Current Status and Trend of Clinical Development of Orphan Drugs in China

Background:Rare diseases have been increasingly recognized as medical and healthy burden worldwide, a growing demand for the development of orphan drugs emerges subsequently. Therefore, it is of great interest for both the regulatory agency and pharmaceutical companies to keep tract on the clinical orphan drug development in China.Objective and Method:This study aims to reveal the current situation and trend of the clinical development of orphan drugs in China, based on the data collected from the Platform for Drug Clinical Trials and Information Registration（http://www.chinadrugtrials.org.cn）of China Food and Drug Administration, dating from 2013 to March 8, 2021.Results:A total of 246 clinical trials for orphan drugs are extracted from the Platform, covering 22 rare diseases and 90 drugs. Among the 22 rare diseases, 3 (14 %) have more than 50 trials each , 17 (77%) had less than10 trials, and 10 (46%) only with one trial. Among 90 orphan drugs, 60 (67%) were chemical drugs, and 30 (33 %) were biological products. In addition, international multi-center trials accounts for nearly 10% of the total trials. The number of the trials with the Data Monitoring Security Committee (DMC) is 25 (10%) and the number of the trials with the trial injury insurance for subjects is 154 (63%). Furthermore, more than half of the total trials are carried in east (333, 30%) and north China (298, 27%), whereas a small portion are in the northwest (62, 6%) and northeast china (45, 4%).Conclusions:The clinical development of orphan drugs for rare diseases in China has made some progress in the passing decades. However, a couple of critical issues still need to be addressed, such as unmet needs for some rare diseases, low coverage of insurance and DMC, and uneven distribution of medical resources for clinical researches. Recommendations are put forward accordingly, which can provide improvement goals for policy makers and stakeholders involved in drug development for rare diseases.

Letter from the Editors

Last year we successfully introduced a new journal: The Journal of Rare Diseases and Orphan Drugs (JRDOD) is a peer-reviewed open-access medical journal that publishes original research, reviews, case reports, and letters covering a broad field of its specialty. We intend to publish articles stimulating to read, educate, and inform readers with the most up-to-date research in genetics, rare diseases, and new orphan drug development in different stages of clinical trials. Journal topics are centered on patients living with undiagnosed rare diseases, the importance of a diagnosis, individual approaches to treatments. We hope that this journal will increase awareness of many difficult to diagnosed and treat medical conditions.

Orphan drug development and epilepsy with Ana Mingorance

Learn more from Ana Mingorance of the Loulou Foundation about the current status of drug development in epilepsy. In this Expert Perspective, Ana describes how the landscape of this field has changed, with new developments in technology as well as challenges associated with the regulatory approval of new drugs leading to a shift in focus to developing novel drugs to treat orphan epilepsy indications.

Talking About Rare Diseases

Originally, rare diseases and orphan diseases were not synonyms. Rare diseases became known as orphan diseases because pharmaceutical companies were not interested in developing treatments for them. The Orphan Drug Act (USA) used financial incentives for orphan drug development. Herewith, a definition for rare disease was also established. This differs slightly across countries. Some rare diseases respond to drugs that are not orphan drugs. Orphan diseases refer to neglected diseases and even common disorders as endometrial cancer and infantile diabetes. Nonetheless, nowadays very often rare and orphan are used as synonyms. The causes for rare diseases are very diverse. The majority are thought to be genetic. Most lack proper diagnosis, treatment, or known therapeutic targets. However, rare disease patients account for a huge proportion of the health burden. This chapter discusses rare (and orphan) diseases, what has been reported about them, and how they appear to the general public. The different categories of rare diseases are introduced.