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Ando Y.,Pharmaceuticals and Medical Devices Agency | Uyama Y.,Office of Regulatory Science Pharmaceuticals and Medical Devices Agency | Uyama Y.,Chiba University
Journal of Biopharmaceutical Statistics | Year: 2012

Multiregional clinical trials including Japanese subjects are playing a key role in new drug development in Japan. In addition to the consideration of differences in intrinsic and extrinsic ethnic factors, deciding the sample size of Japanese subjects is an important issue when a multiregional clinical trial is intended to be used for Japanese submission. Accumulated experience suggests that there are several points to consider, such as the basic principles described in the guidance document, drug development strategy, trial phase, and disease background. The difficulty of interpreting the results of Japanese trials should also be considered. © 2012 Taylor and Francis Group, LLC. Source

Ando Y.,Pharmaceuticals and Medical Devices Agency | Hamasaki T.,Osaka University
Pharmaceutical Statistics | Year: 2010

The multi-regional clinical trials (MRCTs) being administered in different regions of the world now play a major role in providing evidence for the efficacy and safety of new drugs amidst the simultaneous global development and worldwide registration of such drugs, in support of the expeditious availability of medical products to patients. However, such trials present considerable challenges as far as quality, design, implementation, analysis, and interpretation are concerned. In this article, we share our observations and lessons learned from the design, implementation, analysis, and interpretation of some MRCTs with case examples. Current Japanese regulatory guidance on MRCTs is introduced along with some suggestions for design, implementation, and interpretation. Copyright © 2010 John Wiley & Sons, Ltd. Source

Hirakawa A.,Nagoya University | Wages N.A.,University of Virginia | Sato H.,Pharmaceuticals and Medical Devices Agency | Matsui S.,Nagoya University
Statistics in Medicine | Year: 2015

Little is known about the relative performance of competing model-based dose-finding methods for combination phase I trials. In this study, we focused on five model-based dose-finding methods that have been recently developed. We compared the recommendation rates for true maximum-tolerated dose combinations (MTDCs) and over-dose combinations among these methods under 16 scenarios for 3 × 3, 4 × 4, 2 × 4, and 3 × 5 dose combination matrices. We found that performance of the model-based dose-finding methods varied depending on (1) whether the dose combination matrix is square or not; (2) whether the true MTDCs exist within the same group along the diagonals of the dose combination matrix; and (3) the number of true MTDCs. We discuss the details of the operating characteristics and the advantages and disadvantages of the five methods compared. © 2015 John Wiley & Sons, Ltd. Source

Hirakawa A.,Pharmaceuticals and Medical Devices Agency | Hirakawa A.,Tokyo University of Science
Statistics in Medicine | Year: 2012

In this study, we developed a novel adaptive dose-finding approach for inclusion of correlated bivariate binary and continuous outcomes in designing phase I oncology trials. For this approach, binary toxicity and continuous efficacy outcomes are modeled jointly with a factorization model. The basic strategy of the proposed approach is based primarily on the Bayesian method. We based the dose escalation/de-escalation decision rules on the posterior distributions of both toxicity and efficacy outcomes. We compared the operating characteristics of the proposed and existing methods through simulation studies under various scenarios. We found that the recommendation rate of the true recommended dose (RD) in the proposed method was more favorable than that in the existing method when the true RD was relatively at the tail end among the tested doses. It was similar to that of the existing method when the true RD was relatively at the top end. © 2011 John Wiley & Sons, Ltd. Source

Hara A.,Research and Development Division | Sato D.,Pharmaceuticals and Medical Devices Agency | Sahara Y.,Health Policy Bureau
Therapeutic Innovation and Regulatory Science | Year: 2014

Regenerative medicine using stem cells is expected to provide tools for the replacement or repair of damaged tissues, opening up the possibility of treating many diseases that cannot otherwise be effectively treated. To promote the development of and access to regenerative medicine, it is important to take a balance of expedited provision of innovative therapies and appropriate steps to ensure safety and efficacy. While most developed countries have various regulatory frameworks for clinical trials and medical treatments involving stem cells, the Act on the Safety of Regenerative Medicine and the Revised Pharmaceutical Affairs Law have recently been simultaneously passed by the Japanese Diet. According to the former act, these medical technologies are categorized into 3 classes depending on their anticipated potential risk to human health, and the specific procedures falling into each class are determined. In addition, the act enables medical institutions to commission cell processing by business facilities outside the institution (even foreign facilities) that fulfill the requirements set out by the Ministry of Health, Labour and Welfare, with the aim to promote collaboration between academia and industry from an early stage. According to the latter law, a therapeutic product for regenerative medicine is defined as a product distinct from pharmaceuticals and medical devices, enabling regenerative medical products to be given a conditional, time-limited marketing authorization much earlier than that under the previous system. The new legal framework of regenerative medicine is expected to achieve the aim to develop and promote regenerative medicine, aiming at timely provision of safe and effective therapies and products. © The Author(s) 2014. Source

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