Agency Information Collection Activities; Announcement of Office of Management and Budget Approval; Prescription Drug Advertisements, 36541-36542 [2011-15592]
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Federal Register / Vol. 76, No. 120 / Wednesday, June 22, 2011 / Notices
b. Age: Very young children,
adolescents, and adults, including older
adults (age >65 years)?
c. Pregnancy status: Pre-existing type
1 or type 2 diabetes?
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d. Intensive insulin delivery: MDI or
CSII?
TABLE 1—SUMMARY OF PROCESS MEASURES AND INTERMEDIATE AND CLINICAL OUTCOMES
Process measures
•
•
•
•
Intermediate outcomes
Ratio of basal to bolus insulin ........................
Frequency of adjusting insulin therapy ..........
Adherence to insulin therapy/sensor use .......
Frequency of professional or allied health
visits.
Clinical outcomes
• Microvascular*
• Retinopathy
• Nephropathy
• Neuropathy
• Macrovascular*
• Coronary heart disease
• Cerebrovascular disease
• Peropheral arterial disease
• Severe hypoglycemia
• Quality of life
• Fetal outcomes †
• Maternal pregnancy outcomes
• C-section rates
• Primary
• Hemoglobin A1c
• Secondary
• Hyperglycemia
• Weight gain
• Hypoglycemia frequency
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* We will only include objective assessments of microvascular and macrovascular outcomes (i.e., we will be excluding patient self-reported
microvascular and macrovascular outcomes).
† Fetal outcomes include gestational age, birth weight, frequency of neonatal hypoglycemia, birth trauma, major and minor anomalies, and admission to a neonatal intensive care unit.
For each KQ we will identify:
Population(s):
Adults, adolescents, and children
with type 1 or type 2 diabetes mellitus
and pregnant women with pre-existing
diabetes treated with insulin therapy.
1. We will use age ranges prescribed
by the Juvenile Diabetes Research
Foundation (<8 years [very young
children], 8–14 years [children], 14–25
years [adolescent], and >25 years
[adults]); however, our final definitions
will be guided by those used in the
literature that is reviewed.
2. If available, we will examine data
among populations of older adult (>65
years).
Interventions:
The interventions of interest are CSII
(see Appendix 2 for a list of insulin
pumps and models) and rt-CGM (see
Appendix 3 for a list of monitors).
1. We will not be including the
following devices because they are no
longer used in the United States:
a. GlucoWatch continuous glucose
meter
b. Insulin pumps with regular insulin
Comparators:
All studies must have a concurrent
comparison group.
1. CSII would be compared with MDI,
which will be defined as at least three
injections of basal and rapid-acting
insulin per day.
2. rt-CGM would be compared with
SMBG, which will be defined as at least
three fingersticks per day.
Outcomes measures for each KQ:
1. Process measures
a. Ratio of basal to bolus insulin
b. Frequency of adjustments to insulin
therapy
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c. Adherence to insulin therapy/sensor
use
d. Frequency of professional or allied
health visits Intermediate outcomes
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2010–N–0110]
• HbA1c
a. Hyperglycemia
b. Weight gain
c. Hypoglycemia frequency
Agency Information Collection
Activities; Announcement of Office of
Management and Budget Approval;
Prescription Drug Advertisements
Clinical Outcomes
AGENCY:
• Objective assessments of
microvascular outcomes (retinopathy,
nephropathy, and neuropathy)
HHS.
a. Objective assessments of
macrovascular outcomes (coronary
heart disease, cerebrovascular disease,
and peripheral arterial disease)
b. Severe hypoglycemia
c. Quality of life
d. Fetal outcomes (gestational age, birth
weight, frequency of neonatal
hypoglycemia, birth trauma, major
and minor anomalies, and admission
to a neonatal intensive care unit)
e. Maternal pregnancy outcomes
(cesarean section rates)
Timing: Usage of a device for at least
24 hours.
Settings: Outpatient setting.
Dated: June 10, 2011.
Carolyn M. Clancy,
AHRQ, Director.
[FR Doc. 2011–15580 Filed 6–21–11; 8:45 am]
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ACTION:
Food and Drug Administration,
Notice.
The Food and Drug
Administration (FDA) is announcing
that a collection of information entitled
‘‘Prescription Drug Advertisements’’ has
been approved by the Office of
Management and Budget (OMB) under
the Paperwork Reduction Act of 1995.
