转化医学和预测性生物标志物在慢性心力衰竭管理的新型创新治疗发展中的作用:制药行业的观点

S. Douglas, G. Feuerstein
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引用次数: 0

摘要

慢性心力衰竭(CHF)是发病率持续上升的少数心血管疾病之一。虽然与这种恶性疾病相关的社会经济负担仍然很高,但由于缺乏差异化的疗效和/或安全性问题,最近尝试开发新的差异化治疗方法(ET-1, tnf - α,双重ACE/NEP抑制剂)来治疗CHF已经失败。这种令人失望的情况使人们注意到今天在以下方面所面临的困难:(a)为管理这种疾病选择最适当、最具创新性的目标;(b)开发预测性生物标志物,以验证靶标,确定化合物药效学/动力学(安全性/有效性)关系,分类疾病修饰,和/或协助患者选择/分层;(c)最佳慢性心力衰竭临床试验设计。本评论讨论了转化医学在临床前和临床CHF药物发现过程中的作用,并详细说明了如何最好地利用这一新兴科学学科来降低投资风险/成本。关键词:心脏重构;endothelin-1;心力衰竭;LV功能障碍;非侵入性成像;患者分层;药物动力学;预测生物标志物;目标参与;目标验证;转化医学;urotensin-II
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Role of Translational Medicine and Predictive Biomarkers in the Development of Novel, Innovative Treatments for the Management of Chronic Heart Failure: A Pharmaceutical Industry Perspective
Chronic heart failure (CHF) represents one of the few cardiovascular diseases with an incidence that continues to rise. While the socio-economic burden associated with this malignant disease remains high, recent attempts to develop novel, differentiated therapies for the management of CHF (ET-1, TNFα, dual ACE/NEP inhibitors) have met with failure due to lack of differentiated efficacy and/or safety concerns. Such disappointments have drawn attention to the difficulties faced today in (a) the selection of the most appropriate, innovative targets for the management of this disease; (b) the development of predictive biomarkers that validate the target, define compound pharmacodynamic/-kinetic (safety/efficacy) relationships, catalog disease modification, and/or assist in patient selection/stratification; and (c) optimal CHF clinical trial design. The present commentary discusses the role of Translational Medicine in the preclinical and clinical CHF Drug Discovery process and details how this emerging scientific discipline can be best used to minimize investment risk/cost. Keywords: cardiac remodeling; endothelin-1; heart failure; LV dysfunction; noninvasive imaging; patient stratification; pharmacokinetics; predictive biomarkers; target engagement; target validation; Translational Medicine; urotensin-II
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