title: The value of acute toxicity studies to support the clinical management of overdose and poisoning: a cross-discipline consensus.
abstract: Acute toxicity studies are no longer required to support first clinical trials of pharmaceuticals in man. However, it is unclear in the wording of the revised ICH M3 whether acute toxicity studies are required later in drug development (e.g., phase 3) in order to support the management of overdose. The NC3Rs held a workshop in January 2010 with representatives from international poison centres, the pharmaceutical and chemical industries, and regulatory and government bodies to explore further whether acute toxicity studies are used to support the clinical management of overdose of pharmaceuticals and whether this work can be translated to other sectors such as the chemical industry. The consensus formed at the workshop was that acute toxicity studies are not used for managing overdose of pharmaceuticals and are of little value in treating human poisoning from chemicals. In this paper, the authors describe the key considerations in treating human overdose and poisoning, challenge the value of the classification and labelling process of chemicals for this purpose and discuss how acute toxicity studies can be improved to better inform risk assessment.
authors.affiliation: National Centre for the Replacement, Refinement and Reduction of Animals in Research, London, UK. Kathryn.Chapman@nc3rs.org.uk
authors.forename: Kathryn
authors.initials: K
authors.lastname: Chapman
authors.forename: Stuart
authors.initials: S
authors.lastname: Creton
authors.forename: Hugo
authors.initials: H
authors.lastname: Kupferschmidt
authors.forename: G Randall
authors.initials: GR
authors.lastname: Bond
authors.forename: Martin F
authors.initials: MF
authors.lastname: Wilks
authors.forename: Sally
authors.initials: S
authors.lastname: Robinson
mesh_terms: D000818:Animals; D002617:Chemical Industry; D002986:Clinical Trials as Topic; D032921:Consensus; D004345:Drug Industry; D004348:Drug Labeling; D062787:Drug Overdose / Q000188:drug therapy / Q000628:therapy; D064420:Drug-Related Side Effects and Adverse Reactions; D017408:Guidelines as Topic; D006801:Humans; D004364:Pharmaceutical Preparations / Q000145:classification; D011039:Poison Control Centers; D011041:Poisoning / Q000188:drug therapy / Q000628:therapy; D018570:Risk Assessment; D023382:Toxicity Tests, Acute
chemical_list: D004364:Pharmaceutical Preparations