EXPIRED
U.S. Food and Drug Administration (FDA)
The policies, guidelines, terms, and conditions stated in this announcement may differ from those used by the NIH. Where this Funding Opportunity Announcement (FOA) provides specific written guidance that may differ from the general guidance provided in the grant application form, please follow the instructions given in this FOA.
The FDA does not follow the NIH Page Limitation Guidelines or the NIH Review Criteria. Applicants are encouraged to consult with FDA Agency Contacts for additional information regarding page limits and the FDA Objective Review Process.
Center for Drug Evaluation and Research (CDER)
The Use of Polyethylene Glycol in the Pediatric Population (R01)
R01 Research Project Grant
New
RFA-FD-14-088
Not Applicable
93.103
The purpose of the proposed study is to better understand the extent of pediatric accumulation of low molecular weight (LMW) species that may be found in PEG 3350 products (e.g., ethylene and diethylene glycol) and of PEG 3350 metabolites. PEG 3350 products are used in the treatment of constipation. If present in the product when administered and/or produced in the gut and absorbed, these metabolites and LMW species may accumulate in children taking PEG 3350 products -- potentially leading to adverse events. This is an important first step needed to begin to understand if PEG 3350 use contributes to adverse events in children due to the absorption of these species.
June 4, 2014
June 13, 2014
Not Applicable
July 15, 2014, by 11:59 PM Eastern Time.
Applicants are encouraged to apply early to allow adequate time to make any corrections to errors found in the application during the submission process by the due date.
Applicants should be aware that on-time submission means that an application is submitted error free (of both Grants.gov and eRA Commons errors) by 11:59 PM Eastern Time on the application due date.
Not Applicable
August 2014
Not Applicable
September 2014
July 16, 2014
Not Applicable
Required Application Instructions
It is critical that applicants follow the instructions in the SF424 (R&R) Application Guide, except where instructed to do otherwise (in this FOA or in a Notice from the NIH Guide for Grants and Contracts). Conformance to all requirements (both in the Application Guide and the FOA) is required and strictly enforced. Applicants must read and follow all application instructions in the Application Guide as well as any program-specific instructions noted in Section IV. When the program-specific instructions deviate from those in the Application Guide, follow the program-specific instructions. Applications that do not comply with these instructions may be delayed or not accepted for review.
Part 1. Overview Information
Part 2. Full Text of the Announcement
Section I. Funding Opportunity Description
Section II. Award Information
Section III. Eligibility Information
Section IV. Application and Submission
Information
Section V. Application Review Information
Section VI. Award Administration Information
Section VII. Agency Contacts
Section VIII. Other Information
Polyethylene glycol laxative is approved for over-the-counter use for occasional constipation in adults and children = 17 years of age, and is recommended for short term use up to seven days. Use in children less than 17 and chronic use is not approved by the FDA, but nevertheless the laxative is used as such in clinical practice.
Polyethylene glycol (PEG) is a long-chain polymer of ethylene oxide commercially available in molecular weights 300 g/mole to 10,000,000 g/mole. PEG is an osmotic agent which retains water within stool and produces an osmotic diarrhea. The designation PEG 3550 indicates the average molecular weight of that product and therefore includes a distribution of various molecular weights of PEG potentially including low levels of ethylene glycol, diethylene glycol and possibly other low molecular weight species. PEG 3550 exists in a stable powder form. Currently approved products instruct the patients to dissolve the PEG powder in a liquid and use immediately. The approved products have been tested under these conditions and are stable. Ethylene glycol is a precursor for synthesis and a degradation product of PEG. Ethylene glycol is known to be neurotoxic in children, and ethylene glycol poisoning causes metabolic acidosis with an increased anion gap.
The Food and Drug Administration has received a number of reports of adverse events in children taking PEG products. The Agency has conducted a review that documented a number of reports of neurological and psychiatric events associated with chronic PEG use in children. A number of these pediatric patients received an adult dose of PEG (17 grams) for a duration ranging from a few days to a couple of years.
Whether the PEG contributes in some way to these adverse events is not clear at this time. One possible link between PEG use and adverse events in children is the absorption of LMW species leading to these outcomes. In addition, it may be possible that absorption of PEG in children is greater than in adults, especially in constipated patients. Another possible etiology for these safety concerns is that PEG products may be degraded before ingestion if parents pre-mix the product and store in suspension form for a prolonged period. Finally, some children may be more susceptible to the adverse effects of PEG, especially when high doses are given or after prolonged use.
