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Dr. Leen Kawas Explains Why The Patient’s Voice Must Be Integral To The Drug Development Cycle

Dr. Leen Kawas, co-managing partner at Propel Bio Partners, highlights the importance of the patient’s voice within the realm of meaningful and successful drug development.

Author:Karan Emery
Reviewer:Daniel James
Jan 22, 2024
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34.2K Views
The United States’ drug development cycle involves a five-step progression during which the drug candidate’s safety and efficacy undergo close evaluation. Pre-clinical research, clinical research, and a detailed Food and Drug Administration (or FDA) review are key parts of the process.
Near the development cycle’s conclusion, an FDA Advisory Committee may be convened to address specific issues. A Patient Representative is often invited to join this panel. Until this phase, however, the patient has historically not been included in the drug development process.

Dr. Leen Kawas Advocates for Much-Needed Change

Leen Kawas, Ph.D. emphasized that it’s time to change this practice. She strongly believes that the patient’s voice should be integrated into multiple phases of the drug development cycle. In fact, Dr. Kawas previously put this principle into practice while serving as Chief Executive Officer (or CEO) of Athira Pharma, Inc.
Today, as Propel Bio Partners’ Managing General Partner, Dr. Kawas advocates for patient involvement while assisting the venture capital firm’s biotechnology entrepreneurs. She encourages the firm’s partners to include patient contributions in drug development.

The 5-Step Drug Development Cycle

The United States Food & Drug Administration oversees the drug development process, required for all U.S.-based drug candidates. Candidates are weeded out for varied reasons, with only a small percentage receiving FDA approval.

Step 1: Discovery and Development

This two-step phase begins when researchers gain insights into a disease process. Alternatively, researchers may look for molecular compounds’ favorable effects. Current treatments with unplanned results, and new technologies that may facilitate targeted treatments, may also be discovery sources.
After researchers pinpoint a potential drug development candidate, they perform experiments centered around the drug’s performance. During this phase, researchers analyze the drug’s optimal dosage, side effects, interactions, and comparative efficacy.

Step 2: Preclinical Research

Before the drug’s human trials can begin, researchers must determine whether the drug can potentially harm those taking it. During this preclinical research phase, researchers either perform In Vitro research (done in a test tube or lab dish) or In Vivo research (performed on a living organism). Following this phase, researchers determine whether to pursue human testing.

Step 3: Clinical Research

Clinical research demonstrates how the drug will interact with the human body. Carefully designed clinical trials are the foundation of this phase. Before that begins, however, developers must complete the Investigational New Drug Process.
Next, researchers review available information before designing the drug’s clinical trial phases. Clinical trials typically conform to a three-phase study format. Small-scale early Phase 1 studies contrast with large-scale late Phase 3 studies.

Step 4: FDA Drug Review Process

Assume the drug developer now has evidence that a drug is safe and effective during its intended use. The firm can now apply to market the drug via a New Drug Application.
The FDA’s review team carefully evaluates all provided data before deciding whether to approve or deny the application. This phase can involve multiple reviews and exchanges between the FDA and the drug developer.

Step 5: FDA Post-Market Drug Safety Monitoring

Because no one can predict a drug’s future performance, the FDA analyzes reports of issues with prescription medications and over-the-counter drugs. The FDA may add certain cautions for a drug’s use and may take additional action for serious occurrences.

FDA Recognizes Patients’ Value in Drug Development

The Drug Administrationhas acknowledged patients’ key role in the drug development and analysis cycle. To integrate patients into the process, the FDA has launched the Patient-Focused Drug Development (or PFDD) Program.
This forward-thinking approach seeks to bring patients’ needs, priorities, and experiences into the complex drug development cycle. In the FDA’s view, each patient’s firsthand knowledge of their medical condition can be invaluable in developing targeted therapies. The FDA desires to incorporate the patient’s voice in four significant ways:
  • Identify Best Practices to Enable Smoother, Less Burdensome Patient Clinical Trial Enrollment
  • Enable Better Patient Decision Making Through More Effective Communication Regarding Treatment Risks, Benefits, and Burden
  • Engage Appropriate Methods to Obtain Information on Patient Preferences and Their Attitudes Toward Treatment Benefit vs Risk
  • Develop Structured Patient and Caregiver Feedback to Better Inform Drug Development and Regulatory Decision Processes

Dr. Leen Kawas Encourages Patients’ Voices in Clinical Trials

Dr. Leen Kawas strongly agrees with the FDA’s Patient-Focused Drug Development initiative. As an accomplished bioscientist, and Propel Bio Partners’ Managing General Partner, Dr. Kawas brings this paradigm into her work with biotechnology entrepreneurs.
Propel’s venture capital leadership combines financial support and biotechnology expertise. Once a founder is invited aboard, Dr. Kawas guides the company’s drug development cycle, including its clinical trial phase. She takes concrete actions to make patients an integral part of this rigorous process.