FOR FURTHER INFORMATION CONTACT:
Elizabeth Berbakos, Office of
Information Management, Food and
Drug Administration, 1350 Piccard Dr.,
PI50–400B, Rockville, MD 20850, 301–
796–3792,
Elizabeth.Berbakos@fda.hhs.gov.
SUMMARY:
In the
Federal Register of January 24, 2011 (76
FR 4117), the Agency announced that
the proposed information collection had
been submitted to OMB for review and
clearance under 44 U.S.C. 3507. An
Agency may not conduct or sponsor,
and a person is not required to respond
to, a collection of information unless it
displays a currently valid OMB control
number. OMB has now approved the
information collection and has assigned
OMB control number 0910–0686. The
approval expires on June 30, 2014. A
SUPPLEMENTARY INFORMATION:
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36542
Federal Register / Vol. 76, No. 120 / Wednesday, June 22, 2011 / Notices
copy of the supporting statement for this
information collection is available on
the Internet at https://www.reginfo.gov/
public/do/PRAMain.
Dated: June 17, 2011.
Leslie Kux,
Acting Assistant Commissioner for Policy.
[FR Doc. 2011–15592 Filed 6–21–11; 8:45 am]
BILLING CODE 4160–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2011–D–0464]
Draft Guidance for Industry and Food
and Drug Administration Staff: The
Content of Investigational Device
Exemption and Premarket Approval
Applications for Low Glucose Suspend
Device Systems; Availability
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice
The Food and Drug
Administration (FDA) is announcing the
availability of the draft guidance
document entitled ‘‘Draft Guidance for
Industry and Food and Drug
Administration Staff: The Content of
Investigational Device Exemption (IDE)
and Premarket Approval (PMA)
Applications for Low Glucose Suspend
(LGS) Device Systems.’’ This draft
guidance document provides industry
and Agency staff with recommendations
that are intended to improve the safety
and effectiveness of LGS Device
Systems. This draft guidance is not final
nor is it in effect at this time.
DATES: Although you can comment on
any guidance at any time (see 21 CFR
10.115(g)(5)), to ensure that the Agency
considers your comment on this draft
guidance before it begins work on the
final version of the guidance, submit
either electronic or written comments
on the draft guidance by September 20,
2011.
ADDRESSES: Submit written requests for
single copies of the draft guidance
document entitled ‘‘Draft Guidance for
Industry and Food and Drug
Administration Staff: The Content of
Investigational Device Exemption (IDE)
and Premarket Approval (PMA)
Applications for Low Glucose Suspend
(LGS) Device Systems’’ to the Division
of Small Manufacturers, International,
and Consumer Assistance, Center for
Devices and Radiological Health, Food
and Drug Administration, 10903 New
Hampshire Ave., Bldg. 66, rm. 4613,
Silver Spring, MD 20993–0002. Send
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SUMMARY:
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one self-addressed adhesive label to
assist that office in processing your
request, or fax your request to 301–847–
8149. See the SUPPLEMENTARY
INFORMATION section for information on
electronic access to the guidance.
Submit electronic comments on the
draft guidance to https://
www.regulations.gov. Submit written
comments to the Division of Dockets
Management (HFA–305), Food and Drug
Administration, 5630 Fishers Lane, rm.
1061, Rockville, MD 20852. Identify
comments with the docket number
found in brackets in the heading of this
document.
FOR FURTHER INFORMATION CONTACT:
Charles Zimliki, Center for Devices and
Radiological Health, Food and Drug
Administration, 10903 New Hampshire
Ave., Bldg. 66, rm. 2556, Silver Spring,
MD 20993–0002, 301–796–6297.
SUPPLEMENTARY INFORMATION:
I. Background
Diabetes mellitus has reached
epidemic proportions in the United
States and more recently, worldwide.
The morbidity and mortality associated
with diabetes is anticipated to account
for a substantial proportion of health
care expenditures. Although there are
many devices available that help
patients manage the disease, FDA
recognizes the need for new and
improved devices for treatment of
diabetes. One of the more advanced
diabetes management systems is an
artificial pancreas device system. An
artificial pancreas system is a type of
autonomous system that adjusts insulin
infusion based upon the continuous
glucose monitor via control algorithm.
