Bundesinstitut für Arzneimittel und Medizinprodukte, Bonn, Germany.
Child Adolesc Psychiatry Ment Health. 2008 Dec 8;2(1):37. doi: 10.1186/1753-2000-2-37.
Before any medicinal product is authorised for use in adults, it must undergo extensive pharmaceutical consistency and stability tests, toxicological tests and clinical trials to ensure that it is of high quality, safe and effective.The same approach may not always be applied to medicinal products used to treat children.Studies showed that over 50% of the medicinal products used in children may not have been tested for use in this age group. The absence of suitable authorised medicinal products to treat conditions in children results from the fact that pharmaceutical companies do not adapt medicinal products to the needs of the paediatric population. This leaves health care professionals with no alternative other than to use medicinal products "off-label" and to use unauthorised products with the associated risks of inefficacy and/or adverse reactions.The Regulation (EC) No 1901/2006 sets up a system of requirements, rewards and incentives, together with horizontal measures, to ensure that medicinal products are researched, developed and authorised to meet the therapeutic needs of children.The Regulation is addressed to: 1. The pharmaceutical industry by setting out the legal framework for receiving rewards and incentives by conducting clinical trials in the paediatric population. 2. The Member States to set out to support research into, and the development and availability of, medicinal products for paediatric use. 3. The Community as funds for research into medicinal products for the paediatric population shall be provided for in the Community budget in order to support studies relating to medicinal products or active substances not covered by a patent or a supplementary protection certificate. The legal framework for conducting clinical trials, including children/minors, is set up in Directive 2001/20/EC, the Clinical Trials Directive (CTD), for the European Union (EU). The CTD establishes specific provisions regarding conduct of clinical trials, including multi-centre trials, on human subjects involving medicinal products and in particular relating to the implementation of good clinical practice. Compliance with this good practice provides assurance that the rights, safety and well-being of trial subjects are protected, and that the results of the clinical trials are credible. The CTD is addressed to all investigators conducting clinical trials including clinical trials in the paediatric population and had to be applied accordingly.In the framework of the authorisation of medicinal products regulated by the Regulation (EC) No 726/2004 and Directive 2001/83/EC as amended and the CTD, and additional implementing Directives and guidelines, the new Regulation (EC) No 1901/2006 is an important new piece of legislation focusing on the requirements to improve the situation for the paediatric population. All Regulations/Directives to be found: http://ec.europa.eu/enterprise/pharmaceuticals/eudralex/vol1_en.htm.
在任何药品获准用于成人之前,必须进行广泛的药物一致性和稳定性测试、毒理学测试和临床试验,以确保其质量高、安全且有效。但同样的方法并不总是适用于用于治疗儿童的药品。研究表明,超过 50%的用于儿童的药品可能未经测试用于该年龄段。缺乏适合治疗儿童疾病的授权药品是因为制药公司没有根据儿科人群的需求调整药品。这使得医疗保健专业人员别无选择,只能使用“标签外”药品,并使用未经授权的产品,从而带来无效和/或不良反应的风险。
第 1901/2006 号法规(EC)建立了一套要求、奖励和激励措施以及横向措施,以确保药品的研究、开发和授权能够满足儿童的治疗需求。该法规针对:1. 制药行业,规定了在儿科人群中进行临床试验以获得奖励和激励的法律框架。2. 成员国支持儿科用药的研究、开发和供应。3. 共同体为儿科人群药品研究提供共同体预算资金,以支持与未获得专利或补充保护证书的药品或活性物质有关的研究。进行临床试验的法律框架,包括儿童/未成年人,在 2001/20/EC 指令,即临床试验指令(CTD)中为欧盟(EU)建立。CTD 就涉及人类受试者的药品临床试验,特别是与实施良好临床规范有关的临床试验,规定了具体规定。遵守这一良好实践为保护试验对象的权利、安全和福祉以及临床试验结果的可信度提供了保证。CTD 适用于所有进行临床试验的研究者,包括儿科人群中的临床试验,并且必须相应适用。
在第 726/2004 号法规(EC)和经修订的第 2001/83/EC 指令以及 CTD 以及其他实施指令和指南规定的药品授权框架内,第 1901/2006 号新法规(EC)是一项重要的新立法,重点是改善儿科人群状况的要求。所有法规/指令可在以下网址找到:http://ec.europa.eu/enterprise/pharmaceuticals/eudralex/vol1_en.htm。