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LATEST NEWS UPDATES | Drugs on hold over doubts about Indian trials

Drugs on hold over doubts about Indian trials

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published Published on Dec 7, 2014   modified Modified on Dec 7, 2014
-The Telegraph

Regulators in several European countries are suspending marketing approval for 25 generic drugs because of concerns over the quality of data from human studies conducted by an Indian contract research company, a French medical safety agency said on Friday.

Drug regulators in Belgium, France, Germany and Luxembourg have decided to suspend the marketing authorisation for the generic drugs after they discovered "irregularities" in documents relating to human studies conducted by GVK Bio in Hyderabad.

"This decision is taken as a precaution. No element at this stage has led to establish a true risk to human health or a lack of efficacy of these drugs," France's National Agency for Medication Safety and Health Products, or ANSM, said on its website.

The suspended drugs have equivalents made by international drug makers that can be used as alternatives, so patients will not have to interrupt their treatment, the ANSM said.

While the European regulators' decisions have no implications for the marketing of these generic drugs in India, a Delhi-based pharmacology expert said, they highlight concerns that human studies of drugs in India have often breached rules that make up good clinical practice.

GVK Bio had between 2008 and 2014 conducted bio-equivalence studies that were intended to show that the generic drugs have the same pharmacological behaviour in humans as their original branded versions.

During site inspections of GVK Bio in Hyderabad, ANSM inspectors reported finding irregularities in electrocardiogram documents related to the studies.

While electrocardiograms themselves do not show bio-equivalence, they are used to monitor the volunteers who are given the drugs being studied. The irregularities show lack of compliance with good clinical practices, the French agency said.

GVK Bio's CEO, Manni Kantipudi, disputed the French watchdog's findings and said that electrocardiograms were not an important component of the drug efficacy studies.

While the ANSM did not provide details of the purported irregularities, GVK Bio's response to the regulators' decisions suggests there were concerns that multiple electrocardiograms, claimed as belonging to multiple volunteers, had appeared to belong to a single volunteer.

GVK Bio said in a statement on its website that it had submitted independent cardiology assessments of electrocardiograms indicating they belonged to multiple volunteers "and it is difficult to conclude that they belonged to the same volunteer".

The ANSM did not name the 25 generic drugs, but given the nature of bio-equivalence studies, they are likely to be generic drugs manufactured by Indian companies seeking marketing approvals in Europe.

A pharmacology specialist who has been tracking clinical trials said the regulators' decisions affect marketing approvals for the 25 generic drugs only in Europe, but "brings India a bad name".

"This is really an issue between the Indian (drug) exporters, their contract research organisation and European regulators," said Chandra Gulhati, editor of the Monthly Index of Medical Specialities, India.

GVK Bio, Gulhati said, had also been embroiled in controversy six years ago when a man in his mid-20s who had taken part in a bio-equivalence study run by the company died.

While it emerged that the volunteer had taken part in several bio-equivalence studies too close to one another, Gulhati said, those who recruit volunteers for human studies should take the responsibility of ensuring that the volunteers rigorously follow guidelines.

Kantipudi said the ANSM had drawn its conclusions about the electrocardiograms relating to the 25 generic drugs without taking into account the company's views.

"We have agreed to redo the studies, I'm fine with that, but don't say that there was gross manipulation of the ECGs," Kantipudi was quoted as saying.

He said the company had received board approval to spend $5.7-$6.5 million for new studies.

The European Medicines Agency separately released a statement saying it would "issue a recommendation on whether the marketing authorisations of the concerned medicines should be maintained, varied, suspended or withdrawn across the EU". That recommendation is expected in January 2015.

German watchdog BfArM said it was investigating 176 approvals given to 28 drug makers. It did not name the drugs or companies affected.

BfArM said it was ordering drug makers whose approvals had been found to have been based on data from GVK trials to stop distributing the drugs concerned until they could provide data from new studies.

The ANSM said several drug makers, whom it did not identify, had offered to carry out new studies which, if positive, could allow the drugs back on the market again.

Kantipudi said GVK Bio had started conducting new studies for five to six of its clients. About 35 of the company's 400 clients have been affected by the European regulator's move, he said.

He said the US Food and Drug Administration had inspected the company's Hyderabad plant in June, after the French regulator's audit, and was satisfied with electrocardiogram-related data. No other regulator had contacted the company since then, he added.

The quality of Indian pharmaceuticals has come under fire this year, with regulators in Europe and the US citing problems ranging from data manipulation to sanitation and banning the import of certain products from several firms.

Additional reporting by Reuters


The Telegraph, 7 December, 2014, http://www.telegraphindia.com/1141207/jsp/nation/story_2471.jsp#.VIPWAHs_-BE


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