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ANIMAL TOXICITY
STUDY REQUIREMENT
FOR CONDUCT OF
CLINICAL TRIAL
May 9, 2019
1
Toxicology: The study of poisons & is concerned with
the adverse effects of xenobiotics.
Animal toxicology studies also called non-clinical
toxicity studies.
Chemical agents that cause toxicity include-
 Drugs
 Insecticides/herbicides
 Plant toxins
 Animal toxins
 Chemical weapons
 Radioactive elements
2
• Preclinical studies are to be conducted according to
Schedule Y of Drugs and Cosmetic Act 1940.
3
Objective
Identify toxic substance prior to clinical use
Quality assessment of the drug
Quantity assessment of the drug (plasma and
tissue levels)
To study cumulative toxicity
Estimate safe starting dose for clinical studies
& subsequent dose escalation schemes in
humans.
6
• Assess hazards that cannot be
evaluated in clinical trials (e.g.
carcinogenicity and teratogenicity)
• Different types of dose identification can
be done. E.g. lethal dose LD50,
maximum tolerated dose MTD, minimum
effective dose and (ED50)
7
GENERAL PRINCIPLE
8
SOP
Test substances and
instruments should
be properly
standardized.
TYPES OF TOXICITY STUDIES
9
• single dose of a substance, or multiple doses given within 24hrs or
an inhalation exposure of 4hrs, observed for 14 days
ACUTE TOXICITY
several days to 1 month.
SUBACUTE TOXICITY
repeated or spread over an intermediate time range (1-3 months).
SUB CHRONIC TOXICITY:
• Exposures (repeated or continuous) over a long (> 3 months) even up
to 2 years
CHRONIC TOXICITY:
11
Single-dose (Acute) Toxicity Studies
16
2 Rodent
species
Ensures systemic absorption of the drug
(unless the intended route in humans is
only intravenous)
Recommended limit
• 2000 mg/kg or
• 10 times the normal dose that is intended in
humans
Use the
same route
as intended
in humans
Whichever
is higher
• At least 5 animals / sex / group
• At least 4 graded doses (4 dose-groups)
• Observation for toxic effects (if any) : 14 days
• Observation for mortality :
 7 days [parenteral administration]
 14 days [oral administration]
17
Other parameters :
Symptoms, signs and mode of death, signs of
intoxication, effect on body weight
Gross and histopathological changes
LD 10 and LD 50 values, (preferably with 95 % CI)
Genetic effects if any
Establish the:
Maximum tolerated dose (MTD)
Minimum lethal dose (MLD)
Target organ of toxicity (if possible)
18
Cytotoxic anticancer agents
• MTD confirm
• To establish a linear relationship between
toxicity and body surface area
• MTD can be established in non-rodent
species, if:
o Rodents are poor predictors of human toxicity
e.g. antifolate
o Cytotoxic drugs acts by a novel mechanism of
action
19
Repeated dose toxicity studies
(Sub acute/ sub chronic toxicity)
21
Aim:
To identify Target Organ Toxicity
To establish MTD for subsequent studies
Animal- at least 2 mammalian species(1
rodent & 1 non- rodent)
• Rodent- must be between 6-8 weeks
• Non-rodent should be between 4-9 months
Younger and still growing animals are
preferred in initiation of subchronic studies
22
Rodents
• One rodent species (preferably rat)
• At least 4 graded doses including control
• Two groups : control and treatment
• Minimum of 5 animals of each sex
• Proposed clinical route of administration
• Test substance given 7 days a week
Non-Rodents
• One male and one female
• Starting dose (3 to 5 times the extrapolated effective dose) or
MTD (whichever is less)
• Dose escalation every 3rd day, lowered if toxicity seen
• Then test substance given 7 days a week
Dose-ranging study/ Repeated dose toxicity
study
23
Repeated-dose Toxicity Studies
• Wherever applicable, include a Control group
• Drug is given on 14, 28, 90 & 180 days,
• 3 other groups are formed :
 Highest dose Observable toxicity [MTD]
 Lowest dose No observable toxicity
[NOAEL]
should be comparable to intended
therapeutic dose or multiple of it
 Intermediate dose Some symptoms ; not gross
toxicity or death placed
logarithmically between two doses
25
26
Methodology
• Rodent : 6-10/sex/group
• Non-rodent : 2-3/sex/group
14-28 Day repeated-dose
(Sub acute toxicity studies)
• Rodent : 15-30/sex/group
• Non-rodent : 4-6/sex/group
90-Day repeated-dose (Sub
chronic toxicity studies)
• Rodent : 15-30/sex/group
• Non-rodent : 4-6/sex/group
180-Day repeated-dose
(Chronic toxicity studies)
Parameters
to be
monitored
Physiological
Organ
Pathology:
Gross and
Microscopic
ECG and
fundoscopy
(non-rodent)
Behavioral
Biochemical &
microscopic
observations of urine
and blood
27
Number of animals required for
repeated-dose toxicity studies
14-28 days 84-182 days
Group Rodent (Rat) Non-rodent
(Dog or
Monkey)
Rodent (Rat) Non-rodent
(Dog or
Monkey)
M F M F M F M F
Control 6-10 6-10 2-3 2-3 15-30 15-30 4-6 4-6
Low dose 6-10 6-10 2-3 2-3 15-30 15-30 4-6 4-6
Intermediate
dose
6-10 6-10 2-3 2-3 15-30 15-30 4-6 4-6
High dose 6-10 6-10 2-3 2-3 15-30 15-30 4-6 4-6
28
Lethality testing &
calculation
• It is acute toxicity testing in which death is considered a
single end-point
• LD50-
• Intraperitoneal LD50 ̴ 30% of oral
• Iv ̴ 10% of oral
29
SPECIAL TOXICITY
STUDIES
• Reproductive
• Local toxicity
• Allergenicity/hypersensitivity
• Genotoxicity
• Carcinogenicity
• Mutagenicity
30
Reproductive Toxicity
• Male Fertility
• Female Reproduction & Developmental
toxicity
o Female Fertility
o Teratogenicity
o Perinatal development
31
Reproductive toxicology study
FERTILITY STUDY
Rats
Studies are on fertility,
reproductive capability,
estrous cycles, mating
behavior, conception rate
and early stages of
gestation
TERATOLOGY STUDY
Rats and rabbits
Females are treated only
during organogenesis
period since embryo is
most susceptible to
induction of birth defects
at this time.
PRENATAL/ POST
NATAL TESTING
Pregnant females are
treated during last
quarter of pregnancy,
through lactation until
weaning. And then
sacrificed to detect
internal anomalies.
