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Rationalising Optimal Dosing of Phytotherapeutics For Use In Children: Current Status - Potential Solutions - Actions
Andreas Hensel1, Rudolf Bauer2, Michael Heinrich3
1Institute of Pharmaceutical Biology and Phytochemistry, University of Münster, Germany.
Insights
Herbal medicinal products (HMPs) for children show promise but face regulatory hurdles. Adapting the regulatory framework and rationalizing dosing are crucial for safe and effective paediatric use of HMPs.
Area of Science:
- Pharmacology
- Paediatric Medicine
- Regulatory Science
Background:
- WHO emphasizes children are not small adults, prompting EU paediatric regulations in 2007.
- Despite regulations, progress in paediatric herbal medicinal products (HMPs) remains limited.
- A symposium assessed the status and challenges of HMPs for children.
Purpose of the Study:
- Evaluate the current situation of paediatric HMP use.
- Identify reasons for the lack of progress.
- Discuss strategies for proving HMP safety and efficacy in children.
Main Methods:
- Review of current legislative requirements and European national regulations.
- Analysis of existing data and consideration of new approaches like real-world data (RWD).
- Discussion on adapting regulatory frameworks and rationalizing dosing strategies.
Main Results:
- Paediatric HMPs are effective and safe, but current use doesn't meet legislative standards.
- Varied national regulations and traditions complicate HMP registration and marketing in Europe.
- EU herbal monographs offer a common standard, but safety discussions and RWD are emerging considerations.
Conclusions:
- There's a significant need to revise restrictions on paediatric HMP use.
- Rationalizing dosing regimes for children is essential.
- Adapting the regulatory framework and utilizing RWD can improve paediatric HMP development.
Abstract:
"Children are not small adults with respect to the treatment with medicinal products." This statement of the WHO was the basis for the initiative of the European Commission for the establishment of a paediatric regulation in 2007 to improve the health of children by facilitating the development of medicines for children and adolescents. Seventeen years later, in the field of herbal medicinal products, results are still sobering. Therefore, the Foundation Plants for Health, Society for Medicinal Plants and Natural Products Research, and German Society for Phytotherapy organised a symposium to assess the status quo for the paediatric use of herbal medicinal products (HMPs), to analyse the causes of the current situation, and to discuss strategies for establishing the proof of safe and efficacious HMPs for children.The current situation for HMPs and their use in children is not fulfilling the requirements of legislation. HMPs in paediatrics are effective and safe, but considering the needs of children is necessary. In European countries, the use, registration, and marketing of HMPs are different, depending on the respective national regulations and specific traditions. EU herbal monographs are the best common denominator for such procedures. Emerging safety discussions must be considered. New approaches with real-world data might be a solution. The regulatory framework is to be adapted. Defining rationalised dosing for HMPs can be achieved by the extrapolation of data from adults, by using existing clinical data for children, and by using RWD. Therefore, a strong need for revising restrictions for the use of HMPs in children and rationalising defined dosage regimes is obvious.
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