日本制药企业加大对孤儿药的投入

制药企业纷纷表示,对孤儿药的投入不够。然而,在过去的几年里,出现了以罕见疾病治疗药作为研发重点的制药企业。日本政府也推出多项举措支持孤儿药尽快实用化。     

罕见病药物市场与管理

罕见病,又称"孤儿病",是指发病率极低的疾病,绝大部分属于先天性疾病、慢性病,且常常危及生命。近年来,随着公众认知度的提高、国家政策的支持、诊断及治疗技术的进步,罕见病药物市场逐渐发展起来,销售额逐年增加,出现多个"重磅炸弹"级药物。国际大型药企开始抢占罕见病药物市场并且加紧药物研发,目前正在研发的罕见病药物有500多个,主要针对罕见癌症、遗传性疾病、神经类疾病、传染性疾病和自身免疫性疾病等。发达国家和地区在罕见病管理及市场发展方面都已经比较完善,而中国在这方面还比较落后。对中国罕见病药物市场的发展困境进行了分析并提出了几点建议,希望能够促进国内罕见病药物市场的快速发展。     

罕见病治疗用药的发展态势分析

<正>长期以来,罕见病的治疗用药(孤儿药)的开发并未受到重视,因此21世纪以来各国通过罕见病治疗用药物相关法规的建立,来刺激孤儿药的开发。与此同时,在普通疾病的用药开发陷入困难之际,世界各大制药企业也将目光投向了孤儿药的研发。文章就孤儿药的开发现状和部分孤儿药的市场前景进行了分析。     

罕见病基因治疗与孤儿药

孤儿药因面向的罕见病患者群小、市场需求低、研发成本高、缺乏政策支持等,其发展面临困境。随着精准医疗概念的提出,基 因治疗因能够从根本出发,给患者提供 “一劳永逸”的治疗,备受关注。基因治疗以单基因罕见病的治疗作为极佳切入点,为孤儿药的 研发带来了新的希望。概述基因治疗针对的疾病对象、实施策略和属性以及基因药物的结构及基因治疗的载体,以血友病的基因治疗为 例回顾罕见病基因治疗的发展,并分析罕见病基因治疗药物研发现状。     

“首届中国孤儿药研发论坛”专家观点

对2015 年4 月25 日召开的“首届中国孤儿药研发论坛”的专家报告内容进行归纳总结,旨在为从事罕见病诊断和孤儿药研发工 作的人士提供信息参考。报告内容涉及国内外孤儿药研发现状和前景、中国孤儿药政策和审评状况、罕见病诊断以及中国孤儿药研发的机 会等。     

美国孤儿药开发的政策、策略与实践

简述了罕见病及孤儿药的定义和研发意义,重点介绍了美国针对孤儿药开发的现有制度法规、激励政策及管理经验,并以实例 分析从研发、注册和上市等角度探讨了美国孤儿药开发的策略,旨在为从事孤儿药开发工作的人士提供参考。     

基于文献计量学分析的免疫性疾病领域药学研究进展

免疫性疾病是全球发病率和死亡率最高的疾病之一,近年来呈上升趋势。免疫性疾病领域药学研究的快速发展推动了治疗免疫性疾 病的药物的研发和上市。采用文献计量的方法从研发趋势、国家分布、机构分布、研究热点等多个角度对全球免疫性疾病领域药学研究的 情况进行分析,为我国治疗免疫性疾病的药物研发和相关政策制定提供参考。     

“首届中国孤儿药研发论坛”专家观点（续）

对 2015 年 4 月 25 日召开的“首届中国孤儿药研发论坛”与会专家对话内容进行归纳总结,旨在为从事罕见病诊断和孤儿药研发工作的人士提供信息参考。来自产、学、研领域的专家从研发、临床、审评、投资、媒体等角度探讨了中国孤儿药研发策略。     

美国生物制品中孤儿药的研发现状 及对中国孤儿药研发策略的思考

过去30 年, 美国在全球第一部《孤儿药法案》推动和相关政策法规引导下,生物科技飞速发展,尤其在孤儿药研发领域,成果卓著。 对这30 年来美国FDA 批准的生物制品中孤儿药产品作一解析,回顾美国对生物制品中孤儿药的研发策略,介绍孤儿药开发的新型商业 模式,同时反思中国孤儿药研发策略。     

人源化鼠嵌合肝动物模型研究进展

动物模型是人类疾病研究、发病机制、药物研发的重要工具,对于困扰人类健康的肝脏疾病还没有理想的动物模型能有效地反映出人类疾病发病的机制。建立人源化鼠嵌合肝动物模型,对于研究人类肝脏疾病的发病机制、疫苗和药物的研发及疾病的诊治等方面都具有十分广阔的应用前景。     

Access to Orphan Drugs: A Comprehensive Review of Legislations,Regulations and Policies in 35 Countries

ObjectiveTo review existing regulations and policies utilised by countries to enable patient access to orphan drugs.MethodsA review of the literature (1998 to 2014) was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country.ResultsFifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country’s legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35) had in place orphan drug legislation. Access to orphan drugs depends on individual country’s pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access.ConclusionsOverall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases.     