Purpose- determine the
effect of drugs in late
fetal development, labor,
delivery, lactation,
neonatal viability and
growth
32
33
• One rodent species (preferably rat)
• 3 dose groups and a control group :
Dose selection : results of previous 14 or 28-day
toxicity study
Highest dose : showing minimal toxicity in systemic
studies
• 6 adult male animals per group
34
Reproductive Toxicity of Lead Acetate in Adult male Rats: Histopathological and
Cytotoxic Studies
Haouas Z, Zidi I, Sallem A, Bhouri R, Ajina T, et al. (2015) Reproductive Toxicity of Lead Acetate in
Adult male Rats: Histopathological and Cytotoxic Studies. J Cytol Histol 6: 293. doi:10.4172/2157-
7099.1000293
35
Figure 3: Photomicrographs of TUNEL-stained testicular sections from controls (A) and rats
exposed to 2 g/l of lead acetate (B, C, and D). Magnification 400x. Arrows indicated TUNEL-
positive cells (spermatogonia; permatocytes I; spermatids) (A, B, C, D: Scale bar 20 µm)
Test substance by intended route of use
for
• minimum 28 days
• maximum 70 days
Paired with female animals of proven
fertility in a ratio of 1:2
Drug treatment of male animals
continues during pairing
Pairing continued till detection of
Sperm in vagina or 10 days, whichever
is earlier
36
Pregnant females examined after day
13 of gestation
Males sacrificed at the end of the
study
Weight of each testis and epididymis
recorded
Sperms from one epididymis
examined for motility and
morphology
Other epididymis and both testes
examined for histology
37
38
Female Reproduction and
Developmental Toxicity Studies
• For all drugs proposed for women of child bearing age
• Segment I : Female fertility
• Segment II : Teratogenicity
• Segment III : Perinatal development
• Segment I, II and III studies in albino mice or rats, and
• Segment II study also in albino rabbits as a second test
species
39
Female Fertility Study
(Segment I)
• One rodent species (rat preferred)
• 3 graded doses
• Highest dose : doesn’t affect general health of parent
animals
(usually the MTD from previous systemic studies)
• At least 15 males and 15 females per dose group
• Route of administration same as intended for therapeutic
use
40
Pups : Physiology, Behavior, Pathology (sex-wise distribution
noted)
Body weight
Food intake
Clinical signs
of intoxication
Reproduction
and
Parturition
Pathology
Gross &
Micro
Females allowed to litter,
medication continued till weaning of pups
Drug treatment continued during mating and gestation period
Drug administration : 28 days (males) & 14 days (females)
before mating
41
42
In Utero Exposure of Biochanin-A Alters Female Reproduction in Rat.
M.G.S. Soujanya1, K. Prathap Reddy2, V. Sridevi1, P. Ramachandra Reddy1* and P. Sreenivasula Reddy2
1Department of Biochemistry, Yogi Vemana University, Vemanapuram, Kadapa, A.P., India
2Department of Zoology, Sri Venkateswara University, Tirupati, A.P., India
Received date: April 11, 2016; Accepted date: April 22, 2016; Published date: April 24, 2016
Teratogenicity Study
(Segment II)
• Rodent (preferably rat) and Non-rodent (rabbit)
• Drug administered throughout organogenesis
• 3 dose levels and a Control group:
 Highest dose : minimum maternal toxicity
 Lowest dose : as proposed clinical dose or its multiple
• Route of administration : same as intended for humans
• At least 20 pregnant rats (or mice) and 12 rabbits, for each
dose
43
Observation parameters
Females
General
Signs of
intoxication
Body weight
Food
intake
Reproductive
Uterus,
Ovaries
Products of
conception
Fetuses
General
Number
Gender
Length
Weight
Pathology
Gross (n)
Visceral (n/2)
Skeletal (n/2)
44
The Impact of Proximol (Cymbopogon proximus) Intake on Pregnant Albino
Rats and their Fetuses During Gestation Period
International Journal of Morphology June 2017; 35(2):500-505
DOI: 10.4067/S0717-95022017000200019
45
Fig 1. Photographs of the uterus of pregnant rats at the 20th day of
gestation. A) Control. Showing normal symmetrical distribution
of fetuses in the two uterine horns. B) Treated. Asymmetrical
distribution of fetuses in the two uterine horns. Left uterine horn
showing visible embryonic resorption sites (arrow).
Fig 2. Photographs of fetuses at the 20 th day of gestation. A) Control. Fetus
exhibited normal morphology and normal length. B-D) Treated. Showing:
clubfoot (arrow, B), hematoma at the back (arrow, C), and fore limb without
digits (arrow, D).
46
Perinatal Study
• Specially if
→Drug to pregnant / nursing mothers for long periods
→Indications of possible adverse effects on foetus
• One rodent species (preferably rat)
• Dosing comparable to multiples of human dose and route
• At least 4 groups (including control), 15 females / group
• Drug throughout last trimester (from day 15 of gestation)
• Dose causing low foetal loss continued throughout weaning
• Second generation (F2) selected at weaning and studied.
• Observed parameters are same as teratogenicity study 48
Local Toxicity
• Dermal Toxicity
• Ocular Toxicity
• Vaginal Toxicity
• Rectal tolerance test
• Parenteral Drugs Tolerance
• Inhalation toxicity
49
Local Toxicity
• If intended for special route (other than oral) in humans
• Appropriate site (e.g., skin or vaginal mucous
membrane) in a suitable species
• Preferably use of 2 species
• 3 dose levels and untreated and / or (vehicle) Control
• If the drug is absorbed systemically, appropriate
systemic toxicity studies also required
50
Dermal Toxicity
• As cutaneous contamination is always a possibility
• Rabbit and Rat
• Applied on shaved skin (>or = 10% of Body surface area)
• Concentrations several fold higher than the clinical doses
• Period of application : 7 to 90 days
• Evaluation
› Local signs (erythema, oedema and eschar formation)
› Histological examination of sites of application
51
Fig. 6. Effect of CPD photoreactivation on UV-induced erythema and
hyperplasia in the skin of b -act-CPD photolyase transgenic mice. The
depilated back of b -act-CPD-1 transgenic mice was exposed to UV-B light
for four consecutive days (1.5 MED per day) and were either given 3 h of
photoreactivating light or kept in the dark. As a control, non-UV-exposed
animals were used. Animals were killed 3 days after the last exposure and,
except for the photoreactivation step, had been kept in the dark throughout
the experiment. ( A ) Appearance of the dorsal skin of non-UV-exposed (left),
UV-exposed (middle) and UV- exposed/photoreactivated animals (right),
showing clear erythema 52
Phototoxicity
• Tested using armstrong/ harber test in guinea pig
• Drugs used in leucoderma
• Pretest with 8 animals done to ascertain highest non-irritant
dose
• Test performed on 10 animals and 5 controls
• Induction dose – 0.3ml/patch for 2 hours±15 minutes followed
by 10 J/cm2 of UV light
• Repeated on 0, 2, 4, 7, 9 and 11 days
• Animal is then challenged with the same concentration on
days 22 – 24 followed by 10 J/cm2 of UV light
• Observations: erythema, edema formation 24 and 48 hours
later.
• Positive control- musk ambrett/ psoralin should be used.
53
Ocular toxicity studies
 2 species, including an
 albino rabbit with a large conjunctival sac
 Initial single dose application:
To decide exposure concentrations
for repeated-dose studies
Repeated dose study :
o Duration subject to clinical use (Maximum of 90 days)
o 2 different concentrations exceeding human dose
 In acute studies, one eye kept as control. A separate
control group should be included in repeated-dose studies
54
Ocular toxicity studies
• Evaluation
• Slit-lamp examination
o To detect the changes in cornea, iris and aqueous
humor.
• Fluorescent dyes (sodium fluorescein, 0.25 to 1.0%)
o To detect defects in surface epithelium
• Intra-ocular tension monitored by a tonometer
• Histological examination (fixation in Davidson’s or Zenker’s
fluid)
55
Vaginal Toxicity Test
• Rabbit or Dog
• Topical application (vaginal mucosa) as pessary,
cream or ointment
• 6-10 animals per dose group
• Higher concentrations / several daily applications (in
multiples of daily human dose)
• 7-30 days, as per clinical use
• Observation parameters :
 General : swelling, closure of introitus
 Histopathology of vaginal wall
56
Rectal Tolerance Test
• Preparations meant for rectal administration
• In rabbits or dogs
• 6-10 animals per dose group
• Volume comparable to human dose (or the maximum possible
volume) to achieve administration of multiples of daily human dose
• 7-30 days, as per clinical use
• Observation parameters
 Clinical signs :- signs of pain, blood and/or mucus in feces, condition of anal
region/sphincter
 Gross examination and (if required)
 Histological examination of rectal mucosa
57
Parenteral Drugs
 Intravenous/ intramuscular/ subcutaneous/ intradermal
inj.
