完成的临床试验的同行评审出版,以获得儿科专用性
Daniel K Benjamin1, Philip Brian Smith, M Dianne Murphy
1Office of Pediatric Therapeutics, Office of the Commissioner, US Food and Drug Administration, Rockville, Md, USA. danny.benjamin@duke.edu
JAMA
|September 14, 2006
概括
儿科专用计划成功鼓励在儿童中进行药物研究,但只有不到一半的试验结果被公布. 需要进一步努力,以增加这种重要的儿科药物信息的传播.
科学领域:
- 儿科药理学 儿科药理学
- 药物开发 药物开发
- 监管科学是一种监管科学.
背景情况:
- 由于缺乏FDA批准的研究,儿童药物使用通常是非标签的.
- 美国食品和药物管理局 (FDA) 建立了儿科专利,以激励儿科试验.
- 这些试验导致了100多个标签变化,但出版率尚不清楚.
研究的目的:
- 量化针对儿科专用性进行的研究的出版率.
- 评估儿科试验结果在同行评审文献中的传播情况.
主要方法:
- 一项队列研究分析了1998年至2004年期间提交的儿童专用试验.
- 通过2005年的MEDLINE和EMBASE搜索,发现了研究和随后的标签变化.
- 发表在同行评审期刊上是主要的结果指标,标签变化被归类为正面或负面.
主要成果:
- 提交了253项专门用于儿科的研究,重点是疗效,药理动力学和安全性.
- 只有113项 (45%) 的研究发表在同行评审期刊上.
- 有积极标签变化的研究和疗效研究表明,出版率更高.
结论:
- 儿科专用计划有效地刺激了儿科药物研究.
- 研究结果在同行评审文献中的传播仍然有限.
- 改善这些儿科药物数据的出版和更广泛传播的机制需要进一步调查.
相关概念视频
Clinical Trials
Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...
There are four phases in a clinical trial. A phase one...
Clinical Trials: Overview
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmacokinetics in Pediatric Patients: Drug Distribution
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Pharmacokinetics in Pediatric Patients: Drug Metabolism
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...


