在老年人中使用新批准药物的基于证据的数据:从临床试验到专著的分析
Maude Gosselin1, Marie-Laure Baroud2, Odélie-Rose Denis2
1Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada.
Journal of the American Geriatrics Society
|January 25, 2024
概括
新上市的药物往往不包括老年人,导致剂量建议和安全数据不足. 临床试验中的不足代表性使老年人群的基于证据的护理受到损害.
科学领域:
- 老年人药理学 老年人药理学
- 临床试验设计 临床试验设计
- 基于证据的医学基于证据的医学.
背景情况:
- 从历史上看,老年人在临床试验中代表性不足.
- 缺乏数据限制了对这一群体的基于证据的处方.
- 对新上市药物的最新评估至关重要.
研究的目的:
- 评估药物专著中针对老年人的建议.
- 评估在临床试验中老年人的纳入和代表性.
- 随着时间的推移,确定老年人参与的趋势.
主要方法:
- 对加拿大卫生部批准的药物 (2006-2020年) 审查了195个药物专著.
- 分析了加拿大/美国对30种常见药物的373项III-IV期试验.
- 评估参与者的年龄标准,代表性和子组数据.
主要成果:
- 41%的老年人用剂量建议的专著引用了有限的数据.
- 58%的试验缺乏基于年龄的纳入标准,只有30%的老年人得到充分的代表.
- 78%的试验未能报告针对老年人群的有效性/安全性数据.
结论:
- 新上市的药物继续代表老年人不足.
- 不充分的专著建议和试验数据损害了基于证据的实践.
- 这使老年人由于缺乏足够的药物证据而存在健康风险.
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