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中国临床药理学与治疗学 ›› 2022, Vol. 27 ›› Issue (1): 77-85.doi: 10.12092/j.issn.1009-2501.2022.01.011

• 临床药理学 • 上一篇    下一篇

2009-2020年药物首次人体试验设计及结果文献分析

邓锟红1,刘亚昕1,2,孙媛媛1,陈文静1,杨 楠3,胡展晴1,陈凯锋3,黄 洁1,项玉霞1,阳国平1,2   

  1. 1中南大学湘雅三医院临床药理中心,长沙 410013,湖南;2中南大学湘雅药学院,长沙 410013,湖南;3中南大学湘雅三医院药学部,长沙 410013,湖南

  • 收稿日期:2021-10-11 修回日期:2021-12-01 出版日期:2022-01-26 发布日期:2022-02-09
  • 通讯作者: 阳国平,男,博士,主任药师,博导,主要从事临床药理学研究。 Tel: 0731-88618938 E-mail: ygp9880@126.com
  • 作者简介:邓锟红,女,硕士研究生,研究方向:临床药理学。 Tel: 18273120910 E-mail: hidengkunhong@163.com
  • 基金资助:
    湖南省科技重点专项(2020SK2010);湖南省自然科学基金资助项目(2020JJ5852);国家自然科学基金(81803639)

Literature analysis of the design and results of the First-In-Human clinical trials of drugs from 2009 to 2020

DENG Kunhong1, LIU Yaxin1,2, SUN Yuanyuan1, CHEN Wenjing1, YANG Nan3, HU Zhanqing1, CHEN Kaifeng3, HUANG Jie1, XIANG Yuxia1, YANG Guoping1,2   

  1. 1 Center of Clinical Pharmacology, the Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China
  • Received:2021-10-11 Revised:2021-12-01 Online:2022-01-26 Published:2022-02-09

摘要: 目的:全面描述药物首次人体试验的大致情况,总结首次人体试验设计与结果规律。方法:在PubMed上检索2009-2020年首次人体试验的文献,筛选出符合研究目的的文献,通过收集文献相关信息和数据,进行数据分析并总结。结果:本研究共纳入559篇首次人体试验文章,药物类型包括小分子药物(52.42%,293/559),大分子药物(45.62%,255/559)以及少量的细胞和病毒(1.97%,11/559)等。关于起始剂量的确定,不论是在大分子(23.86%,21/88)还是小分子(30.15%,41/136)中都主要以未见明显毒性反应剂量(27.68%,62/224)为主,其次是基于临床前研究(21.88%,49/224)以及最低预期生物效应水平(8.48%,19/224)等。剂量递增试验中50.19%(135/269)的研究使用传统标准3+3剂量递增方法,其次是加速滴定方法(7.06%,19/269),改进3+3方法(6.69%,18/269)等。结论:首次人体试验在研究设计内容和结果上具有一定的规律性,在后续试验中应科学设计首次人体试验,促进药物首次人体试验安全和有效开展。

关键词: 首次人体试验, 临床试验, 最大推荐起始剂量

Abstract: AIM: Describe the general situation of the First-In-Human trials of the drugs, and summarize the design and results of the First-In-Human trials.  METHODS: We searched the literature of the First-In-Human trials in 2009-2020 on PubMed and screened out the literature that met the research purpose. The basic information of the literature was collected. Data analysis was conducted to summarize relevant outcomes. RESULTS: A total of 559 First-In-Human trials were included in this study. The types of drugs included small molecule drugs (52.42%, 293/559), macromolecule drugs (45.62%, 255/559), and a small amount of cells and viruses (1.97%, 11/559) and so on. Regarding the determination of the starting dose, whether it was in macromolecules (23.86%, 21/88) or small molecules (30.15%, 41/136), No Observed Adverse Effect Level (27.68%, 62/224) was mainly used as the main reference basis, followed by preclinical research (21.88%, 49/224) and Minimal Anticipated Biological Effect Level (8.48%, 19/224), etc. In the dose escalation test, 50.19%(135/269) of the studies used the traditional standard 3+3 dose escalation method, followed by the accelerated titration method (7.06%, 19/269), and the improved 3+3 method (6.69%, 18/269), etc. CONCLUSION: The design of First-In-Human clinical trials has certain regularity in the content and results of the research design. In the subsequent trials, it is important to scientifically design the First-In-Human trials, and promote the safe and effective development of the First-In-Human trials of the drugs.

Key words: First-In-Human trials, clinical trial, maximum recommended starting dose

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