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儿科风湿病协作研究组——四十多年来在儿科风湿病领域开展的关键临床药物研究。

Pediatric Rheumatology Collaborative Study Group - over four decades of pivotal clinical drug research in pediatric rheumatology.

作者信息

Brunner Hermine I, Rider Lisa G, Kingsbury Daniel J, Co Dominic, Schneider Rayfel, Goldmuntz Ellen, Onel Karen B, Giannini Edward H, Lovell Daniel J

机构信息

Division of Rheumatology, Cincinnati Children's Hospital Medical Center & Cincinnati Children's Research Foundation, MLC 4010, Cincinnati, OH, 45229, USA.

Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, MD, USA.

出版信息

Pediatr Rheumatol Online J. 2018 Jul 11;16(1):45. doi: 10.1186/s12969-018-0261-x.

Abstract

IMPORTANCE

Specialized research networks are essential to achieve drug approvals for rare pediatric diseases. Such networks help realize the potential of global legislation enacted upon the recognition that most children are treated with drugs whose most beneficial dose and regimen have not been established in pediatric patients. The Pediatric Rheumatology Collaborative Study Group (PRCSG) is a North American clinical trials network that is specialized in the performance of clinical trials of new therapies for pediatric populations with rheumatic diseases. This review provides an overview of the strategies employed by this research network to achieve drug and biologic approvals for children with pediatric rheumatic diseases, particularly juvenile idiopathic arthritis.

OBSERVATIONS

Clinical trial conduct in rare pediatric diseases has required global recruitment. Supported or led by the PRCSG, highly responsive, validated, composite measures have been established to assess drug efficacy. For pediatric orphan diseases with high disease burdens, specialized investigative sites and study designs are needed to complete adequately powered trials at the high standard necessary to enable drug labeling by regulatory agencies. Novel trial designs have been utilized for more efficient testing of innovative drug candidates. All these have been developed or co-developed by the PRCSG research network.

CONCLUSIONS AND RELEVANCE

Specialized research networks in pediatric rheumatology, such as the PRCSG, have changed the landscape of available therapies and improved overall disease outcomes for children with pediatric rheumatic diseases.

摘要

重要性

专业研究网络对于获得罕见儿科疾病的药物批准至关重要。此类网络有助于实现全球立法的潜力,该立法基于认识到大多数儿童使用的药物在儿科患者中尚未确定最有益的剂量和用药方案。儿科风湿病协作研究组(PRCSG)是一个北美临床试验网络,专门从事针对患有风湿性疾病的儿科人群的新疗法临床试验。本综述概述了该研究网络为患有儿科风湿性疾病,特别是幼年特发性关节炎的儿童获得药物和生物制品批准所采用的策略。

观察结果

罕见儿科疾病的临床试验需要全球招募。在PRCSG的支持或领导下,已经建立了高度灵敏、经过验证的综合指标来评估药物疗效。对于疾病负担高的儿科罕见病,需要专门的研究地点和研究设计,以高标准完成足够样本量的试验,从而使监管机构能够批准药物标签。新型试验设计已被用于更高效地测试创新候选药物。所有这些都是由PRCSG研究网络开发或共同开发的。

结论与意义

儿科风湿病领域的专业研究网络,如PRCSG,已经改变了可用治疗方法的格局,并改善了患有儿科风湿性疾病儿童的总体疾病结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda5/6042275/c6e3866c359d/12969_2018_261_Fig1_HTML.jpg

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