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Okumoto A, Nomura Y, Maki K, Ogawa T, Onodera H, Shikano M, Okabe N. Addressing practical issues in the smooth implementation of revised guidelines for non-clinical studies of vaccines for infectious disease prevention. Regul Toxicol Pharmacol 2023:105413. [PMID: 37230176 DOI: 10.1016/j.yrtph.2023.105413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 05/27/2023]
Abstract
Herein, we investigated possible practical issues for the smooth implementation of the revised Japanese Guidelines for Non-clinical Studies of Vaccines for the Prevention of Infectious Diseases, which were raised in response to public comments on the proposed guideline revision and a gap analysis of the World Health Organization and European Medicines Agency guidelines. We identified main issues such as the non-clinical safety studies of adjuvants and evaluation of local cumulative tolerance in toxicity studies. The revised Japanese Pharmaceuticals and Medical Devices Agency (PMDA)/Ministry of Health, Labour and Welfare (MHLW) guidelines require non-clinical safety studies for vaccines containing new adjuvants, but additional safety pharmacology studies or safety studies in two animal species may be required if non-clinical safety studies raise any concerns (i.e., systemic distribution). Adjuvant biodistribution studies may aid in understanding vaccine characteristics. The evaluation of local cumulative tolerance in non-clinical studies, which was the focus of the Japanese review, can be omitted by including a warning in the package insert to avoid injection to the same site. The study's findings will be reflected in a Q&A to be released by the Japanese MHLW. We hope that this study will contribute to the global and harmonized development of vaccines.
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Affiliation(s)
- Atsuko Okumoto
- Graduate School of Pharmaceutical Sciences, Tokyo University of Science, 162-8601, Tokyo, Japan; Pharmaceuticals and Medical Devices Agency, 100-0013, Tokyo, Japan.
| | - Yumiko Nomura
- Graduate School of Pharmaceutical Sciences, Tokyo University of Science, 162-8601, Tokyo, Japan; Ministry of Health, Labor, and Welfare, 100-8916, Tokyo, Japan
| | - Kazushige Maki
- Pharmaceuticals and Medical Devices Agency, 100-0013, Tokyo, Japan
| | - Takashi Ogawa
- Pharmaceuticals and Medical Devices Agency, 100-0013, Tokyo, Japan
| | - Hiroshi Onodera
- National Institute of Health Sciences, 210-9501, Kanagawa, Japan
| | - Mayumi Shikano
- Graduate School of Pharmaceutical Sciences, Tokyo University of Science, 162-8601, Tokyo, Japan; Faculty of Pharmaceutical Sciences, Tokyo University of Science, 162-8601, Tokyo, Japan
| | - Nobuhiko Okabe
- Kawasaki City Institute for Public Health, 210-0821, Kanagawa, Japan
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Nomura Y, Noda K, Oohashi Y, Okuda S, Matsumoto J, Nakano T, Tsuchida N, Ishii KJ, Hayashi K, Iiyama T, Onodera H, Ishii K, Shikano M, Okabe N. Proposal for the revision of guidelines for clinical trials of vaccines to prevent infectious diseases in Japan. Vaccine 2022; 40:6295-6304. [PMID: 36167693 DOI: 10.1016/j.vaccine.2022.09.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/02/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022]
Abstract
The development of vaccines against infectious diseases requires a different approach from that of therapeutics, because vaccines are inoculated into healthy individuals and have a preventive effect by activating the immunity of the inoculated human. In Japan, "The Guideline for Clinical Trials of Vaccines for the Prevention of Infectious Diseases" was published in 2010 before changes occurred in the vaccine development environment in Japan, such as the introductions of foreign vaccines and simultaneous global development. This study aimed to identify current challenges in vaccine development through a questionnaire-based survey of pharmaceutical companies in Japan and by comparing the domestic and international guidelines and surveying review reports of 35 vaccines approved in Japan between April 2010 and December 2020. Identified challenges included the requirement for protective efficacy trials, efficacy evaluation of combination vaccines, development of multiregional and foreign clinical trials, and immunization of older adults and immunocompromised patients. We propose that new vaccines against infectious diseases should be evaluated for the protective efficacy, preferably through multiregional clinical trials. Additionally, differences in the incidence of infectious diseases or in epidemic virus strains between regions may affect the trials, when multiregional clinical trials are conducted, but immunogenicity-based studies can be conducted if a correlation between protective efficacy and immunogenicity has been established. We suggest that licensed combination vaccines can be used as comparators when an antigen is added to a licensed combination vaccine. We also proposed that the efficacy of a vaccine in non-major subjects, such as older adults or immunocompromised patients could be evaluated by comparing immunogenicity in major subjects with the confirmed protective effects of the vaccine. It is expected that these revisions will lead to the rapid advancement of vaccine development, which should contribute to the improvement of public health.
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Affiliation(s)
- Yumiko Nomura
- Graduate School of Pharmaceutical Sciences, Tokyo University of Science, 162-8601, Tokyo, Japan; Ministry of Health, Labour and Welfare, 100-8916, Tokyo, Japan.
| | - Kiyohito Noda
- Faculty of Pharmaceutical Sciences, Tokyo University of Science, 162-8601, Tokyo, Japan
| | - Yuusuke Oohashi
- Graduate School of Pharmaceutical Sciences, Tokyo University of Science, 162-8601, Tokyo, Japan; Pharmaceuticals and Medical Devices Agency, 100-0013, Tokyo, Japan
| | - Shin Okuda
- Faculty of Pharmaceutical Sciences, Tokyo University of Science, 162-8601, Tokyo, Japan
| | - Jun Matsumoto
- Pharmaceuticals and Medical Devices Agency, 100-0013, Tokyo, Japan
| | | | - Nao Tsuchida
- National Hospital Organization, 152-8621, Tokyo, Japan
| | - Ken J Ishii
- The Institute of Medical Science, The University of Tokyo, 108-8639, Tokyo, Japan
| | | | - Tatsuo Iiyama
- National Center for Global Health and Medicine, 162-8655, Tokyo, Japan
| | - Hiroshi Onodera
- National Institute of Health Sciences, 210-9501, Kanagawa, Japan
| | - Koji Ishii
- National Institute of Infectious Diseases, 162-8640, Tokyo, Japan
| | - Mayumi Shikano
- Graduate School of Pharmaceutical Sciences, Tokyo University of Science, 162-8601, Tokyo, Japan; Faculty of Pharmaceutical Sciences, Tokyo University of Science, 162-8601, Tokyo, Japan
| | - Nobuhiko Okabe
- Kawasaki City Institute for Public Health, 210-0821, Kanagawa, Japan
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