Ali Areeg Anwer, Charoo Naseem Ahmad, Abdallah Daud Baraka
Department of Clinical Pharmacy and Pharmacology, RAKCOPS, RAK Medical and Health Sciences University , Ras Al Khaimah , UAE .
Drug Dev Ind Pharm. 2014 Oct;40(10):1283-99. doi: 10.3109/03639045.2013.850713. Epub 2014 Jan 31.
Absence of safe, effective and appropriate treatment is one of the main causes of high mortality and morbidity rates among the pediatric group. This review provides an overview of pharmacokinetic differences between pediatric and adult population and their implications in pharmaceutical development. Different pediatric dosage forms, their merits and demerits are discussed. Food and Drug Administration Act of 1997 and the Best Pharmaceuticals for Children Act 2002 added 6 months patent extension and exclusivity incentives to pharmaceutical companies for evaluation of medicinal products in children. Prescription Drug User Fee Act and Food and Drug Administration Amendments Act of 2007 made it mandatory for pharmaceutical companies to perform pediatric clinical studies on new drug products. Drug development program should include additional clinical bridge studies to evaluate differences in pharmacokinetics and pharmacodynamics of drugs in adult and child populations. Additionally, pharmaceutical development should consider ease of administration, palatability, appropriate excipients, stability and therapeutic equivalency of pediatric dosage forms. Pediatric population is diverse with individual preferences and demand for custom made dosage formulations. Practically it is not feasible to have different pharmaceutical dosage forms for each group. Hence, an appropriate dosage form that can be administered across pediatric population is warranted.
缺乏安全、有效且合适的治疗方法是导致儿科群体高死亡率和高发病率的主要原因之一。本综述概述了儿科人群与成人人群在药代动力学方面的差异及其在药物研发中的影响。讨论了不同的儿科剂型及其优缺点。1997年的《食品药品管理法》和2002年的《儿童最佳药品法》为制药公司评估儿童用药产品增加了6个月的专利延期和排他性激励措施。2007年的《处方药使用者付费法案》和《食品药品管理局修正案》规定制药公司必须对新药产品进行儿科临床研究。药物研发计划应包括额外的临床衔接研究,以评估药物在成人和儿童人群中药代动力学和药效学的差异。此外,药物研发应考虑儿科剂型的给药便利性、口感、合适的辅料、稳定性和治疗等效性。儿科人群多种多样,对定制剂型有个人偏好和需求。实际上,为每个群体提供不同的药物剂型是不可行的。因此,需要一种适用于所有儿科人群的合适剂型。