Development of Paediatric Medicines: Key Risk Factors and Non-clinical Research Programmes
https://doi.org/10.30895/1991-2919-2023-500
Abstract
The lack of approved paediatric medicines is a global problem. Since paediatric patients are a high-risk group, a developer of paediatric medicines needs to evaluate and minimise unjustified risks early in the development process.
The aim of the study was to analyse the current regulatory and methodological framework for non-clinical research and identify key risk factors that need addressing in paediatric drug development in order to substantiate the safety of children. One of the main objectives of non-clinical safety assessment of a medicinal product intended for children is to identify undesirable effects on child growth and development. According to national and international methodological guidelines, the developer may obtain the most valuable information to decide whether it is safe to enrol children into a clinical trial from the safety data collected in clinical studies in adult subjects. If the safety data available from studies in mature animals and adult subjects are insufficient to evaluate the safety of the clinical trial for paediatric patients, the developer may consider conducting non-clinical studies in immature (juvenile) animals. A paediatric non-clinical testing programme should be in line with a comprehensive significance assessment of key risk factors carried out on a case-by-case basis using weight-of-evidence (WoE) analysis. The conclusion on the safety of a medicinal product for children should be based on risk assessment in relevant clinical and non-clinical studies.
Keywords
About the Authors
G. N. EngalychevaRussian Federation
Galina N. Engalycheva - Cand. Sci. (Biol.).
8/2 Petrovsky Blvd, Moscow 127051
R. D. Syubaev
Russian Federation
Rashid D. Syubaev - Dr. Sci. (Med.).
8/2 Petrovsky Blvd, Moscow 127051
References
1. Volskaya EA. Five years later: regulation of pediatric clinical trials in action. Remedium. 2013;(3):8–17 (In Russ.).
2. Smolenov IV. Pediatric clinical trials: from encouragement to regulatory requirements. Pediatric Pharmacology. 2010;7(4):7–11 (In Russ.).
3. Romanov BK, Zyryanov SK. Pharmacology in spe cial populations: extreme age. Good Clinical Practice. 2019;(2):70–4 (In Russ.). https://doi.org/10.24411/2588-0519-2019-10074
4. Taube AA. Regulatory aspects of preclinical and clinical trials of drugs. Pharmacy. 2020;69(6):38–45 (In Russ.). https://doi.org/10.29296/25419218-2020-06-07
5. Downes N. Juvenile toxicity: are we asking the right questions? Toxicol Pathol. 2012;40(5):830–7. https://doi.org/10.1177/0192623312439124
6. Weed DL. Weight of evidence: a review of concept and methods. Risk Anal. 2005;25(6):1545–57. https://doi.org/10.1111/j.1539-6924.2005.00699.x
7. EFSA Scientific Committee, Hardy A, Benford D, Halldorsson T, Jeger MJ, Knutsen HK. Guidance on the use of the weight of evidence approach in scientific assessments. EFSA J. 2017;15(8):e04971. https://doi.org/10.2903/j.efsa.2017.4971
8. Koterov AN, Ushenkova LN, Biryukov AP. Hill’s “biological plausibility” criterion. Integration of data from various disciplines in epidemiology and radiation epidemiology. Radiation Biology. Radioecology. 2020;60(5):453–80 (In Russ.). https://doi.org/10.31857/S0869803120050069
9. Cappon GD, Bailey GP, Buschmann J, Feuston MH, Fisher JE, Kok Wah Hew, et al. Juvenile animal toxicity study designs to support pediatric drug development. Birth Detects Res B Dev Reprod Toxicol. 2009;86(6):463–9. https://doi.org/10.1002/bdrb.20220
10. Kim NN, Parker RM, Weinbauer GF, Remick AK, Steinbach T. Points to consider in designing and conducting juvenile toxicology studies. Int J Toxicol. 2017;36(4):325–39. https://doi.org/10.1177/1091581817699975
11. Schmitt G, Barrow P. Considerations for and against dosing rodent pups before 7 days of age in juvenile toxicology studies. Reprod Toxicol. 2022;112:77–87. https://doi.org/10.1016/j.reprotox.2022.06.010
Review
For citations:
Engalycheva G.N., Syubaev R.D. Development of Paediatric Medicines: Key Risk Factors and Non-clinical Research Programmes. Bulletin of the Scientific Centre for Expert Evaluation of Medicinal Products. Regulatory Research and Medicine Evaluation. 2023;13(1):14-26. (In Russ.) https://doi.org/10.30895/1991-2919-2023-500