儿童高风险医疗器械临床试验的证据:范围审查
Kathrin Guerlich1,2, Bernadeta Patro-Golab1, Paulina Dworakowski3
1LMU-Ludwig Maximilians Universität Munich, Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, Munich, Germany.
Pediatric research
|September 27, 2023
概括
高风险儿科医疗器械的临床试验往往缺乏并发控制,并很少招收幼儿. 本综述强调了儿科器械研究和监管合规性方面的挑战.
科学领域:
- 医疗器械规则 医疗器械规则
- 儿科医疗器械 儿童医疗器械
- 临床试验方法论临床试验方法论
背景情况:
- 导航欧洲医疗器械法规 (EU 2017/745) 对临床评估提出了挑战,特别是对高风险儿科设备.
- 加强监管审查需要对儿童使用的设备提供强有力的临床证据.
研究的目的:
- 对高风险儿科医疗器械的临床试验进行范围审查.
- 系统地总结儿科器械临床试验中使用的方法.
- 确定儿科医疗器械研究中的挑战,并通知监管要求.
主要方法:
- 对研究高风险儿科医疗器械的临床试验进行范围审查.
- 从2017年1月到2022年11月,搜索了Medline和Embase数据库.
- 包括心脏病学,糖尿病学,骨科和手术学0-21岁的患者.
主要成果:
- 从1692份选记录中,包括了99项试验,主要来自北美和欧洲.
- 糖尿病学设备被评价最多;大多数试验招募了青少年,其中39%包括儿童和成人.
- 随机对照试验占样本的38%;64%的试验有<100名参与者,许多缺乏并发的对照组.
结论:
- 高风险儿科医疗器械的临床试验表现出多样化的设计,往往缺乏并发控制,婴儿和幼儿的代表性不足.
- 在进行足够强大的小儿器械随机对照试验方面存在挑战.
- 调查结果可以帮助当局根据新法规制定适用于儿科器械合格认证的现实证据要求.
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