To better understand the level of polyethylene glycol impurities in PEG, the FDA Chemistry and Manufacturing group evaluated PEG 3350. This analysis of eight lots of PEG 3350 confirmed the presence of small amounts of ethylene glycol and diethylene glycol in all lots tested. The lower limit of quantitation (LLOQ) for the assay was 15 g/mL. Other low molecular weight PEGs were not included in this analysis. It is not known if any of these LMW species are absorbed and, if so, to what extent. Understanding the human absorption profile of PEG 3350 metabolites and LMW species is the first step needed in trying to understand the possible contribution of PEG 3350 use to the development of adverse events in children using this product chronically. This will require development of ultra-sensitive assays for assessing human exposures following oral dosing with clinically relevant doses of PEG3350. Although the LLOQ for the FDA assay was 15 g/mL, we anticipate that the assays developed in response to this funding opportunity will need to further maximize assay sensitivity.
The purpose of the proposed study is to understand the extent of accumulation of low molecular weight species that may be found in PEG 3350 products and of PEG 3350 metabolites in the pediatric population taking this product chronically.
All funded studies will be required to develop assays for the relevant PEG 3350 metabolites and LMW species, recruit individuals aged of 0-17 years with chronic constipation who are already taking PEG 3350 on a chronic basis ( chronic is to be defined and justified by the investigator) as prescribed by their physician, collect samples of an appropriate bodily fluid from subjects, and analyze the samples using the assays developed. At a minimum, analysis for the following will be needed: diethylene glycol, ethylene glycol, diglycolic acid, glycolic acid, 2-hydroxyethoxyacetic acid, and 200 and 400 molecular weight PEGs. Grantees are also expected to obtain or determine the distribution of LMW species in the PEG 3350 product administered to subjects.
Prior to developing the assay, determine and justify the lower limit of detection for the assay based on data or literature. Develop as sensitive an assay as possible. Very low levels of the species of interest are expected to be present; thus, assays will need to be extremely sensitive. Once the assay is developed, grantees must submit proof of assay sensitivity for each species and justification for the lower limit of detection for FDA prior approval before enrolling pediatric subjects.
Justify the number of subjects proposed and stratify subjects by age from 0-6, 6-12 and 12-17 years, with an emphasis on the younger age children. These children may or may not have other underlying disorders or be on other medications. Consent/assent will need to be obtained from the children and their parents. Clinical information including the indication for PEG 3350 use, dosage and duration of use, a description of underlying disease(s) and other medication(s) as well as age and weight of the child should also be obtained. A description of any adverse events -- especially those related to neuropsychiatric events -- should also be collected, if present. Propose and justify the time period for which adverse events will be collected.
Although the main objective of this funding opportunity is to better understand the extent of accumulation of PEG 3350 metabolites and LMW species when PEG 3350 is used chronically, we highly recommend that samples (sample type to be determined by the investigator) be collected from individuals with and without adverse events.
Record the timing of the last dose of PEG 3350 prior to sample collection. This information is critical for understanding if these species may be contributing in any way to adverse events seen in some children taking PEG 3350 chronically. Propose and justify the optimal timepoint(s), including duration of sample collection, to capture maximal accumulation of the species of interest. We anticipate that samples may need to be collected starting a few hours after dosing to obtain quantifiable levels of PEG 3350 metabolites and LMW species. Samples will need to be collected at the same specified time(s) after dosing from all subjects. These samples will need to be stored appropriately until they can be assayed for PEG 3350 metabolites and LMW species. PEG-free collection and storage equipment will need to be used.
This information specifically related to the potential for accumulation of PEG 3350 metabolites and LMW species has heretofore not been collected and is the first step needed to begin to understand if PEG 3350 use contributes to adverse events in children. At the end of the study, provide data analysis and a clinical study report to the Agency.
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New
The OER Glossary and the SF424 (R&R) Application Guide provide details on these application types.
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FDA/CDER intends to fund up to $325,000 in total costs (direct + indirect) to this grant program for Fiscal Year 2014.
It is anticipated that up to one award will be made, not to exceed $325,000 in total costs (direct plus indirect) per award.
Awards are contingent upon the availability of funds. Budgets should not exceed $325,000 in total costs.
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This FOA does not require cost sharing as defined in the HHS Grants Policy Statement.
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The FDA will not accept duplicate or highly overlapping applications under review at the same time. This means that the FDA will not accept:
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The following section supplements the instructions found in the SF424 (R&R) Application Guide and should be used for preparing an application to this FOA.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed with the following additional instructions:
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
Resource Sharing Plan: Individuals are required to comply with the instructions for the Resource Sharing Plans (Data Sharing Plan, Sharing Model Organisms, and Genome Wide Association Studies (GWAS)) as provided in the SF424 (R&R) Application Guide, with the following modification:
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Information on the submission process and a definition of on-time submission are provided in the SF424 (R&R) Application Guide.