There are a variety of types of artificial
pancreas systems depending upon the
nature of the control algorithm. They
can be generally divided into three
categories, LGS, Treat-to-Range, and
Treat-to-Target. In this notice, FDA is
announcing a draft guidance for the first
type of artificial pancreas, the LGS
system. An LGS system links a
continuous glucose monitor to an
insulin pump and automatically reduces
or suspends insulin infusion
temporarily based upon specified
thresholds of measured glucose levels.
This type of system is designed to
reduce or mitigate the likelihood of a
hypoglycemic event. There are
significant challenges in creating an
autonomous system, which were
discussed in a joint FDA and National
Institutes of Health (NIH) artificial
pancreas workshop on November 10,
2010 (information available at: https://
www.fda.gov/MedicalDevices/News
Events/WorkshopsConferences/
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ucm226251.htm. Currently, there is no
FDA-approved artificial pancreas for
home use. This workshop sought
feedback on ways to overcome the
obstacles towards developing an
artificial pancreas. The feedback
received from this workshop and the
continued communication with
investigators in this field has provided
valuable input for FDA’s first guidance
for a LGS device. This guidance will
outline considerations for development
of clinical studies, and recommends
elements that should be included in IDE
and PMA applications, focusing on
critical elements of safety and
effectiveness for approval of this device
type. The guidance includes one
suggested approach to support safety
and effectiveness, but given the early
stage of this technology, FDA is open to
considering alternative study design
approaches and seeks comments
regarding alternative approaches. FDA
particularly seeks comments regarding
the validity of the Continuous Glucose
Monitor based event for hypoglycemia
endpoint, pivotal study design, and
patient population. As the LGS system
is one of three types of artificial
pancreas systems, comments to the LGS
guidance will not only assist FDA in
finalizing guidance on LGS systems, but
also assist in developing future draft
guidance for the other types of artificial
pancreas systems. FDA continues to
work with the investigators in this field
and is developing a second guidance to
address the remaining artificial pancreas
device systems.
II. Significance of Guidance
This draft guidance is being issued
consistent with FDA’s good guidance
practices regulation (21 CFR 10.115).
The draft guidance, when finalized, will
represent the Agency’s current thinking
on LGS Device systems. It does not
create or confer any rights for or on any
person and does not operate to bind
FDA or the public. An alternative
approach may be used if such approach
satisfies the requirements of the
applicable statute and regulations.
III. Electronic Access
Persons interested in obtaining a copy
of the draft guidance may do so by using
the Internet. A search capability for all
CDRH guidance documents is available
at https://www.fda.gov/MedicalDevices/
DeviceRegulationandGuidance/
GuidanceDocuments/default.htm.
Guidance documents are also available
at https://www.regulations.gov. To
receive ‘‘Draft Guidance for Industry
and Food and Drug Administration
Staff: The Content of Investigational
Device Exemption (IDE) and Premarket
E:\FR\FM\22JNN1.SGM
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Agencies
[Federal Register Volume 76, Number 120 (Wednesday, June 22, 2011)]
[Notices]
[Pages 36541-36542]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-15592]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2010-N-0110]
Agency Information Collection Activities; Announcement of Office
of Management and Budget Approval; Prescription Drug Advertisements
AGENCY: Food and Drug Administration, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA) is announcing that a
collection of information entitled ``Prescription Drug Advertisements''
has been approved by the Office of Management and Budget (OMB) under
the Paperwork Reduction Act of 1995.
FOR FURTHER INFORMATION CONTACT: Elizabeth Berbakos, Office of
Information Management, Food and Drug Administration, 1350 Piccard Dr.,
PI50-400B, Rockville, MD 20850, 301-796-3792,
Elizabeth.Berbakos@fda.hhs.gov.
SUPPLEMENTARY INFORMATION: In the Federal Register of January 24, 2011
(76 FR 4117), the Agency announced that the proposed information
collection had been submitted to OMB for review and clearance under 44
U.S.C. 3507. An Agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays
a currently valid OMB control number. OMB has now approved the
information collection and has assigned OMB control number 0910-0686.
The approval expires on June 30, 2014. A
[[Page 36542]]
copy of the supporting statement for this information collection is
available on the Internet at https://www.reginfo.gov/public/do/PRAMain.
Dated: June 17, 2011.
Leslie Kux,
Acting Assistant Commissioner for Policy.
[FR Doc. 2011-15592 Filed 6-21-11; 8:45 am]
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