Dr. Leen Kawas’ Patient-Centric Clinical Trial Experiences

Dr. Leen Kawas developed her patient-centric focus while serving as Chief Executive Officer of Athira Pharma, Inc. While managing a high-achieving drug development team, Dr. Kawas kept patients’ goals at the forefront.
“We built a team that did not think about barriers. We only thought about solutions and how we can do things better, differently, with a mindset that we are serving the key stakeholders, which are the patients.
“Track the success and satisfaction of your customers (in life sciences, the patients). That’s going to drive value. You are developing therapies. You are changing people’s lives. Once you achieve that, the financial value is going to follow,” Dr. Leen Kawas remarked.

How Patients Can Help Drive Higher Trial Participation

Clinical trials can only proceed when a certain number of patients agree to participate. However, patients may be hesitant to enroll if trials conflict with other commitments and/or involve stringent requirements. Dr. Leen Kawas understood that insufficient patient participation means a drug development program grinds to a halt.
To encourage higher clinical trial participation, Dr. Kawas pinpointed the factors important to the patients. In other words, she wanted to give the patients a voice in the clinical trial design, a somewhat unusual practice in biotechnology circles.
“If you design clinical trials that have the patient’s voice in them, patient retention will increase (which is a problem in our industry).” Dr. Kawas also made clinical trial participants’ well-being a priority. During one clinical trial, she ordered onsite meals for participating Alzheimer’s patients along with their caregivers.

How 21st-Century Patients Are Involved in Drug Development

Today’s technology-savvy patients are taking a more active role in their healthcare and physical well-being. This growing participation extends to patients’ involvement in the drug development cycle. The December 2021edition detailed two ways in which patients are making their voices heard.

Dynamic Information Exchange

Historically, many patients depended heavily on their healthcare provider for medical condition management. Today, however, Internet-savvy patients regularly delve into credible sources such as peer-reviewed studies and other reliable medical content. The patient also brings their firsthand experiences into the mix. Forward-thinking healthcare providers are actively listening to patients’ voices.
Patients are also sharing their information on social media, in patient forums, and in patient advocacy groups. This collective knowledge exchange is helping clinicians better identify and manage rare disease risks.
Finally, certain pharmaceutical companies now operate closed patient groups. These communication-rich exchanges often spur patients to better adhere to their medication regimens.

Active Patient Organizations

Patient organizations bridge the gap between pharmaceutical firms and patients. In these associations, patients can share experiences and feel confident the pharma companies are listening.
Taking it a step further, patient organizations can enter into collaborations with pharma companies. The organization’s goal: to address patient priorities and spur the growth of experience-driven drug development.

Patient Organizations and the Drug Development Cycle

Ideally, pharmaceutical firms will work with patient organizations in three ways. First, patient organizations can offer recommendations on improving patient clinical trial recruitment (and retention).
Next, patient organizations can point out barriers to recruitment such as unclear legal and technical jargon in clinical trial information. Patients’ difficulties in understanding these details could deter them from trial participation.
Finally, patient organizations can address patient logistical concerns about clinical trial enrollment. Issues may include work commitments, family responsibilities, and lack of transportation. Resolving these issues can help drive better patient trial participation.
Dr. Leen Kawas Supports Ongoing Patient Recognition Initiatives
In Dr. Leen Kawas’ influential Propel Bio Partners role, she guides partner companies through the complex drug development cycle. Therefore, Dr. Leen Kawas is well-positioned to encourage patient involvementin every applicable phase. She looks forward to more opportunities to amplify patients’ collective voices.
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Karan Emery

Karan Emery

Author
Karan Emery, an accomplished researcher and leader in health sciences, biotechnology, and pharmaceuticals, brings over two decades of experience to the table. Holding a Ph.D. in Pharmaceutical Sciences from Stanford University, Karan's credentials underscore her authority in the field. With a track record of groundbreaking research and numerous peer-reviewed publications in prestigious journals, Karan's expertise is widely recognized in the scientific community. Her writing style is characterized by its clarity and meticulous attention to detail, making complex scientific concepts accessible to a broad audience. Apart from her professional endeavors, Karan enjoys cooking, learning about different cultures and languages, watching documentaries, and visiting historical landmarks. Committed to advancing knowledge and improving health outcomes, Karan Emery continues to make significant contributions to the fields of health, biotechnology, and pharmaceuticals.
Daniel James

Daniel James

Reviewer
Daniel James is a distinguished gerontologist, author, and professional coach known for his expertise in health and aging. With degrees from Georgia Tech and UCLA, including a diploma in gerontology from the University of Boston, Daniel brings over 15 years of experience to his work. His credentials also include a Professional Coaching Certification, enhancing his credibility in personal development and well-being. In his free time, Daniel is an avid runner and tennis player, passionate about fitness, wellness, and staying active. His commitment to improving lives through health education and coaching reflects his passion and dedication in both professional and personal endeavors.
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