Horavova L, Nebeska K, Souckova L, Demlova R, Babula P
Department of Applied Pharmacy, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.
Department of Pharmacology, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic.
Ther Innov Regul Sci. 2020 Nov;54(6):1461-1472. doi: 10.1007/s43441-020-00173-9. Epub 2020 Jun 5.
Paediatric non-commercial interventional clinical trials (NICTs) are crucial for healthcare provision. In spite of the fact that current regulations and initiatives try to enhance the quantity and quality of paediatric NICTs, there are still shortcomings that need to be addressed in order to accelerate the conduct of relevant clinical trials in children. To improve the current landscape of paediatric clinical research, it is necessary to identify and analyse the main trends and shortcomings, along with their impact on national performance in paediatric NICTs and this is the aim of this work.
A retrospective systematic search of paediatric NICTs was performed on four international clinical trials registries. Entries were filtered by date from 01/01/2004 to 31/12/2017. Each identified paediatric NICT was screened and analysed for sponsors, funders, type of intervention, therapeutic area, design characteristics and associated publications.
The search identified 439 unique NICTs. When stratifying the trials by enrolment ages, 86 trials were found involving the paediatric population. Most trials investigated the use of medicinal products and were focused on cancer or cardiovascular diseases. The most common sources of the funding were non-profit organizations. Furthermore, from the total number of completed trials, only half of them already published their results.
The main shortcomings-specifically, ethical, methodological and, in particular, economic obstacles were identified. There is a continual need for greater support and collaboration between all major stakeholders including health policymakers, grant agencies, research institutions, pharmaceutical industries and healthcare providers at the national and international level.
儿科非商业性介入临床试验(NICTs)对医疗保健服务至关重要。尽管现行法规和举措试图提高儿科NICTs的数量和质量,但仍存在一些不足之处,需要加以解决,以加快儿童相关临床试验的开展。为改善当前儿科临床研究的状况,有必要识别和分析主要趋势及不足之处,以及它们对国家儿科NICTs表现的影响,这就是本研究的目的。
在四个国际临床试验注册库中对儿科NICTs进行回顾性系统检索。检索条目按日期从2004年1月1日至2017年12月31日进行筛选。对每个识别出的儿科NICT进行筛选和分析,内容包括申办者、资助者、干预类型、治疗领域、设计特征及相关出版物。
检索共识别出439项独特的NICTs。按入组年龄对试验进行分层时,发现有86项试验涉及儿科人群。大多数试验研究了药品的使用,且主要集中在癌症或心血管疾病方面。资金的最常见来源是非营利组织。此外,在所有完成的试验中,只有一半已经发表了结果。
确定了主要的不足之处,特别是伦理、方法学以及尤其是经济方面的障碍。在国家和国际层面,包括卫生政策制定者、资助机构、研究机构、制药行业和医疗服务提供者在内的所有主要利益相关者之间,持续需要更大的支持与合作。