1 The PROTECT project Introduction Xavier Kurz Pharmacovigilance and Risk management Patient Health Protection Unit European Medicines Agency Brookings Active Surveillance Implementation Council Meeting #2 The Brookings Institution, Washington DC November 18, 2010
2 PROTECT is receiving funding from the European Community's Seventh Framework Programme (FP7/ ) for the Innovative Medicine Initiative (www.imi.europa.eu).
3 Partners Public Private Regulators: EMA (Co-ordinator) DKMA (DK) AEMPS (ES) MHRA (UK) GSK (Deputy Co-ordinator) Sanofi- Aventis Roche Novartis Academic Institutions: University of Munich FICF (Barcelona) INSERM (Paris) Mario Negri Institute (Milan) University of Groningen University of Utrecht Imperial College London University of Newcastle Upon Tyne SMEs: Others: WHO UMC GPRD IAPO CEIFE Pfizer Amgen Genzyme Merck Serono Bayer Schering Astra Zeneca Lundbeck NovoNordisk Outcome Europe PGRx
4 PROTECT Goal To strengthen the monitoring of benefit-risk of medicines in Europe by developing innovative methods to enhance early detection and assessment of adverse drug reactions from different data sources (clinical trials, spontaneous reporting and observational studies) to enable the integration and presentation of data on benefits and risks These methods will be tested in case studies.
5 Data collection from consumers WP4 Clinical trials Observational studies Electronic health records Spontaneous ADR reports Benefits Risks Signal detection WP3 Benefit-risk integration and representation WP5 Signal evaluation WP2 Validation studies WP6 Training and education WP7
6 WP 2: Framework for pharmacoepidemiological studies To: develop test disseminate Objectives: methodological standards for the: design conduct analysis of pharmacoepidemiological studies applicable to: different safety issues using different data sources
7 Work Package 2 WG1 Databases Conduct of 5 adverse event - drug pair studies in different EU databases Selection of 5 key adverse event - drug pairs Development of study protocols for all 5 pairs Compare results of studies Identify sources of discrepancies Antidepressants (incl. Benzodiazepines) -Hip Fracture Antibiotics - Acute liver injury Beta2 Agonists - Myocardial infarction Antiepileptics - Suicide Calcium Channel Blockers - Cancer
8 Work Package 3: Signal Detection Objective: To improve early and proactive signal detection from spontaneous reports, electronic health records, and clinical trials.
9 Work Package 3: Signal Detection Scope Develop new methods for signal detection in Individual Case Safety Reports. Develop methods and guidelines for signal detection and strengthening in Electronic Health Records. Evaluate signal detection based on Suspected Unexpected Serious Adverse Reactions from clinical trials. Recommendations for good signal detection practices.
10 Work Package 3: Sub-projects 1. Merits of disproportionality analysis 2. Structured database of known ADRs 3. Risk estimates from trials 4. Signal detection recommendations 5. Better use of existing ADR terminologies 6. Novel tools for grouping ADRs 7. Other information to enhance signal detection 8. Signal detection based on SUSARs 9. Subgroups and risk factors 10. Signal detection in Electronic Health Records 11. Drug-drug interaction detection 12. Duplicate detection
11 Work Package 4: Data collection from consumers Objectives: To assess the feasibility, efficiency and usefulness of modern methods of data collection including using web-based data collection and computerised, interactive voice responsive systems (IVRS) by telephone WP 4 will address limitations of data capture through conventional methods such as health care professionals and electronic health records.
12 Work Package 5: Benefit-risk Integration and Representation Objectives: To assess and test methodologies for the benefit-risk assessment of medicines To develop tools for the visualisation of benefits and risks of medicinal products Considerations given to: Perspectives of patients, healthcare prescribers, regulatory agencies and drug manufacturers From pre-approval to post-approval B-R assessment Individual and population-based decision-making Wave 1 case studies: Tysabri, Accomplia, Raptiva, Ketek
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