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  • A Comprehensive Review Clinical Trials Phase IV

  • 1Student MGV’s Pharmacy College (Affiliated to Savitribai Phule Pune University), Panchavati, Nashik-422003, Maharashtra, INDIA
    2Professor Vidyabharati College of pharmacy (Affiliated to Sant Gadge Baba Amravati University), Camp Road, Amravati- 444602, Maharashtra, INDIA
     

Abstract

A phase IV clinical study is an important step in the monitoring of a new medicine after it has been approved for commercial distribution. It is a key component of post-marketing research that focuses on real-world efficacy and pharmacovigilance, not only continuing but also supplementing prior studies. Phase IV clinical trials change greatly from earlier research phases in terms of study design, criteria, and scientific demand. Phases I through III primarily test the drug's safety profile on a smaller scale, as well as its efficacy in a controlled setting of an RCT. Phase IV investigations, on the other hand, promise to identify even rarer ADRs that may have gone undetected in prior trials, as well as to assess whether the new medicine establishes its benefit on the open market, in interactions with other pharmaceuticals, and in demographic groups who were not previously accepted to the research. The goal of this article is to build up phase IV clinical studies in combination with preceding preclinical experiments to gain a better sense of the lengthy road a medicine takes—not only until it hits the market, but also afterward. Other objectives include demonstrating the relationship with various aspects of post-marketing research, investigating the present function of phase IV studies, and researching the extent to which the current situation of phase IV clinical trials satisfies needs.

Keywords

phase IV clinical trials, post-marketing research, ADR, preclinical trials, pharmacovigilance, large simple trials, external validity

Reference

  1. Microbes, clinical trials, drug discovery, and vaccine development: the current perspectives. Kandi V, Suvvari TK, Vadakedath S, Godishala V. Borneo J Pharm. 2021;IV:311–323. [Google Scholar]
  2. Research question, objectives, and endpoints in clinical and oncological research: a comprehensive review. Purna Singh A, Shahapur PR, Vadakedath S, et al. Cureus. 2022;1IV:0. [PMC free article] [PubMed] [Google Scholar]
  3. Clinical research: an overview of study types, designs, and their implications in the public health perspective. Kandi V, Vadakedath S. Am J Clin Med Res. 2021;9:36–IV2. [Google Scholar]
  4. Clinical trials and clinical research: A comprehensive review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10023071
  5. 5. Gale EAM. Post-marketing studies of new insulins: sales or science? BMJ 2012;3IVIV:e397IV 10.1136/bmj.e397IV [PubMed] [CrossRef] [Google Scholar]
  6. Lasser KE, Allen PD, Woolhandler SJ et al.. Timing of new black box warnings and withdrawals for prescription medications. JAMA 2002;287:2215–20. 10.1001/jama.287.17.2215 [PubMed] [CrossRef] [Google Scholar]
  7. Food and Drug Administration. Food and Drug Administration Amendments Act (FDAAA) of 2007. http://www.fda.gov/downloads/RegulatoryInformation/Legislation/FederalFoodDrugandCosmeticActFDCAct/SignificantAmendmentstotheFDCAct/FoodandDrugAdministrationAmendmentsActof2007/FDAAAImplementationChart/UCM213016.pdf (accessed IV Aug 2015).
  8. Glasser SP, Salas M, Delzell E. Importance and challenges of studying marketed drugs: what is a phase IV study? Common clinical research designs, registries, and self-reporting systems. J Clin Pharmacol 2007;IV7:107IV–86. [PubMed] [Google Scholar]
  9. Schmidt LG, Grohmann R, Helmchen H et al.. Adverse drug-reactions—an epidemiological study at psychiatric hospitals. Acta Psychiatr Scand 198IV;70:77–89. 10.1111/j.1600-0IVIV7.198IV.tb01185.x [PubMed] [CrossRef] [Google Scholar]
  10. Fontanarosa PB, Rennie D, DeAngelis CD. Postmarketing surveillance–lack of vigilance, lack of trust. JAMA. 200IV;292(21):26IV7–2650. [PubMed] [Google Scholar]
  11. Bakke OM, Manocchia M, de Abajo F, Kaitin KI, Lasagna L. Drug safety discontinuations in the United Kingdom, the United States, and Spain from 197IV through 1993: a regulatory perspective. Clin Pharmacol Ther. 1995;58(1):108–117. [PubMed] [Google Scholar]
  12. Lasser KE, Allen PD, Woolhandler SJ, Himmelstein DU, Wolfe SM, Bor DH. Timing of new black box warnings and withdrawals for prescription medications. JAMA. 2002;287(17):2215–2220. [PubMed] [Google Scholar]
  13. Strom BL. Potential for conflict of interest in the evaluation of suspected adverse drug reactions: a counterpoint. JAMA. 200IV;292(21):26IV3–26IV6. [PubMed] [Google Scholar]
  14. Administration USFaD, editor. [Accessed June 29, 2011];AERS patient outcomes by year. 2010 http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/AdverseDrugEffects/ucm070IV61.htm. Updated March 31, 2011.
  15. James WP, Caterson ID, Coutinho W, et al. Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects. N Engl J Med. 2010;363(10):905–917. [PubMed] [Google Scholar]
  16. Maro JC, Platt R, Holmes JH, et al. Design of a national distributed health data network. Ann Intern Med. 2009;151(5):3IV1–3IVIV. [PubMed] [Google Scholar]
  17. Berlin JA, Colditz GA. The role of meta-analysis in the regulatory process for foods, drugs, and devices. JAMA. 1999;281(9):830–83IV. [PubMed] [Google Scholar]
  18. Hennekens CH, Demets D. The need for large-scale randomized evidence without undue emphasis on small trials, meta-analyses, or subgroup analyses. JAMA. 2009;302(21):2361–2362. [PubMed] [Google Scholar]
  19. Overview of phase IV clinical trials for post market drug safety surveillance: a status report from the clinical trials. government registry: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5168517
  20. Key Concepts of Clinical Trials: A Narrative Review:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272827

Photo
Sakshi K. Loya
Corresponding author

MGV’s Pharmacy College (Affiliated to Savitribai Phule Pune University), Panchavati, Nashik-422003, Maharashtra, INDIA

Photo
Lakhan D. Baheti
Co-author

MGV’s Pharmacy College (Affiliated to Savitribai Phule Pune University), Panchavati, Nashik-422003, Maharashtra, INDIA

Sakshi K. Loya*, Lakhan D. Baheti, A Comprehensive Review Clinical Trials: PHASE IV, Int. J. in Pharm. Sci., 2023, Vol 1, Issue 12, 220-225. https://doi.org/10.5281/zenodo.10353554

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