Grimsrud Kristin N, Sherwin Catherine M T, Constance Jonathan E, Tak Casey, Zuppa Athena F, Spigarelli Michael G, Mihalopoulos Nicole L
Department of Surgery, School of Medicine, University of California, Davis, Sacramento, CA, USA.
Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA.
Clin Res Regul Aff. 2015;32(2):47-56. doi: 10.3109/10601333.2015.1001900.
Special populations, including women (non-pregnant and pregnant), pediatrics, and the elderly, require additional consideration with regard to clinical research. There are very specific regulatory laws, which protect these special populations, that need to be understood and adhered to in order to perform clinical research. This review provides a broad overview of some of the physiological differences in special populations and discusses how these differences may affect study design and regulatory considerations. These various special populations, with respect to regulatory affairs, are clearly defined within the Code of Federal Regulations. The definition of "special population" exists to provide enhanced awareness of their vulnerabilities, thereby allowing the creation of regulatory guidance aimed to decrease injury or outright harm. Currently, progress is being made to be more inclusive of special populations in clinical trials. This reflects changing attitudes towards drug information, with it being more representative of those patients that will ultimately be prescribed or exposed to the therapy. However, all research undertaken in these populations should be performed in a manner that ensures all protections of each participant are upheld.
特殊人群,包括女性(非孕期和孕期)、儿科患者和老年人,在临床研究方面需要额外考虑。有非常具体的监管法律来保护这些特殊人群,为了开展临床研究,需要理解并遵守这些法律。本综述对特殊人群的一些生理差异进行了广泛概述,并讨论了这些差异如何可能影响研究设计和监管考量。就监管事务而言,这些不同的特殊人群在《联邦法规法典》中有明确界定。“特殊人群”的定义旨在提高对其脆弱性的认识,从而制定旨在减少伤害或直接损害的监管指南。目前,在临床试验中纳入特殊人群方面正在取得进展。这反映了对药物信息态度的转变,使其更能代表最终会被开出处方或接触该疗法的患者。然而,在这些人群中进行的所有研究都应以确保维护每位参与者的所有保护措施的方式进行。