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Grint I, Crea F, Vasiliadou R. The Combination of Electrochemistry and Microfluidic Technology in Drug Metabolism Studies. Chemistry 2022; 11:e202200100. [PMID: 36166688 PMCID: PMC9716038 DOI: 10.1002/open.202200100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/25/2022] [Indexed: 01/31/2023]
Abstract
Drugs are metabolized within the liver (pH 7.4) by phase I and phase II metabolism. During the process, reactive metabolites can be formed that react covalently with biomolecules and induce toxicity. Identifying and detecting reactive metabolites is an important part of drug development. Preclinical and clinical investigations are conducted to assess the toxicity and safety of a new drug candidate. Electrochemistry coupled to mass spectrometry is an ideal complementary technique to the current preclinical studies, a pure instrumental approach without any purification steps and tedious protocols. The combination of microfluidics with electrochemistry towards the mimicry of drug metabolism offers portability, low volume of reagents and faster reaction times. This review explores the development of microfluidic electrochemical cells for mimicking drug metabolism.
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Affiliation(s)
- Isobel Grint
- School of Life, Health and Chemical SciencesThe Open UniversityWalton Hall, Karen HillsMilton KeynesMK7 6AAUK
| | - Francesco Crea
- School of Life, Health and Chemical SciencesThe Open UniversityWalton Hall, Karen HillsMilton KeynesMK7 6AAUK
| | - Rafaela Vasiliadou
- School of Life, Health and Chemical SciencesThe Open UniversityWalton Hall, Karen HillsMilton KeynesMK7 6AAUK
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2
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How physiologically based pharmacokinetic models should be improved for drug development. Future Med Chem 2020; 12:1107-1109. [PMID: 32349520 DOI: 10.4155/fmc-2020-0074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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3
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Hirota S, Yamaguchi T. Timing of Pediatric Drug Approval and Clinical Evidence Submitted to Regulatory Authorities: International Comparison Among Japan, the United States, and the European Union. Clin Pharmacol Ther 2019; 108:985-994. [PMID: 31869436 DOI: 10.1002/cpt.1757] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 11/13/2019] [Indexed: 11/08/2022]
Abstract
Many prescription drugs approved for adult use lack pediatric labeling information, resulting in their off-label use in children. Drug regulatory authorities have developed legal and regulatory frameworks to promote pediatric drug development. However, the current state of pediatric indication approval and quality of efficacy evidence, which forms the basis of regulatory approvals, is unknown. Here, we analyzed novel therapeutics approved in Japan, the United States, and the European Union during 2005-2014 to investigate the timing and frequency of pediatric indication approval, and characterized the design of pediatric studies supporting regulatory approval. We found that the United States and European Union experienced a higher frequency of supplemental indication approval in pediatrics based on better-designed studies than Japan. The speed and efficiency of pediatric drug development will improve by coordinating pediatric studies on an international basis. The results also implied the necessity for a robust system of postmarketing monitoring of pediatric efficacy and safety.
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Affiliation(s)
- Saeko Hirota
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
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Tsang VWL, West L, Woods C, Koh CJ, McCune S, Mullin T, Smith SR, Gaillard S, Claverol J, Nafria B, Preston J, Dicks P, Thompson C. Role of Patients and Parents in Pediatric Drug Development. Ther Innov Regul Sci 2019; 53:601-608. [PMID: 30663334 PMCID: PMC6744949 DOI: 10.1177/2168479018820875] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/26/2018] [Indexed: 12/15/2022]
Abstract
Patient engagement in health care has been an emerging priority in the global effort and move toward the consideration of patients as experts of their own conditions. However, the input of pediatric patients and their families have not been consistently requested nor regarded as valuable when deriving protocols for, as well as assessing the outcomes of, pediatric clinical trials. Extending this mutual collaboration further upstream is important, especially in the area of pediatric drug development where the lack of formalized trials for children and adolescents result in the increased use of off-label prescribing and risk of adverse effects. While recent changes to European and North American legislation contributed to the inclusion of children and youth in pediatric drug development, the lack of systematic guidelines and methodologies in literature serve as barriers for practical application. When combined with the work of external pediatric advocacy and patient advisory groups, the hope is that pediatric patient voices can be brought forward for the future. This article brings together international experts to review current best practices, progress from regulatory agencies, as well as global advocacy efforts to involve patients and families in the pursuit of drug development processes that value the voice of children and youth.
