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Paediatric Drug Development in Japan: Current Status and Future Challenges
Rieko Inagaki1, Mamoru Narukawa2
1Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan. inagakirieko@gmail.com.
Insights
Measures promoting pediatric drug development in Japan show success, with increasing approvals. However, wider use of adult data extrapolation is needed for more pediatric drug indications.
Area of Science:
- Pharmacology
- Pediatric Drug Development
- Regulatory Science
Background:
- Limited pediatric drug labeling globally before 2000.
- Regulatory initiatives in the US and Europe, and ICH-E11 guideline, increased pediatric drug labels.
- Japan has implemented measures to foster pediatric drug development.
Purpose of the Study:
- To evaluate the success of Japanese initiatives promoting pediatric drug development.
- To analyze trends in pediatric drug approvals and development characteristics in Japan.
Main Methods:
- Examined new drug approvals for pediatric indications in Japan (2006-2023).
- Assessed clinical data packages, drug characteristics, and pediatric clinical trials.
- Quantified the percentage of adult data extrapolation in recent pediatric drug development (2015-2023).
Main Results:
- Paediatric drug approvals show an increasing trend (2006-2023).
- Proportion of paediatric indications rose to 48% in 2023.
- Simultaneous adult/pediatric development was 59% (2015-2023), but adult data extrapolation was limited (11.2%).
Conclusions:
- Upward trend in paediatric drug approvals suggests promotional measures are effective in Japan.
- Limited number of drugs with additional pediatric indications remains a concern.
- Scientific justification for adult data extrapolation should be considered for development strategies.
Introduction:
Until around 2000, the number of medicinal products labelled for paediatric use was limited worldwide. Regulatory measures to promote paediatric drug development in the US and Europe and the establishment of an international guideline (ICH-E11) have led to an increase in the number of paediatric labels. In Japan, efforts have been made to promote the development of paediatric drugs. This study was aimed to examine whether these supportive efforts are successful in Japan.
Methods:
This study examined the number of new drugs approved for paediatric indications in Japan from 2006 to 2023, as well as the clinical data package, that is, characteristics of the approved paediatric drugs and paediatric clinical trials, and the percentage of extrapolation of adult data, in the most recent 9-year period.
Results:
The number of paediatric drug approvals showed an increasing trend between 2006 and 2023 with some fluctuations. The proportion of drugs indicated for paediatric patients to the total number of approved drugs was about 30% until 2022, but increased to 48% in 2023. During the period from 2015 to 2023, simultaneous development in adults and children accounted for 59% (159/269) of paediatric development, but the complete extrapolation of adult data to paediatric populations has not been widely utilized (11.2%, 30/269).
Conclusions:
The number of paediatric drug approvals has shown an upward trend, suggesting that measures to promote the development of paediatric drugs may have been exerting a favourable effect in Japan. However, there is still a limited number of drugs that have additional indications for paediatric use. Appropriate development strategies, such as the extrapolation of adult data to paediatric populations, should be considered if scientifically justified.
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