Kolling Institute, The University of Sydney and Northern Sydney Local Health District, St Leonards, NSW, Australia.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Drugs Aging. 2024 Aug;41(8):633-640. doi: 10.1007/s40266-024-01129-6. Epub 2024 Jul 9.
With ageing of the population worldwide and discovery of new medications for prevention and management of age-related conditions, there is increasing use of medications by older adults. There are international efforts to increase the representativeness of participants in clinical trials to match the intended real-world users of the medications across a range of characteristics including age, multimorbidity, polypharmacy and frailty. Currently, much of the data on medication-related harm in older adults are from pharmacovigilance studies. New methods in pre-clinical models have allowed for measurement of exposures (such as chronic exposure, polypharmacy and deprescribing) and outcomes (such as health span functional measures and frailty) that are highly relevant to geriatric pharmacotherapy. Here we describe opportunities for design and implementation of pre-clinical models that can better predict drug effects in geriatric patients. This could improve the translation of new drugs from bench to bedside and improve outcomes of pharmacotherapy in older adults.
随着全球人口老龄化以及预防和管理与年龄相关疾病的新药物的发现，老年人越来越多地使用药物。国际上正在努力增加临床试验参与者的代表性，以在包括年龄、多种合并症、多种药物治疗和虚弱在内的一系列特征上与药物的预期实际使用者相匹配。目前，老年人药物相关伤害的数据主要来自药物警戒研究。临床前模型中的新方法允许测量与老年药理学高度相关的暴露（如慢性暴露、多种药物治疗和药物减停）和结果（如健康跨度功能测量和虚弱）。在这里，我们描述了设计和实施临床前模型的机会，这些模型可以更好地预测老年患者的药物效应。这可以改善新药从实验室到临床的转化，并改善老年患者药物治疗的结果。