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Affiliation(s)
- Vivian W. L. Tsang
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Leanne West
- Children’s Healthcare of Atlanta Pediatric Technology Center at the Georgia Institute of Technology, Atlanta, GA, USA
| | | | - Chester J. Koh
- Division of Urology, Department of Surgery, Texas Children’s Hospital, and Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Susan McCune
- Office of Pediatric Therapeutics, US Food and Drug Administration, Silver Spring, MD, USA
| | - Theresa Mullin
- Associate Director for Strategic Initiatives, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD USA
| | - Sharon R. Smith
- Department of Pediatrics, University of Connecticut, CT Children’s Medical Center, Hartford, CT, USA
| | - Segolene Gaillard
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacologie Clinique, 69677, Bron, France. Université de Lyon, Service de Pharmacologie Clinique, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Université Lyon 1, 69622, Villeurbanne, France. RIPPS (Réseau d’investigations pédiatriques des produits de santé)-KIDS France Groupement Hospitalier Est - Bâtiment “Les Tilleuls” 59 Boulevard Pinel 69677 Bron France
| | - Joana Claverol
- Institut de Recerca Sant Joan de Déu, Clinical Research Unit, Fundació Sant Joan de Déu, Barcelona, Spain
| | - Begonya Nafria
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu Pg. Sant Joan de Déu, Barcelona, Spain
| | - Jennifer Preston
- National Institute for Health Research, Alder Hey Children’s Hospital, University of Liverpool, UK
| | - Pamela Dicks
- National Health Service National Research Services Children’s Research Network, NHS Grampian, Scotland
| | - Charles Thompson
- Pfizer Inc, New York, NY, USA
- International Children’s Advisory Network, Hartford, CT, USA
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Broglio KR, Sandalic L, Albertson T, Berry SM. Bayesian dose escalation in oncology with sharing of information between patient populations. Contemp Clin Trials 2015; 44:56-63. [DOI: 10.1016/j.cct.2015.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 07/01/2015] [Accepted: 07/03/2015] [Indexed: 10/23/2022]
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6
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Rose K, Kummer H. A New Ethical Challenge for Institutional Review Boards (IRBs)/Ethics Committees (ECs) in the Assessment of Pediatric Clinical Trials. CHILDREN (BASEL, SWITZERLAND) 2015; 2:198-210. [PMID: 27417359 PMCID: PMC4928761 DOI: 10.3390/children2020198] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 05/19/2015] [Indexed: 11/16/2022]
Abstract
Both the US and EU have introduced pediatric pharmaceutical legislation to facilitate clinical trials in children and development of better medicines for children. The first concerns were published in 2014 that the European Medicines Agency (EMA)'s Pediatric Committee (PDCO) may be over-enthusiastic and has compelled questionable pediatric clinical trials from pharmaceutical companies. Numerous clinical trials are mandated in rare conditions for which not enough patients exist for even one trial. Furthermore, where these trials are mandated in adolescent patients, the legal age limit of the 18th birthday is confused with a medical age limit and can result in separate clinical trials in adolescent patients that neither make medical nor scientific sense nor will ever recruit enough patients for a meaningful outcome. To confirm our concerns we searched the registry clinicaltrials.gov and found examples for PDCO-triggered unethical trials. We conclude that such trials should not be accepted by institutional review boards (IRBs)/ethics committees (ECs) and that clinical trials resulting from negotiations with EMA's PDCO need extra careful scrutiny by IRBs/ECs in order to prevent unethical studies and damage to pediatric research and unnecessary risks to pediatric patients.
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Affiliation(s)
- Klaus Rose
- Consulting, Pediatric Drug Development & More, Aeussere Baselstrasse 308, 4125 Riehen, Switzerland.
| | - Hans Kummer
- University of Basel, Im Kirsgarten 57, 4106 Therwil, Basel-Landschaft, Switzerland.
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Hempel G. Physiology-Based Pharmacokinetic Modeling—Promise for Pediatric Drug Development? CURRENT FUNGAL INFECTION REPORTS 2014. [DOI: 10.1007/s12281-014-0174-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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8
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Dickey M, Clark P. Changing the outcomes of pediatric drug trials: APNs making a difference. J Pediatr Health Care 2013; 27:222-5. [PMID: 23434364 DOI: 10.1016/j.pedhc.2013.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 01/21/2013] [Accepted: 01/21/2013] [Indexed: 11/25/2022]
Affiliation(s)
- Michelle Dickey
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Kohane IS, Szolovits P. Marco Ramoni: an appreciation of academic achievement. J Am Med Inform Assoc 2011; 18:367-9. [PMID: 21474623 PMCID: PMC3128413 DOI: 10.1136/amiajnl-2011-000218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 03/22/2011] [Indexed: 01/28/2023] Open
Abstract
We review the scholarly career of our colleague, Marco Ramoni, who died unexpectedly in the summer of 2010. His work mainly explored the development and application of Bayesian techniques to model clinical, public health, and bioinformatics questions. His contributions have led to improvements in our ability to model behavior that evolves in time, to explore systematic relationships among large sets of covariates, and to tease out the meaning of data on the role of genetic variation in the genesis of important diseases.