 Injection sites in systemic toxicity studies examined
grossly and microscopically
 If needed, reversibility of adverse effects may be
determined on a case to case basis
58
Inhalation toxicity studies
• 1 rodent and 1 non-rodent species
• Acute, subacute and chronic toxicity studies according to the
intended duration of human exposure
• Gases and vapors given in whole body exposure chambers;
aerosols are given by nose-only method
• Dose (limit dose of 5mg/l) in multiples of human exposure
• Evidence of exposure of test substance of particle size of 4
micron (especially for aerosols) with not less that 25% being 1
micron should be provided
59
Inhalation toxicity studies
 3 dose groups and a control
 Duration of exposure : maximum of 6 hr/day & 5 days/week
Evaluation :
 Respiratory rate, Bronchial lavage fluid examination,
histological examination of respiratory passages and lung
tissue
 Regular parameters of systemic toxicity studies or assessment
of margin of safety
60
Allergenicity /
Hypersensitivity
Any one of the standard tests:
• Guinea pig :
o Maximization test (GPMT)
• Mouse :
o Local lymph node assay (LLNA)
61
Guinea Pig Maximization Test
Challenge
(skin reaction
appears)
Induction : Minimum irritant dose (intradermal injection)
Challenge : Maximum nonirritant dose (topical application)
Doses are determined by a preliminary study
Induction
(immune response
develops)
62
Main test
• A minimum of 6 male and 6 female animals per group
 One test group
 One control group
 One positive control group (preferable)
• If no response : re-challenge 7-30 days after primary
challenge
63
Induction (Day 0)
3 pairs of intradermal injections on either shoulders :
• 0.1 ml Freund’s adjuvant alone
• 0.1 ml test material (lowest irritant dose)
• 0.1 ml test material in Freund’s adjuvant
Day 7 : Topical patch at prepared shoulders (lowest irritant dose)
Challenge (Day 21)
Topical patch at prepared flanks (highest non-irritant dose)
• Left side: Test agent
• Right side: Vehicle
Evaluation [Edema and Erythema] after 48 hr.
64
Local Lymph Node Assay
• Mice of the same sex, either only males or only females
• Drug treatment given on ear skin
• 3 graded doses (the highest being maximum nonirritant
dose) plus vehicle control
• A minimum of 6 mice per group
Test material applied on ear skin on 3 consecutive days
On day 5, i.v. 3H-thymidine / bromo-deoxy-uridine (BrdU)
Draining auricular lymph nodes dissected after 5 hrs
Evaluation : Increase in 3H-thymidine or BrdU incorporation
65
GENOTOXICITY
66
• Genotoxic compounds are presumed to be trans-species
carcinogens, may not require long-term carcinogenicity studies
• If intended for chronic administration, a chronic toxicity study (up
to one year) to detect early tumorigenic effects
ICH Standard Tests are generally conducted
• In vitro test for gene mutation in bacteria
• In vitro cytogenetic evaluation of chromosomal damage :
• Mammalian cells or
• Mouse lymphoma tic assay
• In vivo test for chromosomal damage using rodent
hematopoietic cells
67
Ames’ Test
( Bacterial Reverse Mutation Assay )
• S. typhimurium tester strains TA98, TA100, TA102,
TA1535, TA97 or
• Escherichia coli WP2 uvrA or Escherichia coli WP2 uvrA
• In-vitro exposure at a minimum of 5 log dose levels
• “Solvent” and “positive control”
• 2.5 fold (or more) increase in number of revertants in
comparison to spontaneous revertants are considered
positive
68
In-vitro cytogenetic assay
• Performed in CHO cells or on human lymphocyte in
culture
• In-vitro exposure using a minimum of 3 log doses
• “Solvent” and “positive control”
• [Positive control : Cyclophosphamide / Mitomycin C
gives a reproducible and detectable increase in
clastogenic effect]
• > 50% inhibition of cells is considered significant
69
In-vivo cytogenetic assay
Clastogenic & Aneugenic effects in metaphase chromosomes (min
100)
Bone marrow : Giemsa staining
Sacrificed 2 hours after colchicine administration
Dosing on day 1 followed by i.p. colchicine administration at 22
hours
• One rodent species (preferably rat)
• Route of administration same as intended for humans
• 5 animals/sex/dose groups
• 3 dose levels, “solvent” and “positive” control (Cyclophosphamide)
70
In-vivo micronucleus assay
↑micronuclei in polychromatic erythrocytes [M-PCE] (min 1000)
Bone marrow : Smeared with May Gruenwald / Giemsa stain
Sacrifice of animals 6 hours after the last injection
Dosing : day 1 and 2 of study
• 1 rodent species (preferably mouse) needed
• Route of administration of test substance same as humans
• 5 animals / sex / dose groups
• At least 3 dose levels, plus “solvent” and “positive” control
• Positive control : mitomycin C or cyclophosphamide
71
CARCINOGENICITY
72
Carcinogenicity
 For expected clinical use more than 6 months
 For drugs used frequently in an intermittent manner
 If concern about the carcinogenic potential due to :
Previous demonstration in the product class
Structure-activity relationship suggests carcinogenic
risk
Preneoplastic lesions in repeated dose toxicity
studies
Long-term tissue retention results in reactions
73
Carcinogenicity
 Where life-expectancy in the indicated population is
short (i.e., less than 2 - 3 years) - no long-term
carcinogenicity studies
 Where therapy is generally successful, there may be
later concerns regarding secondary cancers. So
carcinogenicity studies needed
• A rodent species (preferably rat). Mouse only if justified
• Strain should not have normal incidence of spontaneous
tumors
74
Carcinogenicity
• At least 3 dose levels :
Highest dose : sub-lethal, should not reduce life span
of animals by more than 10% of expected normal
Lowest dose : should be comparable to the intended
human therapeutic dose or a multiple of it, e.g. 2.5x;
to make allowance for the sensitivity of the species
Intermediate dose : placed logarithmically between
the other 2
Untreated control and (if indicated) a Vehicle control
group
75
Carcinogenicity
• Life span comparable to human’s over which drug use is
intended
• Generally, 24 months for rats and 18 months for mice
• Atleast 50 animals of each sex
• Observation parameters
 Physiology, Behavior, Biochemistry, Pathology
 Comprehensive descriptions of benign and malignant
tumor development, time of their detection, site,
dimensions, histological typing etc
76
Animal Toxicity
requirements for clinical
trials and marketing of a
new drug
77
Route of
administration
Duration of
proposed human
administration
Human Phase(s)
for which study is
proposed to be
conducted
Long term toxicity
requirements
Systemic Toxicity Studies
Oral or Parentral
or Transdermal
Single dose or
several doses in one
day, Upto 1wk
I,II,III 2species,2wk
> 1 wk but Upto
2wk
I,II,III 2species;4wk
(2 weeks)
Upto 2 weeks Marketing
permission
2 species; 4 week
> 2 wk but Upto
4wk
I,II,III 2species;12wk
> 2 wk but Upto
4wk
I,II,III 2 species equal to
duration of human
exposure
Marketing
permission
2 species; 12 week78
79
Route of
administration
Duration of proposed
human
administration
Human Phase(s) for
which study is
proposed to be
conducted
Long term toxicity
requirements
Systemic Toxicity Studies
Oral or
Parentral or
Transdermal
> 4 weeks up to 12
weeks
I,II,III 2 species equal to
duration of human
exposure
Marketing
permission
2 species; 24 week
> 12 weeks up to 24
weeks
I,II,III 2 species equal to
duration of human
exposure
Marketing
permission
2 species; 24 week; non-
rodent 36weeks
> 24 weeks I,II,III 2 species; 24 week; non-
rodent 36weeks
Marketing
permission
2 species; 24 week; non-
rodent 36weeks
Route of
administration
Duration of
proposed
human
administration
Human Phase(s) for which study
is proposed to be conducted
Inhalation
(general
anesthetics,
aerosols)
Upto 2 wk I,II,III 2species;1month
; (Exposure time
3h/d, 5d/wk)
Upto 4wk I,II,III 2species;12week
, (Exposure time
6h/d, 5d/wk)
> 14wk I,II,III 2species;24week
, (Exposure time
6h/d, 5d/wk)
80
Local Toxicity Studies
Dermal Upto 2 week I,II 1species ;4 week
III 2species ; 4 week
> 2 week I,II,III 2species ;12week
Ocular or Otic
or Nasal
Upto 2 week I,II 1species ;4week
III 2species ;4week
> 2 week I,II,III 2species ;12week
Vaginal or
Rectal
Upto 2 week I,II 1species ;4week
III 2species ;4week
> 2 week I,II,III 2species ;12week
81
Laboratory parameters to be
included in toxicity studies
• Hematological parameters
• Urinalysis Parameters
• Blood Biochemical Parameters
• Gross and Microscopic Pathology
82
Hematological parameters
Haemoglo
bin
Total
RBC
Count
Haemat
ocrit
Differen
tial
WBC
Count
Total
WBC
Count
Reticulo
cyte
Platele
t
Count
Termina
l Bone
Marrow
Examin
ation
ESR
(Non-
rodents
only)
General
Blood
Picture
Coagulation
Parameters
(Non-
rodents
only):
Coagulation Parameters: Bleeding Time, Coagulation Time, Prothrombin
Time, Activated Partial Thromboplastin Time. 83
Urinalysis Parameters
Colour &
Appearance
24-hour urinary
output
Specific Gravity Sugar & Acetone
Albumin & Bile
pigments
Reaction (pH) Urobilinogen
Occult Blood
Microscopic
examination of
urinary sediment.