各国孤儿药政策对比分析

据统计，医学上明确诊断的罕见病有5 000~8 000 种。虽然因患病人数少而得名罕见病，但考虑到疾病种类之多，罕见病仍是 各国不可忽视的公共卫生挑战。协助和激励医疗行业开发治疗罕见病的孤儿药，是各国政府一项重要的公共卫生政策。重点介绍了美国、 日本和欧盟的孤儿药立法，激励政策以及对病患、医药行业的积极影响。     

eRepo-ORP: Exploring the Opportunity Space to Combat Orphan Diseases with Existing Drugs

About 7000 rare, or orphan, diseases affect more than 350 million people worldwide. Although these conditions collectively pose significant health care problems, drug companies seldom develop drugs for orphan diseases due to extremely limited individual markets. Consequently, developing new treatments for often life-threatening orphan diseases is primarily contingent on financial incentives from governments, special research grants, and private philanthropy. Computer-aided drug repositioning is a cheaper and faster alternative to traditional drug discovery offering a promising venue for orphan drug research. Here, we present eRepo-ORP, a comprehensive resource constructed by a large-scale repositioning of existing drugs to orphan diseases with a collection of structural bioinformatics tools, including eThread, eFindSite, and eMatchSite. Specifically, a systematic exploration of 320,856 possible links between known drugs in DrugBank and orphan proteins obtained from Orphanet reveals as many as 18,145 candidates for repurposing. In order to illustrate how potential therapeutics for rare diseases can be identified with eRepo-ORP, we discuss the repositioning of a kinase inhibitor for Ras-associated autoimmune leukoproliferative disease. The eRepo-ORP data set is available through the Open Science Framework at https://osf.io/qdjup/.     

Drug repositioning for orphan diseases

The need and opportunity to discover therapeutics for rare or orphan diseases are enormous. Due to limited prevalence and/or commercial potential, of the approximately 6000 orphan diseases (defined by the FDA Orphan Drug Act as <200 000 US prevalence), only a small fraction (5%) is of interest to the biopharmaceutical industry. The fact that drug development is complicated, time-consuming and expensive with extremely low success rates only adds to the low rate of therapeutics available for orphan diseases. An alternative and efficient strategy to boost the discovery of orphan disease therapeutics is to find connections between an existing drug product and orphan disease. Drug Repositioning or Drug Repurposing--finding a new indication for a drug--is one way to maximize the potential of a drug. The advantages of this approach are manifold, but rational drug repositioning for orphan diseases is not trivial and poses several formidable challenges--pharmacologically and computationally. Most of the repositioned drugs currently in the market are the result of serendipity. One reason the connection between drug candidates and their potential new applications are not identified in an earlier or more systematic fashion is that the underlying mechanism 'connecting' them is either very intricate and unknown or indirect or dispersed and buried in an ever-increasing sea of information, much of which is emerging only recently and therefore is not well organized. In this study, we will review some of these issues and the current methodologies adopted or proposed to overcome them and translate chemical and biological discoveries into safe and effective orphan disease therapeutics.     

Orphanet – das europäische Portal für seltene Krankheiten

Orphanet is a relational database of rare diseases and orphan drugs. This internet-based information platform was established jointly by the French Ministry of Health and the French National Institute of Health and Medical Research (INSERM) in 1997. Since 2000 Orphanet progressed as a European project. The concept was to provide all stakeholders with compiled information on rare diseases through a directory of expert services. This directory of services provides information on specialised outpatient clinics, clinical laboratories, research projects, registries, clinical trials and patient organisations from currently 38 countries. The Services are directly associated with the inventory of rare diseases; furthermore, a comprehensive encyclopaedia is available. All information is freely accessible in five languages at the website http://www.orpha.net.     

Database identifies FDA-approved drugs with potential to be repurposed for treatment of orphan diseases

Facing substantial obstacles to developing new therapies for rare diseases, some sponsors are looking to 'repurpose' drugs already approved for other conditions and use those therapies to treat rare diseases. In an effort to facilitate such repurposing and speed the delivery of new therapies to people who need them, we have established a new resource, the Rare Disease Repurposing Database (RDRD). The advantages of repurposed compounds include their demonstrated efficacy (in some clinical contexts), their observed toxicity profiles and their clearly described manufacturing controls. To create the RDRD, we matched the US Food and Drug Administration (FDA) orphan designation database to FDA drug and biological product approval lists. The RDRD lists 236 products that have received orphan status designation--that is, were found to be 'promising' for the treatment of a rare disease--and though not yet approved for marketing for that rare disease, they are already approved for marketing to treat some other disease or condition. The RDRD contains three tables: Orphan-designated products with at least one marketing approval for a common disease indication (N = 109); orphan-designated products with at least one marketing approval for a rare disease indication (N = 76); and orphan-designated products with marketing approvals for both common and rare disease indications (N = 51). While the data included in the database is a re-configuration/cross-indexing of information already released by the FDA, it offers sponsors a new tool for finding special opportunities to develop niche therapies for rare disease patients.     

Histamine: an undercover agent in multiple rare diseases?

Histamine is a biogenic amine performing pleiotropic effects in humans, involving tasks within the immune and neuroendocrine systems, neurotransmission, gastric secretion, cell life and death, and development. It is the product of the histidine decarboxylase activity, and its effects are mainly mediated through four different G-protein coupled receptors. Thus, histamine-related effects are the results of highly interconnected and tissue-specific signalling networks. Consequently, alterations in histamine-related factors could be an important part in the cause of multiple rare/orphan diseases. Bearing this hypothesis in mind, more than 25 rare diseases related to histamine physiopathology have been identified using a computationally assisted text mining approach. These newly integrated data will provide insight to elucidate the molecular causes of these rare diseases. The data can also help in devising new intervention strategies for personalized medicine for multiple rare diseases.