Respiratory Safety Pharmacology Endpoints in Toxicology

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Respiratory Safety Pharmacology Endpoints in Toxicology Simon Authier, DVM, MBA, PhD Director - Safety Pharmacology and Veterinary Science CIToxLAB North America

Agenda Introduction Preliminary results from an Industry Survey Expert panel presentations Pros: Jeff Tepper, PhD, DABT (Tepper Nonclinical Consulting) Cons: Dennis Murphy, PhD, DABT (GlaxoSmithKline Pharmaceuticals) Open discussions Closing remarks

Introduction Inclusion of safety pharmacology in toxicology has received increasing attention over the last 2 years: Scientific session at the 2010 Annual ACT Meeting in Baltimore Continuing education session at the 2011 SPS meeting in Innsbruck, Austria Industry survey launched by the SPS in August 2012 Discussed in a publication in the 2012 Safety Pharmacology Special Issue of the Journal of Pharmacological and Toxicological Methods (Ewart et al.) Upcoming scientific activities on SP in toxicology studies: 2 additional webinars organized by the SPS in September 2012 One Continuing Education and one Plenary session at the 2012 Annual SPS meeting in Phoenix AZ A scientific whitepaper from the SPS in 2013 integrating Industry survey results and Webinar discussions

Introduction: Methodologies Multiple monitoring methods are available for respiratory safety pharmacology in toxicology studies

Preliminary Industry Survey Results

Preliminary Industry Survey Results

Preliminary Industry Survey Results

On what study day(s) do you measure safety pharmacology endpoints in your toxicology study (day 1 = first day of dosing)? Choose all that apply 80% 70% 60% 50% 40% 30% 20% 10% 0% Baseline Day 1 Day 2 to avoid interferences from study activities on Day 1 Last week of dosing After the last dosing During week 1 for biological agents

Preliminary Industry Survey Results

Number of answers Preliminary Industry Survey Results If you have conducted respiratory safety pharmacology investigations by adding endpoints to toxicology studies, which species have you used? 250 Minipigs 200 19 11 Mouse 150 100 50 0 82 47 3 23 15 48 44 53 Respiratory SP included in nonregulatory studies Respiratory SP included in regulatory tox for biologics 68 54 Respiratory SP included in regulatory tox for NCE Rat Canine Nonhuman primate

Preliminary Industry Survey Results Based on your opinion, S7A safety pharmacology endpoints in toxicology studies are generally appropriate for: 180 160 140 120 100 80 60 40 20 0 Completely or partially agree = 61% 54 54 49 48 33 38 22 13 11 12 Respiratory safety pharmacology for small molecules Respiratory safety pharmacology for large molecules Completely agree Partially agree Neither agree nor disagree Partially disagree Completely disagree

Preliminary Industry Survey Results

Preliminary Industry Survey Results If you have received feedback from regulators what did it indicate? 25 20 15 10 5 0 21 1 Respiratory measurement This methodology was considered acceptable by the agency This methodology was NOT considered acceptable by the agency The agency suggested modification(s) to the design

Preliminary Industry Survey Results Based on your experience, which of the following do you consider a meaningful advantage of adding S7 safety pharmacology endpoints to regulatory toxicology studies: 200 180 160 140 Very important advantage 120 Important advantage 100 80 Modest advantage 60 40 Not an advantage 20 0 Increased sensitivity due to increased number of treated animals and assessment after repeat dosing Overall reduction in number of animals used (3Rs) Added value interpretation due to combined experimental endpoints in same animals Practice acceptable to regulatory agencies Cost savings on overall program development Allows better risk mitigation by enabling more diverse evaluation panels for core battery systems

Slides of expert panel members

Questions for open discussions Based on your opinion, S7A safety pharmacology endpoints in regulatory toxicology studies are generally appropriate for: Respiratory safety pharmacology for small molecules? Respiratory safety pharmacology for large molecules?

Questions for open discussions In your organization, has the ability to add safety pharmacology endpoints onto regulatory toxicology studies had any of the following consequences? Allowed you to manage safety risk more effectively Data contributed to the halting the progression of a compound Data addressed a specific concern and supported the continuation of a compound

Questions for open discussions Based on your experience, please state any disadvantages of safety pharmacology investigations in toxicology studies? Interferences on functional safety pharmacology endpoints by toxicology related activities in the room are unavoidable Safety pharmacology investigations in toxicology studies could have significant interferences on toxicology endpoints and parameters. Assignment of safety pharmacology expert technical staff to conduct investigations in toxicology studies is problematic Sensitivity of safety pharmacology in toxicology is insufficient to provide an acceptable assessment in most programs Safety pharmacology in toxicology represents a risk during regulatory submission as it is not an industry standard

Questions for open discussions Based on your experience, please state any advantages of safety pharmacology investigations in toxicology studies? Increased sensitivity due to increased number of treated animals and assessment after repeat dosing Overall reduction in number of animals used (3Rs) Added value interpretation due to combined experimental endpoints in same animals Practice acceptable to regulatory agencies Cost savings on overall program development Allows better risk mitigation by enabling more diverse evaluation panels for core battery systems

Questions for open discussions Have you received regulatory feedback on inclusion of respiratory safety pharmacology in toxicology studies?

Thank you for your time and participation! Looking forward to see you in Phoenix for the 2012 Annual SPS meeting