84
Blood Biochemical Parameters
Glucose
Cholesterol &
Triglycerides
HDL & LDL
(Non-rodents only)
Alkaline
Phosphatase
(ALP) & GGT
(Non-rodents only)
SGPT (ALT) &
SGOT (AST)
Bilirubin
Blood Urea
Nitrogen &
Creatinine
Albumin &
Globulin
Sodium,
Potassium,
Phosphorus,
Calcium
85
Gross and Microscopic Pathology
Brain*: Cerebrum,
cerebellum, Midbrain
Liver*
(Rectum)
Urinary bladder
Uterus*
Epididymis
Ovary
Testis*
Skin
Mammary gland
Mesenteric
lymph node
Skeletal muscle
(Middle Ear)
Eye
(Spinal Cord)
(Parathyroid)
Thyroid
Spleen*
(Trachea)
Lung*
Stomach
Oesophagus
AortaHeart*
(Pancreas)
Adrenal*
Thymus
Kidney*
Colon
Terminal ileum
JejunumDuodenum
* Organs marked with an asterisk should be weighed.
() Organs listed in parenthesis should be examined if indicated by the nature of the
drug or observed effects. 86
Observations
that should be
carried out
Clinical
signs of
intoxication
Mating
behavior
Body
weight
Food
intake
Post-partum health &
gross pathology of
affected organ
Progress of
gestation/
parturition periods
Length of
gestation
Parturition
Growth
parameter
Survival
87
Limitations of toxicity
studies
• There may be variation of toxicity in different species
• Various types of allergic reaction e.g hypersensitivity reactions,
genetically determined A/E that my occur in human may not be
detected in animal studies
• Toxicity studies are time consuming (2-5 yrs)
• Large number of animals may be needed to obtain valid
preclinical data
88
• Extrapolation of TI & toxicity data from animal to human
is not predictive of all toxicities
• For statistical reason, rare adverse effect are unlikely to
be detected in preclinical studies
• Subjective responses nausea, tinnitus, loss of libido d/t
new drug are difficult to discover
89
Pharmacokinetic Studies
• Once a compound is cleared of toxicological studies PK
studies are performed
• Mice, rats & non human primate like monkeys
• Done to provide data on how a drug is
o Absorbed
o Its bioavailability on oral & iv
o Volume of distribution
o Biotransformation and
o Excreted from the body & elimination half life
90
How to calculate LD50
1.Mathematical/Arithmetical method:
• Karber’s method, simple, rapid but crude method
• Does not involve plotting of DRC
2.Graphical method:
• Accurate & preferred method
• Percentage mortality is converted into probit
• Values thus obtained are plotted on DRC
• Log dose on X-axis, probit Scale on Y-axis
91
• MM=diff of 2 adjacent no.of dead animal/2
• E.g =(A+B)/2=(0+2)/2=1
• ∑(DD×MM)=84.5,divided by no.of animal (n=10)
• Hence 84.5/10=8.45, finally value is subtracted from minimum
dose which produces 100% mortality i.e 20 mg/kg
• So LD50=20-8.45=11.55mg/kg
Exp
Group
dose
mg/kg
Dose
diff.DD
No.of
Animal
n
No.of
dead
animal
Mean
mortality
MM
DD×MM
1 3 - 10 0 (A) - -
2 5 2 10 2(B) 1 2
3 10 5 10 3 2.5 12.5
4 12 2 10 5 4 8
5 15 3 10 7 6.5 19.5
6 20 5 10 10 8.5 42.5
∑(DD×MM) 84.5
92
Graphical method
5 LD50=antilog(1d)
probit
0
1d log dose
Fig. Determination of LD50
93
For Phase I studies: -
• Single dose toxicity studies
• Dose Ranging studies
• Repeated dose systemic studies of appropriate duration
to support the duration of proposed human exposure.
o Male Fertility study
o In-vitro Genotoxicity tests
• Relevant local toxicity studies
• Allergenicity/hypersensitivity tests
• Photo-allergy or dermal photo-toxicity test
94
Phase II Clinical Trials
• Non-clinical safety data (listed previously) already
submitted while obtaining the permissions for phase I trial,
with appropriate references.
• Directly starting phase II trial – complete details of the non-
clinical safety data needed for obtaining permission for
phase-I trial
• Repeat dose systemic toxicity studies of appropriate
duration to support the duration of proposed human
exposure.
• In-vivo genotoxicity tests
- segment II reproductive/developmental toxicity study
95
Phase III Clinical Trials
• Summary of non-clinical safety and Phase I and Phase II
trials data already submitted while obtaining the
permissions
• Directly starting Phase III trial – complete details of the
non-clinical safety data needed for obtaining permission for
Phase-I trial and Phase II
• Repeat dose systemic toxicity studies of appropriate
duration to support the duration of proposed human
exposure
• Reproductive/developmental toxicity studies. (female
reproduction or teratogenic toxicity)
• Carcinogenicity studies ( when there is a cause for concern
or when the drug is to be used for more than 6 months)
96
Phase IV Clinical Trials
• Summary of all the non-clinical safety data already
submitted while obtaining the permissions or Phase I, II
and Phase III trials with appropriate references
• Directly initiate Phase IV trial- complete details of the
non-clinical safety data needed for obtaining permission
for Phase-I, II trial and Phase II I trial
97
Application Of Good
Laboratory Practices (GLP)
• The animal studies be conducted in an accredited
laboratory. Toxicology studies, also be conducted in an
accredited laboratory.