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For assistance with your electronic application or for more information on the electronic submission process, visit Applying Electronically.
Important
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and to include a valid PD/PI Commons ID in the credential field will prevent
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registration requirements.
The applicant organization must ensure that the DUNS number it provides on the
application is the same number used in the organization’s profile in the eRA
Commons and for the System for Award Management. Additional information may be
found in the SF424 (R&R) Application Guide.
See more
tips for avoiding common errors.
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Significance
Does the project address an important problem or a critical barrier to progress in the field? If the aims of the project are achieved, how will scientific knowledge, technical capability, and/or clinical practice be improved? How will successful completion of the aims change the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field?
Investigator(s)
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Innovation
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Approach
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Environment
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Protections for Human Subjects
For research that involves human subjects but does
not involve one of the six categories of research that are exempt under 45 CFR
Part 46, the committee will evaluate the justification for involvement of human
subjects and the proposed protections from research risk relating to their
participation according to the following five review criteria: 1) risk to
subjects, 2) adequacy of protection against risks, 3) potential benefits to the
subjects and others, 4) importance of the knowledge to be gained, and 5) data
and safety monitoring for clinical trials.
For research that involves human subjects and meets the criteria for one or
more of the six categories of research that are exempt under 45 CFR Part 46,
the committee will evaluate: 1) the justification for the exemption, 2) human
subjects involvement and characteristics, and 3) sources of materials. For
additional information on review of the Human Subjects section, please refer to
the Guidelines
for the Review of Human Subjects.
Inclusion of Women, Minorities, and Children
When the proposed project involves human subjects and/or FDA defined clinical research, the committee will evaluate the proposed plans for the inclusion (or exclusion) of individuals on the basis of sex/gender, race, and ethnicity, as well as the inclusion (or exclusion) of children to determine if it is justified in terms of the scientific goals and research strategy proposed. For additional information on review of the Inclusion section, please refer to the Guidelines for the Review of Inclusion in Clinical Research.
Vertebrate Animals
The committee will evaluate the involvement of live vertebrate animals as part of the scientific assessment according to the following five points: 1) proposed use of the animals, and species, strains, ages, sex, and numbers to be used; 2) justifications for the use of animals and for the appropriateness of the species and numbers proposed; 3) adequacy of veterinary care; 4) procedures for limiting discomfort, distress, pain and injury to that which is unavoidable in the conduct of scientifically sound research including the use of analgesic, anesthetic, and tranquilizing drugs and/or comfortable restraining devices; and 5) methods of euthanasia and reason for selection if not consistent with the AVMA Guidelines on Euthanasia. For additional information on review of the Vertebrate Animals section, please refer to the Worksheet for Review of the Vertebrate Animal Section.
Biohazards
Reviewers will assess whether materials or procedures proposed are potentially hazardous to research personnel and/or the environment, and if needed, determine whether adequate protection is proposed.
Resubmissions
Not Applicable
Renewals
Not Applicable
Revisions
Not Applicable
As applicable for the project proposed, reviewers will consider each of the following items, but will not give scores for these items, and should not consider them in providing an overall composite score.
Applications from Foreign Organizations
Reviewers will assess whether the project presents special opportunities for furthering research programs through the use of unusual talent, resources, populations, or environmental conditions that exist in other countries and either are not readily available in the United States or augment existing U.S. resources.
Select Agent Research
Reviewers will assess the information provided in this section of the application, including 1) the Select Agent(s) to be used in the proposed research, 2) the registration status of all entities where Select Agent(s) will be used, 3) the procedures that will be used to monitor possession use and transfer of Select Agent(s), and 4) plans for appropriate biosafety, biocontainment, and security of the Select Agent(s).
Resource Sharing Plans
Reviewers will comment on whether the following Resource Sharing Plans, or the rationale for not sharing the following types of resources, are reasonable: 1) Data Sharing Plan; 2) Sharing Model Organisms; and 3) Genome Wide Association Studies (GWAS).
Budget and Period of Support
Reviewers will consider whether the budget and the requested period of support are fully justified and reasonable in relation to the proposed research.
Applications determined to be complete and responsive will undergo an objective review process. An objective review panel will evaluate complete and responsive applications, using the stated review criteria.
As part of the objective review, all applications:
Appeals of objective review will not be accepted for applications submitted in response to this FOA.
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