药品常务委员会会议上,尽管27个成员国中有26个支持CMA撤销,但有几个成员国指出这种致残性疾病的患者的高度未满足需求以及“这一案例的独特情况”,即并无替代治疗手段。此外,还有人担心突然停止接受Translarna治疗的患者遭受的影响,特别是在医生认为继续使用该药物将有益的情况下。

Translarna在全球其他市场也有批准,包括英国、巴西和以色列,但其在美国的上市之路也不顺利,目前仍在等待FDA的审评。该公司曾在2017年收到完全回应函。2024年10月,FDA接受了PTC重新提交申请。

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Directive 2001/83/EC of the European Parliament and of the Council, also known as the Community code relating to medicinal products for human use, is a comprehensive regulatory framework that governs various aspects of medicinal products, including their definitions, scope, placement on the market, manufacture, importation, labelling, advertising, and pharmacovigilance, among other things. This directive has been amended several times to incorporate new regulations and to address evolving needs in the pharmaceutical sector.

Applicable Positions:

  • Regulatory Affairs (RA): Must stay updated on all changes to ensure regulatory compliance.
  • Quality Assurance (QA): Ensures that manufacturing and quality control processes adhere to the guidelines.
  • Research and Development (R&D): Needs to be aware of the definitions and classifications that may affect new drug development.
  • Clinical Research: Should be knowledgeable about the requirements for clinical trials and pharmacovigilance.
  • Marketing Authorization Holder (MAH): Responsible for compliance with all aspects of the directive, including pharmacovigilance and product labelling.

Work Suggestions:

  • RA: Continuously monitor updates and amendments to Directive 2001/83/EC to ensure timely implementation of changes.
  • QA: Develop and maintain quality systems that are aligned with the directive's requirements for GMP and GDP.
  • R&D: Design research projects with awareness of the directive's classifications and definitions to facilitate smooth regulatory pathways.
  • Clinical Research: Ensure that clinical trials are conducted and reported in compliance with the directive, focusing on safety and efficacy.
  • MAH: Maintain oversight of all activities related to the product's lifecycle, from development through to post-marketing surveillance.

Scope of the Directive:

  • Applies to all medicinal products for human use intended to be placed on the market within the European Union.
  • Covers chemical药品, biological制品, vaccines, radiopharmaceuticals, and advanced therapy medicinal products.
  • Includes regulations for both innovative drugs and generic medicines, as well as specific provisions for homeopathic and herbal medicinal products.

Key Points from the Directive:

  1. Definitions and Classifications: The directive provides a comprehensive list of definitions for terms such as medicinal product, active substance, excipient, and various categories of medicinal products, including advanced therapy medicinal products and homeopathic medicinal products.
  2. Marketing Authorization: No medicinal product can be placed on the market unless a marketing authorization has been issued by the competent authorities, with specific procedures for mutual recognition and decentralized procedures.
  3. Pharmacovigilance: A robust system for monitoring the safety of authorized medicinal products and detecting any changes to their risk-benefit balance is mandatory.
  4. Manufacture and Importation: Manufacturing of medicinal products is subject to authorization and must comply with good manufacturing practices (GMP).
  5. Labelling and Package Leaflet: Specific requirements ensure that all necessary information is provided to healthcare professionals and patients, including details of the product, its uses, dosage, and potential side effects.

Conclusion:
The directive sets out a stringent regulatory framework aimed at ensuring the quality, safety, and efficacy of medicinal products available in the EU. It is essential for all relevant stakeholders in the pharmaceutical industry to be fully acquainted with its contents and to implement the necessary processes to comply with its requirements. Regular updates and revisions to the directive reflect the evolving nature of the pharmaceutical sector and the ongoing commitment to protect public health.

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