Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain.
Department of Psychiatry, Langley Porter Psychiatric Institute and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
Eur Neuropsychopharmacol. 2021 Jul;48:49-88. doi: 10.1016/j.euroneuro.2021.02.020. Epub 2021 Mar 27.
In the last decade there has been a revolution in terms of genetic findings in neurodevelopmental disorders (NDDs), with many discoveries critical for understanding their aetiology and pathophysiology. Clinical trials in single-gene disorders such as fragile X syndrome highlight the challenges of investigating new drug targets in NDDs. Incorporating a developmental perspective into the process of drug development for NDDs could help to overcome some of the current difficulties in identifying and testing new treatments. This paper provides a summary of the proceedings of the 'New Frontiers Meeting' on neurodevelopmental disorders organised by the European College of Neuropsychopharmacology in conjunction with the Innovative Medicines Initiative-sponsored AIMS-2-TRIALS consortium. It brought together experts in developmental genetics, autism, NDDs, and clinical trials from academia and industry, regulators, patient and family associations, and other stakeholders. The meeting sought to provide a platform for focused communication on scientific insights, challenges, and methodologies that might be applicable to the development of CNS treatments from a neurodevelopmental perspective. Multidisciplinary translational consortia to develop basic and clinical research in parallel could be pivotal to advance knowledge in the field. Although implementation of clinical trials for NDDs in paediatric populations is widely acknowledged as essential, safety concerns should guide each aspect of their design. Industry and academia should join forces to improve knowledge of the biology of brain development, identify the optimal timing of interventions, and translate these findings into new drugs, allowing for the needs of users and families, with support from regulatory agencies.
在过去的十年中,神经发育障碍(NDD)的遗传发现领域发生了革命性的变化,许多发现对于理解其病因和病理生理学至关重要。脆性 X 综合征等单基因疾病的临床试验凸显了在 NDD 中研究新药物靶点的挑战。将发育观点纳入 NDD 药物开发过程中,有助于克服目前在确定和测试新疗法方面遇到的一些困难。本文总结了由欧洲神经精神药理学学院与创新药物倡议赞助的 AIMS-2-TRIALS 联盟联合举办的“神经发育障碍新前沿会议”的会议记录。会议汇集了来自学术界和工业界、监管机构、患者和家庭协会以及其他利益相关者的发育遗传学、自闭症、NDD 和临床试验方面的专家。会议旨在提供一个平台,重点交流从神经发育角度开发中枢神经系统治疗的科学见解、挑战和方法学,多学科转化联盟可以并行开展基础和临床研究,对于推进该领域的知识至关重要。虽然在儿科人群中开展 NDD 临床试验被广泛认为是必不可少的,但安全性问题应指导其设计的各个方面。工业界和学术界应联手提高对大脑发育生物学的认识,确定干预的最佳时机,并将这些发现转化为新药,同时在监管机构的支持下满足用户和家庭的需求。