Bioequivalence and Statistics in Clinical Pharmacology

Scott D. Patterson, Byron Jones

• Bioequivalence & Biopharmaceutical DevelopmentDrug Development and Clinical PharmacologyAims of This BookBiopharmaceutical DevelopmentClinical PharmacologyStatistics in Clinical PharmacologyStructure of the BookHistory and Regulation of BioequivalenceWhen and How BE Studies Are PerformedWhy Are BE Studies Performed?Deciding When Formulations Are BioequivalentPotential Issues with TOST BioequivalentCurrent International RegulationSome Practical NotesTesting for Average BioequivalenceBackgroundLinear Model for 2 x 2 DataApplying the TOST ProcedureCarry-over, Sequence, and Interaction EffectsChecking Assumptions Made about the Linear ModelPower and Sample Size for ABE in the 2 x 2 DesignExample Where Test and Reference Are Not ABENonparametric AnalysisBE Studies with More Than Two PeriodsBackgroundThree-period DesignsWithin-subject VariabilityRobust Analyses for Three Period DesignsFour-period DesignsDesignes with More Than Two TreatmentsAdjusting for Multiple TestingNonparametric Analyses of TmaxTechnical appendix: EfficiencyTables of DataSpecial Topics in BioequivalenceDealing with Special BE ChallengesRestricted Maximum Likelihood ModellingFailing BE and the DER AssessmentSimulationData-based SimulationCarry-overOptimal DesignsDetermining Trial SizeWhat Outliers Are and How to Handle Their DataBayesian BE AssessmentAdaptive Bioequivalence TrialsBackgroundTwo-stage design for testing for ABETOST using the standard combination testExample of using the standard combination testThe maximum combination testExample of using the maximum combination testConditional errors and conditional powerAlgorithm for sample size re-estimationOperating characteristicsConclusionsTechniccal Appendix: R codeScaled Average Bioequivalence TestingBackgroundScaled Average Bioequivalence in EuropeScaled Average Bioequivalence in USADiscussion and CautionsClinical PharmacologyClinical Pharmacology Safety StudiesBackgroundFirst-time-in-humansSub-chronic Dosing StudiesFood-Effect Assessment and DDIsDose-ProportionalityTechnical AppendixQTcBackgroundModelling of QTc DataInterpreting the QTc Modelling FindingsDesign of a Thorough QTc Study in the FutureClinical Pharmacology Efficacy StudiesBackgroundSub-chronic DosingPhase IIa and the Proof of ConceptPopulation PharmacokineticsPopulation and PharmacokineticsAbsolute and Relative BioavailabilityAge and Gender Pharmacokinetic StudiesEthnicityLiver DiseaseKidney DiseaseTechnical Appendix Vaccines & Epilogue Vaccine TrialsBrief Introduction to Vaccine Research and DevelopmentPhase I Vaccine StudiesProof of Concept and Phase IILot ConsistencyConcomitant VaccinationCross-over Trials in VaccinesEpilogue BibliographyIndex

"The two authors are well-respected statisticians with numerous publications in BE and broad pharmaceutical industry experience. … The book is written in plain language and statistics is presented with minimum mathematical proof, which makes it a great introduction and reference for statisticians and clinical pharmacologists. With case studies and associated SAS and R codes included in the book and website, both statisticians and clinical pharmacologists will find this book helpful in understanding the context to use a method and implementing the ready-to-use codes. Particularly, each chapter begins with an interesting real-life story of the authors working as statisticians in the pharmaceutical industry, which makes the reading delightful. …In summary, Bioequivalence and Statistics in Clinical Pharmacology, Second Edition, provides an update on regulatory recommendations, statistical methods, and applications in clinical pharmacology and BE studies to support drug product development. With its inclusion of SAS and R codes, this book will be a valuable reference for pharmaceutical scientists, statisticians, and regulators working in these areas."—Wangjie Sun and Wenlei Jiang, US Food and Drug Administration, in Journal of the American Statistical Association, January 2018"This book is a second edition of the authors’ take on the concepts and methods in the analysis and design of bioequivalence studies, supported by references to regulation authorities’ guidelines ... The authors are working in the pharmaceutical industry and therefore bring a view from the inside compared to the other reference work in the field by academics … Throughout the book, different examples with data and codes are provided both showing and not showing bioequivalence to facilitate the learning process. … To conclude, this book covers efficiently the statistical methods of bioequivalence testing and their many applications in clinical pharmacology. Furthermore, the dense reference list provides a helpful guide for the reader to go in deeper details on topics of interest."—Julie Bertrand, Faculté de Médecine Bichat, IAME, in Journal of Biopharmaceutical Statistics, May 2017"The first edition of Bioequivalence and Statistics in Clinical Pharmacology was a classic text book for researchers and statisticians in the field of clinical pharmacology and pharmaceutical industry. This new second edition is a timely update with the inclusion of new areas such as adaptive bioequivalence trials, scaled average bioequivalence testing, and vaccine trials. This is one of few books in the literature with the focus on statistical issues in clinical pharmacology and bioequivalence. The topics it covers are critical for understanding the pharmacology of an investigational drug, and are becoming increasingly important in the era of precision medicine. The book is just as well structured as the first edition, in an accessible, thorough, and clear manner. Case studies and associated SAS code included in the book are extremely helpful. In summary, the book is a most welcome addition to the collection of pharmaceutic statisticians and researchers in clinical pharmacology." —Liang Fang, Director of Biostatistics, Gilead Sciences Inc."Bioequivalence and Statistics in Clinical Pharmacology, Second Edition, provides readers with a statistical background of bioequivalence and presents several special topics in clinical pharmacology. This second edition contains updated and extended discussions of these topics and includes new chapters on adaptive bioequivalence studies, scaled average bioequivalence, and vaccine trials. The book’s presentation is comprehensive and clear, and is complimented by numerous illustrations, examples, and computer programs with data analyses. Scientists and practitioners working in industry, regulatory authorities, and academia will find this book useful, interesting, and enjoyable due to the delightful and instructive stories featured in the introductions of each chapter, the various important and relevant topics covered by these chapters, and the informative and practical technical appendices."—Laszlo Endrenyi, Professor Emeritus, University of TorontoPraise for the First Edition:"… the book provides a good introduction to common uses of statistics in early phases of the drug development process by using a good mix of technical detail, intuitive understanding and factual knowledge. … personal accounts together with the numerous real data examples which are accompanied by SAS code for analysis and the opportunity to download the data to gain first-hand experience are the best features of the book. … the authors did a fine job in providing an introduction to statistics in the early stages of the drug development process. The availability of real example data allows the reader to engage himself easily in the topic and the long experience of the authors ensures that many different aspects of pharmacological studies are discussed."—Thomas Jaki, Lancaster University, Journal of the Royal Statistical Society, Series A, 2010"I really enjoyed reading this book. Each chapter includes an excellent introduction based on Scott Patterson's experience working as a biometrician. This will especially be of interest to young statisticians starting their career in the pharmaceutical industry. Therefore, I strongly recommend this book to all pharmaceutical statisticians to learn more of the challenging statistical problems being generated in drug development. In addition, the presented material provides a springboard for all scientists from academia who are looking to do research in this area of medical applications."—Dieter Haushcke, Biometrics, September, 2006"The authors formulate bioequivalence exhaustively and clearly. … Given the background of the authors, they constitute a key piece of social information in understanding the context in which clinical pharmacology research develops within the pharmaceutical industry."—Journal of Biopharmaceutical Statistics