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Affiliation(s)
- Isaac S Kohane
- Harvard Medical School, Children's Hospital Informatics Program, Boston, Massachusetts, USA
| | - Peter Szolovits
- MIT Computer Science and Artificial Intelligence Laboratory, Cambridge, Massachusetts, USA
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Cappon GD. Nonclinical support of pediatric drug development in a global context: an industry perspective. ACTA ACUST UNITED AC 2011; 92:269-72. [PMID: 21594976 DOI: 10.1002/bdrb.20303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 04/08/2011] [Indexed: 11/10/2022]
Abstract
The earlier inclusion of children into clinical trials has challenged toxicologists to develop nonclinical strategies to support these trials early in the drug development process, and the routine practise of global development strategies (i.e., concomitant development and filing in multiple geographical regions) adds another complication. Ideally, one would like to develop a stagey that would meet regulatory requirements from all regions. This presentation illustrated the challenges faced in developing a strategy regarding the need to perform a toxicity study in juvenile animals and the design of any necessary study that will receive global regulatory agreement.
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Affiliation(s)
- Gregg D Cappon
- Pfizer Global Research & Development, Groton Laboratories, Eastern Point Rd., Groton, CT 06340, USA.
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11
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Antiparasitic drugs for paediatrics: systematic review, formulations, pharmacokinetics, safety, efficacy and implications for control. Parasitology 2011; 138:1620-32. [PMID: 21349223 DOI: 10.1017/s0031182011000023] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Drug development for paediatric applications entails a number of challenges, such as the wide age spectrum covered - from birth to adolescence - and developmental changes in physiology during biological maturation that influence the efficacy and toxicity of drugs. Safe and efficacious antiparasitic drugs for children are of pivotal importance given the large proportion of burden attributable to parasitic diseases in this age group, and growing efforts to administer, as widely as possible, antiparasitic drugs to at-risk populations, such as infants and school-aged children, often without prior diagnosis. The purpose of this review is to investigate whether antiparasitic drugs have been adequately studied for use in paediatrics. We approached this issue through a systematic review using PubMed and the Cochrane Central Register of Trials covering a period of 10 years and 8 months until the end of August 2010 to identify trials that investigated efficacy, safety and pharmacokinetic (PK) parameters of antiparasitic drugs for paediatrics. Overall, 269 clinical drug trials and 17 PK studies met our inclusion criteria. Antimalarial drugs were the most commonly studied medicines (82·6%). Most trials were carried out in Africa and children aged 2-11 years were the age group most often investigated. Additionally, we critically examined available drug formulations for anthelminthics and identified a number of shortcomings that are discussed. Finally, we shed new light on current proposals to expand 'preventive chemotherapy' to preschool-aged children and emphasise that new research, including risk-benefit analyses, are needed before such a strategy can be adopted more widely.
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Knellwolf AL, Bauzon S, Alberighi ODC, Lutsar I, Bácsy E, Alfarez D, Panei P. Framework conditions facilitating paediatric clinical research. Ital J Pediatr 2011; 37:12. [PMID: 21345195 PMCID: PMC3055809 DOI: 10.1186/1824-7288-37-12] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 02/23/2011] [Indexed: 12/05/2022] Open
Abstract
The use of unlicensed and "off-label" medicines in children is widespread. Between 50-80% of the medicines currently administered to children have neither been tested nor authorized for their use in the paediatric population which represents approximately 25% of the whole European population. On 26 January 2007, entered into force the European Regulation of Paediatric Medicines. It aims at the quality of research into medicines for children but without subjecting the paediatric population to unnecessary clinical trial. This article addresses ethical and legal issues arising from the regulation and makes recommendations for the framework conditions facilitating the development of clinical research with children.
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Affiliation(s)
- Anne-Laure Knellwolf
- Dept. of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Stéphane Bauzon
- Storia e Teoria del Diritto, Facoltà di Giurisprudenza, University of Rome "Tor Vergata", Rome, Italy
| | | | - Irja Lutsar
- Dept. of Microbiolgoy, University of Tartu, Tartu, Estonia
| | - Ernö Bácsy
- Medical Research Council of Hungary, Budapest, Hungary
| | - Deborah Alfarez
- ERA-NET Priority Medicines for Children Coordination, The Netherlands Organization for Health Research and Development, The Hague, The Netherlands
| | - Pietro Panei
- Dept. of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy
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