98
References
• Schedule Y (March 19, 2019, page 188 – 199)
• Bikash Medhi
99
THANK YOU
100
Vehicles used for dosing
• ORAL: Water, Methylcellulose or Carboxymethylcellulose(0.5-
5% aqueous suspension), Oil ( corn, peanut, sesame)
• DERMAL: Physiological saline, Water, Ethanol, Acetone,
Mineral oil
• PARENTERAL: Physiological saline(sterile), sterile water for
injection
101

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Animal toxicity study requirements for conduct of clinical trial april 13 2019

  • 1. ANIMAL TOXICITY STUDY REQUIREMENT FOR CONDUCT OF CLINICAL TRIAL May 9, 2019 1
  • 2. Toxicology: The study of poisons & is concerned with the adverse effects of xenobiotics. Animal toxicology studies also called non-clinical toxicity studies. Chemical agents that cause toxicity include-  Drugs  Insecticides/herbicides  Plant toxins  Animal toxins  Chemical weapons  Radioactive elements 2
  • 3. • Preclinical studies are to be conducted according to Schedule Y of Drugs and Cosmetic Act 1940. 3
  • 4. Objective Identify toxic substance prior to clinical use Quality assessment of the drug Quantity assessment of the drug (plasma and tissue levels) To study cumulative toxicity Estimate safe starting dose for clinical studies & subsequent dose escalation schemes in humans. 6
  • 5. • Assess hazards that cannot be evaluated in clinical trials (e.g. carcinogenicity and teratogenicity) • Different types of dose identification can be done. E.g. lethal dose LD50, maximum tolerated dose MTD, minimum effective dose and (ED50) 7
  • 6. GENERAL PRINCIPLE 8 SOP Test substances and instruments should be properly standardized.
  • 7. TYPES OF TOXICITY STUDIES 9 • single dose of a substance, or multiple doses given within 24hrs or an inhalation exposure of 4hrs, observed for 14 days ACUTE TOXICITY several days to 1 month. SUBACUTE TOXICITY repeated or spread over an intermediate time range (1-3 months). SUB CHRONIC TOXICITY: • Exposures (repeated or continuous) over a long (> 3 months) even up to 2 years CHRONIC TOXICITY:
  • 8. 11
  • 9. Single-dose (Acute) Toxicity Studies 16 2 Rodent species Ensures systemic absorption of the drug (unless the intended route in humans is only intravenous) Recommended limit • 2000 mg/kg or • 10 times the normal dose that is intended in humans Use the same route as intended in humans Whichever is higher
  • 10. • At least 5 animals / sex / group • At least 4 graded doses (4 dose-groups) • Observation for toxic effects (if any) : 14 days • Observation for mortality :  7 days [parenteral administration]  14 days [oral administration] 17
  • 11. Other parameters : Symptoms, signs and mode of death, signs of intoxication, effect on body weight Gross and histopathological changes LD 10 and LD 50 values, (preferably with 95 % CI) Genetic effects if any Establish the: Maximum tolerated dose (MTD) Minimum lethal dose (MLD) Target organ of toxicity (if possible) 18
  • 12. Cytotoxic anticancer agents • MTD confirm • To establish a linear relationship between toxicity and body surface area • MTD can be established in non-rodent species, if: o Rodents are poor predictors of human toxicity e.g. antifolate o Cytotoxic drugs acts by a novel mechanism of action 19
  • 13. Repeated dose toxicity studies (Sub acute/ sub chronic toxicity) 21
  • 14. Aim: To identify Target Organ Toxicity To establish MTD for subsequent studies Animal- at least 2 mammalian species(1 rodent & 1 non- rodent) • Rodent- must be between 6-8 weeks • Non-rodent should be between 4-9 months Younger and still growing animals are preferred in initiation of subchronic studies 22
  • 15. Rodents • One rodent species (preferably rat) • At least 4 graded doses including control • Two groups : control and treatment • Minimum of 5 animals of each sex • Proposed clinical route of administration • Test substance given 7 days a week Non-Rodents • One male and one female • Starting dose (3 to 5 times the extrapolated effective dose) or MTD (whichever is less) • Dose escalation every 3rd day, lowered if toxicity seen • Then test substance given 7 days a week Dose-ranging study/ Repeated dose toxicity study 23
  • 16. Repeated-dose Toxicity Studies • Wherever applicable, include a Control group • Drug is given on 14, 28, 90 & 180 days, • 3 other groups are formed :  Highest dose Observable toxicity [MTD]  Lowest dose No observable toxicity [NOAEL] should be comparable to intended therapeutic dose or multiple of it  Intermediate dose Some symptoms ; not gross toxicity or death placed logarithmically between two doses 25
  • 17. 26 Methodology • Rodent : 6-10/sex/group • Non-rodent : 2-3/sex/group 14-28 Day repeated-dose (Sub acute toxicity studies) • Rodent : 15-30/sex/group • Non-rodent : 4-6/sex/group 90-Day repeated-dose (Sub chronic toxicity studies) • Rodent : 15-30/sex/group • Non-rodent : 4-6/sex/group 180-Day repeated-dose (Chronic toxicity studies)
  • 18. Parameters to be monitored Physiological Organ Pathology: Gross and Microscopic ECG and fundoscopy (non-rodent) Behavioral Biochemical & microscopic observations of urine and blood 27
  • 19. Number of animals required for repeated-dose toxicity studies 14-28 days 84-182 days Group Rodent (Rat) Non-rodent (Dog or Monkey) Rodent (Rat) Non-rodent (Dog or Monkey) M F M F M F M F Control 6-10 6-10 2-3 2-3 15-30 15-30 4-6 4-6 Low dose 6-10 6-10 2-3 2-3 15-30 15-30 4-6 4-6 Intermediate dose 6-10 6-10 2-3 2-3 15-30 15-30 4-6 4-6 High dose 6-10 6-10 2-3 2-3 15-30 15-30 4-6 4-6 28
  • 20. Lethality testing & calculation • It is acute toxicity testing in which death is considered a single end-point • LD50- • Intraperitoneal LD50 ̴ 30% of oral • Iv ̴ 10% of oral 29
  • 21. SPECIAL TOXICITY STUDIES • Reproductive • Local toxicity • Allergenicity/hypersensitivity • Genotoxicity • Carcinogenicity • Mutagenicity 30
  • 22. Reproductive Toxicity • Male Fertility • Female Reproduction & Developmental toxicity o Female Fertility o Teratogenicity o Perinatal development 31
  • 23. Reproductive toxicology study FERTILITY STUDY Rats Studies are on fertility, reproductive capability, estrous cycles, mating behavior, conception rate and early stages of gestation TERATOLOGY STUDY Rats and rabbits Females are treated only during organogenesis period since embryo is most susceptible to induction of birth defects at this time. PRENATAL/ POST NATAL TESTING Pregnant females are treated during last quarter of pregnancy, through lactation until weaning. And then sacrificed to detect internal anomalies. Purpose- determine the effect of drugs in late fetal development, labor, delivery, lactation, neonatal viability and growth 32
  • 24. 33
  • 25. • One rodent species (preferably rat) • 3 dose groups and a control group : Dose selection : results of previous 14 or 28-day toxicity study Highest dose : showing minimal toxicity in systemic studies • 6 adult male animals per group 34
  • 26. Reproductive Toxicity of Lead Acetate in Adult male Rats: Histopathological and Cytotoxic Studies Haouas Z, Zidi I, Sallem A, Bhouri R, Ajina T, et al. (2015) Reproductive Toxicity of Lead Acetate in Adult male Rats: Histopathological and Cytotoxic Studies. J Cytol Histol 6: 293. doi:10.4172/2157- 7099.1000293 35 Figure 3: Photomicrographs of TUNEL-stained testicular sections from controls (A) and rats exposed to 2 g/l of lead acetate (B, C, and D). Magnification 400x. Arrows indicated TUNEL- positive cells (spermatogonia; permatocytes I; spermatids) (A, B, C, D: Scale bar 20 µm)
  • 27. Test substance by intended route of use for • minimum 28 days • maximum 70 days Paired with female animals of proven fertility in a ratio of 1:2 Drug treatment of male animals continues during pairing Pairing continued till detection of Sperm in vagina or 10 days, whichever is earlier 36
