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Published on: March 24, 2017
Accelerating clinical drug development for children with tuberculosis
S Murray1, L McKenna2, E Pelfrene3
1The Global Alliance for TB Drug Development, New York, New York.
Insights
Pediatric tuberculosis (TB) drug development needs acceleration. Strategies include earlier pediatric study initiation, concomitant enrollment of children, and leveraging adult development pathways for child-friendly TB treatments.
Area of Science:
- Pediatric pharmacology
- Infectious disease research
- Drug development
Background:
- Childhood tuberculosis (TB) treatment lags adult options.
- Children are often excluded from TB drug development research.
Purpose of the Study:
- To propose strategies for accelerating pediatric TB drug development.
- To integrate pediatric drug development into adult pathways.
Main Methods:
- Initiating pediatric studies post-adult Phase II efficacy data.
- Implementing concomitant enrollment across pediatric age groups.
- Utilizing the Unified Pathway and regimen development concepts.
Main Results:
- The proposed strategies aim to expedite the availability of child-friendly TB drugs.
- Integration into adult pathways can streamline development.
Conclusions:
- Accelerated development of pediatric TB drugs is crucial.
- Adopting new enrollment and pathway strategies can improve child access to TB treatments.
Abstract:
Despite urgent need, the development, approval and availability of child-friendly anti-tuberculosis drugs lag significantly behind that of adults, with children having been ignored in anti-tuberculosis drug development research. This paper outlines possible strategies for accelerating and better integrating the development of drugs and regimens for pediatric tuberculosis (TB) into existing drug development pathways for adults: initiation of pediatric studies of new treatments as soon as promising efficacy data have been generated in adults following successful phase II studies, shifting from the current age de-escalated approach to concomitant enrollment of children from the various age groups in studies, and leveraging the concepts of both the Unified Pathway and regimen development that have helped speed the study and development of novel regimens in adults.
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