  • 28. Pregnant females examined after day 13 of gestation Males sacrificed at the end of the study Weight of each testis and epididymis recorded Sperms from one epididymis examined for motility and morphology Other epididymis and both testes examined for histology 37
  • 30. • For all drugs proposed for women of child bearing age • Segment I : Female fertility • Segment II : Teratogenicity • Segment III : Perinatal development • Segment I, II and III studies in albino mice or rats, and • Segment II study also in albino rabbits as a second test species 39
  • 31. Female Fertility Study (Segment I) • One rodent species (rat preferred) • 3 graded doses • Highest dose : doesn’t affect general health of parent animals (usually the MTD from previous systemic studies) • At least 15 males and 15 females per dose group • Route of administration same as intended for therapeutic use 40
  • 32. Pups : Physiology, Behavior, Pathology (sex-wise distribution noted) Body weight Food intake Clinical signs of intoxication Reproduction and Parturition Pathology Gross & Micro Females allowed to litter, medication continued till weaning of pups Drug treatment continued during mating and gestation period Drug administration : 28 days (males) & 14 days (females) before mating 41
  • 33. 42 In Utero Exposure of Biochanin-A Alters Female Reproduction in Rat. M.G.S. Soujanya1, K. Prathap Reddy2, V. Sridevi1, P. Ramachandra Reddy1* and P. Sreenivasula Reddy2 1Department of Biochemistry, Yogi Vemana University, Vemanapuram, Kadapa, A.P., India 2Department of Zoology, Sri Venkateswara University, Tirupati, A.P., India Received date: April 11, 2016; Accepted date: April 22, 2016; Published date: April 24, 2016
  • 34. Teratogenicity Study (Segment II) • Rodent (preferably rat) and Non-rodent (rabbit) • Drug administered throughout organogenesis • 3 dose levels and a Control group:  Highest dose : minimum maternal toxicity  Lowest dose : as proposed clinical dose or its multiple • Route of administration : same as intended for humans • At least 20 pregnant rats (or mice) and 12 rabbits, for each dose 43
  • 35. Observation parameters Females General Signs of intoxication Body weight Food intake Reproductive Uterus, Ovaries Products of conception Fetuses General Number Gender Length Weight Pathology Gross (n) Visceral (n/2) Skeletal (n/2) 44
  • 36. The Impact of Proximol (Cymbopogon proximus) Intake on Pregnant Albino Rats and their Fetuses During Gestation Period International Journal of Morphology June 2017; 35(2):500-505 DOI: 10.4067/S0717-95022017000200019 45 Fig 1. Photographs of the uterus of pregnant rats at the 20th day of gestation. A) Control. Showing normal symmetrical distribution of fetuses in the two uterine horns. B) Treated. Asymmetrical distribution of fetuses in the two uterine horns. Left uterine horn showing visible embryonic resorption sites (arrow).
  • 37. Fig 2. Photographs of fetuses at the 20 th day of gestation. A) Control. Fetus exhibited normal morphology and normal length. B-D) Treated. Showing: clubfoot (arrow, B), hematoma at the back (arrow, C), and fore limb without digits (arrow, D). 46
  • 38. Perinatal Study • Specially if →Drug to pregnant / nursing mothers for long periods →Indications of possible adverse effects on foetus • One rodent species (preferably rat) • Dosing comparable to multiples of human dose and route • At least 4 groups (including control), 15 females / group • Drug throughout last trimester (from day 15 of gestation) • Dose causing low foetal loss continued throughout weaning • Second generation (F2) selected at weaning and studied. • Observed parameters are same as teratogenicity study 48
  • 39. Local Toxicity • Dermal Toxicity • Ocular Toxicity • Vaginal Toxicity • Rectal tolerance test • Parenteral Drugs Tolerance • Inhalation toxicity 49
  • 40. Local Toxicity • If intended for special route (other than oral) in humans • Appropriate site (e.g., skin or vaginal mucous membrane) in a suitable species • Preferably use of 2 species • 3 dose levels and untreated and / or (vehicle) Control • If the drug is absorbed systemically, appropriate systemic toxicity studies also required 50
  • 41. Dermal Toxicity • As cutaneous contamination is always a possibility • Rabbit and Rat • Applied on shaved skin (>or = 10% of Body surface area) • Concentrations several fold higher than the clinical doses • Period of application : 7 to 90 days • Evaluation › Local signs (erythema, oedema and eschar formation) › Histological examination of sites of application 51
  • 42. Fig. 6. Effect of CPD photoreactivation on UV-induced erythema and hyperplasia in the skin of b -act-CPD photolyase transgenic mice. The depilated back of b -act-CPD-1 transgenic mice was exposed to UV-B light for four consecutive days (1.5 MED per day) and were either given 3 h of photoreactivating light or kept in the dark. As a control, non-UV-exposed animals were used. Animals were killed 3 days after the last exposure and, except for the photoreactivation step, had been kept in the dark throughout the experiment. ( A ) Appearance of the dorsal skin of non-UV-exposed (left), UV-exposed (middle) and UV- exposed/photoreactivated animals (right), showing clear erythema 52
  • 43. Phototoxicity • Tested using armstrong/ harber test in guinea pig • Drugs used in leucoderma • Pretest with 8 animals done to ascertain highest non-irritant dose • Test performed on 10 animals and 5 controls • Induction dose – 0.3ml/patch for 2 hours±15 minutes followed by 10 J/cm2 of UV light • Repeated on 0, 2, 4, 7, 9 and 11 days • Animal is then challenged with the same concentration on days 22 – 24 followed by 10 J/cm2 of UV light • Observations: erythema, edema formation 24 and 48 hours later. • Positive control- musk ambrett/ psoralin should be used. 53
  • 44. Ocular toxicity studies  2 species, including an  albino rabbit with a large conjunctival sac  Initial single dose application: To decide exposure concentrations for repeated-dose studies Repeated dose study : o Duration subject to clinical use (Maximum of 90 days) o 2 different concentrations exceeding human dose  In acute studies, one eye kept as control. A separate control group should be included in repeated-dose studies 54
  • 45. Ocular toxicity studies • Evaluation • Slit-lamp examination o To detect the changes in cornea, iris and aqueous humor. • Fluorescent dyes (sodium fluorescein, 0.25 to 1.0%) o To detect defects in surface epithelium • Intra-ocular tension monitored by a tonometer • Histological examination (fixation in Davidson’s or Zenker’s fluid) 55
  • 46. Vaginal Toxicity Test • Rabbit or Dog • Topical application (vaginal mucosa) as pessary, cream or ointment • 6-10 animals per dose group • Higher concentrations / several daily applications (in multiples of daily human dose) • 7-30 days, as per clinical use • Observation parameters :  General : swelling, closure of introitus  Histopathology of vaginal wall 56
  • 47. Rectal Tolerance Test • Preparations meant for rectal administration • In rabbits or dogs • 6-10 animals per dose group • Volume comparable to human dose (or the maximum possible volume) to achieve administration of multiples of daily human dose • 7-30 days, as per clinical use • Observation parameters  Clinical signs :- signs of pain, blood and/or mucus in feces, condition of anal region/sphincter  Gross examination and (if required)  Histological examination of rectal mucosa 57
  • 48. Parenteral Drugs  Intravenous/ intramuscular/ subcutaneous/ intradermal inj.  Injection sites in systemic toxicity studies examined grossly and microscopically  If needed, reversibility of adverse effects may be determined on a case to case basis 58
  • 49. Inhalation toxicity studies • 1 rodent and 1 non-rodent species • Acute, subacute and chronic toxicity studies according to the intended duration of human exposure • Gases and vapors given in whole body exposure chambers; aerosols are given by nose-only method • Dose (limit dose of 5mg/l) in multiples of human exposure • Evidence of exposure of test substance of particle size of 4 micron (especially for aerosols) with not less that 25% being 1 micron should be provided 59
  • 50. Inhalation toxicity studies  3 dose groups and a control  Duration of exposure : maximum of 6 hr/day & 5 days/week Evaluation :  Respiratory rate, Bronchial lavage fluid examination, histological examination of respiratory passages and lung tissue  Regular parameters of systemic toxicity studies or assessment of margin of safety 60
  • 51. Allergenicity / Hypersensitivity Any one of the standard tests: • Guinea pig : o Maximization test (GPMT) • Mouse : o Local lymph node assay (LLNA) 61
  • 52. Guinea Pig Maximization Test Challenge (skin reaction appears) Induction : Minimum irritant dose (intradermal injection) Challenge : Maximum nonirritant dose (topical application) Doses are determined by a preliminary study Induction (immune response develops) 62
  • 53. Main test • A minimum of 6 male and 6 female animals per group  One test group  One control group  One positive control group (preferable) • If no response : re-challenge 7-30 days after primary challenge 63
  • 54. Induction (Day 0) 3 pairs of intradermal injections on either shoulders : • 0.1 ml Freund’s adjuvant alone • 0.1 ml test material (lowest irritant dose) • 0.1 ml test material in Freund’s adjuvant Day 7 : Topical patch at prepared shoulders (lowest irritant dose) Challenge (Day 21) Topical patch at prepared flanks (highest non-irritant dose) • Left side: Test agent • Right side: Vehicle Evaluation [Edema and Erythema] after 48 hr. 64
  • 55. Local Lymph Node Assay • Mice of the same sex, either only males or only females • Drug treatment given on ear skin • 3 graded doses (the highest being maximum nonirritant dose) plus vehicle control • A minimum of 6 mice per group Test material applied on ear skin on 3 consecutive days On day 5, i.v. 3H-thymidine / bromo-deoxy-uridine (BrdU) Draining auricular lymph nodes dissected after 5 hrs Evaluation : Increase in 3H-thymidine or BrdU incorporation 65
  • 57. • Genotoxic compounds are presumed to be trans-species carcinogens, may not require long-term carcinogenicity studies • If intended for chronic administration, a chronic toxicity study (up to one year) to detect early tumorigenic effects ICH Standard Tests are generally conducted • In vitro test for gene mutation in bacteria • In vitro cytogenetic evaluation of chromosomal damage : • Mammalian cells or • Mouse lymphoma tic assay • In vivo test for chromosomal damage using rodent hematopoietic cells 67
  • 58. Ames’ Test ( Bacterial Reverse Mutation Assay ) • S. typhimurium tester strains TA98, TA100, TA102, TA1535, TA97 or • Escherichia coli WP2 uvrA or Escherichia coli WP2 uvrA • In-vitro exposure at a minimum of 5 log dose levels • “Solvent” and “positive control” • 2.5 fold (or more) increase in number of revertants in comparison to spontaneous revertants are considered positive 68
  • 59. In-vitro cytogenetic assay • Performed in CHO cells or on human lymphocyte in culture • In-vitro exposure using a minimum of 3 log doses • “Solvent” and “positive control” • [Positive control : Cyclophosphamide / Mitomycin C gives a reproducible and detectable increase in clastogenic effect] • > 50% inhibition of cells is considered significant 69
  • 60. In-vivo cytogenetic assay Clastogenic & Aneugenic effects in metaphase chromosomes (min 100) Bone marrow : Giemsa staining Sacrificed 2 hours after colchicine administration Dosing on day 1 followed by i.p. colchicine administration at 22 hours • One rodent species (preferably rat) • Route of administration same as intended for humans • 5 animals/sex/dose groups • 3 dose levels, “solvent” and “positive” control (Cyclophosphamide) 70
  • 61. In-vivo micronucleus assay ↑micronuclei in polychromatic erythrocytes [M-PCE] (min 1000) Bone marrow : Smeared with May Gruenwald / Giemsa stain Sacrifice of animals 6 hours after the last injection Dosing : day 1 and 2 of study • 1 rodent species (preferably mouse) needed • Route of administration of test substance same as humans • 5 animals / sex / dose groups • At least 3 dose levels, plus “solvent” and “positive” control • Positive control : mitomycin C or cyclophosphamide 71
  • 63. Carcinogenicity  For expected clinical use more than 6 months  For drugs used frequently in an intermittent manner  If concern about the carcinogenic potential due to : Previous demonstration in the product class Structure-activity relationship suggests carcinogenic risk Preneoplastic lesions in repeated dose toxicity studies Long-term tissue retention results in reactions 73
  • 64. Carcinogenicity  Where life-expectancy in the indicated population is short (i.e., less than 2 - 3 years) - no long-term carcinogenicity studies  Where therapy is generally successful, there may be later concerns regarding secondary cancers. So carcinogenicity studies needed • A rodent species (preferably rat). Mouse only if justified • Strain should not have normal incidence of spontaneous tumors 74
  • 65. Carcinogenicity • At least 3 dose levels : Highest dose : sub-lethal, should not reduce life span of animals by more than 10% of expected normal Lowest dose : should be comparable to the intended human therapeutic dose or a multiple of it, e.g. 2.5x; to make allowance for the sensitivity of the species Intermediate dose : placed logarithmically between the other 2 Untreated control and (if indicated) a Vehicle control group 75
  • 66. Carcinogenicity • Life span comparable to human’s over which drug use is intended • Generally, 24 months for rats and 18 months for mice • Atleast 50 animals of each sex • Observation parameters  Physiology, Behavior, Biochemistry, Pathology  Comprehensive descriptions of benign and malignant tumor development, time of their detection, site, dimensions, histological typing etc 76
  • 67. Animal Toxicity requirements for clinical trials and marketing of a new drug 77
  • 68. Route of administration Duration of proposed human administration Human Phase(s) for which study is proposed to be conducted Long term toxicity requirements Systemic Toxicity Studies Oral or Parentral or Transdermal Single dose or several doses in one day, Upto 1wk I,II,III 2species,2wk > 1 wk but Upto 2wk I,II,III 2species;4wk (2 weeks) Upto 2 weeks Marketing permission 2 species; 4 week > 2 wk but Upto 4wk I,II,III 2species;12wk > 2 wk but Upto 4wk I,II,III 2 species equal to duration of human exposure Marketing permission 2 species; 12 week78
  • 69. 79 Route of administration Duration of proposed human administration Human Phase(s) for which study is proposed to be conducted Long term toxicity requirements Systemic Toxicity Studies Oral or Parentral or Transdermal > 4 weeks up to 12 weeks I,II,III 2 species equal to duration of human exposure Marketing permission 2 species; 24 week > 12 weeks up to 24 weeks I,II,III 2 species equal to duration of human exposure Marketing permission 2 species; 24 week; non- rodent 36weeks > 24 weeks I,II,III 2 species; 24 week; non- rodent 36weeks Marketing permission 2 species; 24 week; non- rodent 36weeks
  • 70. Route of administration Duration of proposed human administration Human Phase(s) for which study is proposed to be conducted Inhalation (general anesthetics, aerosols) Upto 2 wk I,II,III 2species;1month ; (Exposure time 3h/d, 5d/wk) Upto 4wk I,II,III 2species;12week , (Exposure time 6h/d, 5d/wk) > 14wk I,II,III 2species;24week , (Exposure time 6h/d, 5d/wk) 80
  • 71. Local Toxicity Studies Dermal Upto 2 week I,II 1species ;4 week III 2species ; 4 week > 2 week I,II,III 2species ;12week Ocular or Otic or Nasal Upto 2 week I,II 1species ;4week III 2species ;4week > 2 week I,II,III 2species ;12week Vaginal or Rectal Upto 2 week I,II 1species ;4week III 2species ;4week > 2 week I,II,III 2species ;12week 81
  • 72. Laboratory parameters to be included in toxicity studies • Hematological parameters • Urinalysis Parameters • Blood Biochemical Parameters • Gross and Microscopic Pathology 82
  • 74. Urinalysis Parameters Colour & Appearance 24-hour urinary output Specific Gravity Sugar & Acetone Albumin & Bile pigments Reaction (pH) Urobilinogen Occult Blood Microscopic examination of urinary sediment. 84
  • 75. Blood Biochemical Parameters Glucose Cholesterol & Triglycerides HDL & LDL (Non-rodents only) Alkaline Phosphatase (ALP) & GGT (Non-rodents only) SGPT (ALT) & SGOT (AST) Bilirubin Blood Urea Nitrogen & Creatinine Albumin & Globulin Sodium, Potassium, Phosphorus, Calcium 85
  • 76. Gross and Microscopic Pathology Brain*: Cerebrum, cerebellum, Midbrain Liver* (Rectum) Urinary bladder Uterus* Epididymis Ovary Testis* Skin Mammary gland Mesenteric lymph node Skeletal muscle (Middle Ear) Eye (Spinal Cord) (Parathyroid) Thyroid Spleen* (Trachea) Lung* Stomach Oesophagus AortaHeart* (Pancreas) Adrenal* Thymus Kidney* Colon Terminal ileum JejunumDuodenum * Organs marked with an asterisk should be weighed. () Organs listed in parenthesis should be examined if indicated by the nature of the drug or observed effects. 86
  • 77. Observations that should be carried out Clinical signs of intoxication Mating behavior Body weight Food intake Post-partum health & gross pathology of affected organ Progress of gestation/ parturition periods Length of gestation Parturition Growth parameter Survival 87
  • 78. Limitations of toxicity studies • There may be variation of toxicity in different species • Various types of allergic reaction e.g hypersensitivity reactions, genetically determined A/E that my occur in human may not be detected in animal studies • Toxicity studies are time consuming (2-5 yrs) • Large number of animals may be needed to obtain valid preclinical data 88
  • 79. • Extrapolation of TI & toxicity data from animal to human is not predictive of all toxicities • For statistical reason, rare adverse effect are unlikely to be detected in preclinical studies • Subjective responses nausea, tinnitus, loss of libido d/t new drug are difficult to discover 89
  • 80. Pharmacokinetic Studies • Once a compound is cleared of toxicological studies PK studies are performed • Mice, rats & non human primate like monkeys • Done to provide data on how a drug is o Absorbed o Its bioavailability on oral & iv o Volume of distribution o Biotransformation and o Excreted from the body & elimination half life 90
  • 81. How to calculate LD50 1.Mathematical/Arithmetical method: • Karber’s method, simple, rapid but crude method • Does not involve plotting of DRC 2.Graphical method: • Accurate & preferred method • Percentage mortality is converted into probit • Values thus obtained are plotted on DRC • Log dose on X-axis, probit Scale on Y-axis 91
  • 82. • MM=diff of 2 adjacent no.of dead animal/2 • E.g =(A+B)/2=(0+2)/2=1 • ∑(DD×MM)=84.5,divided by no.of animal (n=10) • Hence 84.5/10=8.45, finally value is subtracted from minimum dose which produces 100% mortality i.e 20 mg/kg • So LD50=20-8.45=11.55mg/kg Exp Group dose mg/kg Dose diff.DD No.of Animal n No.of dead animal Mean mortality MM DD×MM 1 3 - 10 0 (A) - - 2 5 2 10 2(B) 1 2 3 10 5 10 3 2.5 12.5 4 12 2 10 5 4 8 5 15 3 10 7 6.5 19.5 6 20 5 10 10 8.5 42.5 ∑(DD×MM) 84.5 92
  • 83. Graphical method 5 LD50=antilog(1d) probit 0 1d log dose Fig. Determination of LD50 93
  • 84. For Phase I studies: - • Single dose toxicity studies • Dose Ranging studies • Repeated dose systemic studies of appropriate duration to support the duration of proposed human exposure. o Male Fertility study o In-vitro Genotoxicity tests • Relevant local toxicity studies • Allergenicity/hypersensitivity tests • Photo-allergy or dermal photo-toxicity test 94
  • 85. Phase II Clinical Trials • Non-clinical safety data (listed previously) already submitted while obtaining the permissions for phase I trial, with appropriate references. • Directly starting phase II trial – complete details of the non- clinical safety data needed for obtaining permission for phase-I trial • Repeat dose systemic toxicity studies of appropriate duration to support the duration of proposed human exposure. • In-vivo genotoxicity tests - segment II reproductive/developmental toxicity study 95
  • 86. Phase III Clinical Trials • Summary of non-clinical safety and Phase I and Phase II trials data already submitted while obtaining the permissions • Directly starting Phase III trial – complete details of the non-clinical safety data needed for obtaining permission for Phase-I trial and Phase II • Repeat dose systemic toxicity studies of appropriate duration to support the duration of proposed human exposure • Reproductive/developmental toxicity studies. (female reproduction or teratogenic toxicity) • Carcinogenicity studies ( when there is a cause for concern or when the drug is to be used for more than 6 months) 96
  • 87. Phase IV Clinical Trials • Summary of all the non-clinical safety data already submitted while obtaining the permissions or Phase I, II and Phase III trials with appropriate references • Directly initiate Phase IV trial- complete details of the non-clinical safety data needed for obtaining permission for Phase-I, II trial and Phase II I trial 97
  • 88. Application Of Good Laboratory Practices (GLP) • The animal studies be conducted in an accredited laboratory. Toxicology studies, also be conducted in an accredited laboratory. 98
  • 89. References • Schedule Y (March 19, 2019, page 188 – 199) • Bikash Medhi 99
  • 91. Vehicles used for dosing • ORAL: Water, Methylcellulose or Carboxymethylcellulose(0.5- 5% aqueous suspension), Oil ( corn, peanut, sesame) • DERMAL: Physiological saline, Water, Ethanol, Acetone, Mineral oil • PARENTERAL: Physiological saline(sterile), sterile water for injection 101

Notes de l'éditeur

  1. The MED is defined as the lowest dose level of a pharmaceutical product that provides a clinically significant response in average efficacy, which is also statistically significantly superior to the response provided by the placebo. Therapeutic index can be calculated = LD50/ED50
  2. Documents to be maintained up till 5 years after the drug is approved.
  3. In case of nonlinearity, a more sensitive species may be used
  4. First dose ranging is done, then doses are given on 14, 28, 90 and 180 days then final systematic toxicity studies are done.
  5. Maximum tolerated dose – maximum dose of medicine that will produce the desired effect without resulting in unacceptable adverse effect.
  6. Cyclobutane pyrimidine dimers
  7. International conference on Harmonisation
  8. It is not necessary that if toxicity occurs in animals then it will be same in human & vice versa though by and large
  9. Though reasonably predictive of many
  10. International Council of Harmonization