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Barrett JS, Cala Pane M, Knab T, Roddy W, Beusmans J, Jordie E, Singh K, Davis JM, Romero K, Padula M, Thebaud B, Turner M. Landscape analysis for a neonatal disease progression model of bronchopulmonary dysplasia: Leveraging clinical trial experience and real-world data. Front Pharmacol 2022; 13:988974. [PMID: 36313352 PMCID: PMC9597633 DOI: 10.3389/fphar.2022.988974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/21/2022] [Indexed: 11/27/2022] Open
Abstract
The 21st Century Cures Act requires FDA to expand its use of real-world evidence (RWE) to support approval of previously approved drugs for new disease indications and post-marketing study requirements. To address this need in neonates, the FDA and the Critical Path Institute (C-Path) established the International Neonatal Consortium (INC) to advance regulatory science and expedite neonatal drug development. FDA recently provided funding for INC to generate RWE to support regulatory decision making in neonatal drug development. One study is focused on developing a validated definition of bronchopulmonary dysplasia (BPD) in neonates. BPD is difficult to diagnose with diverse disease trajectories and few viable treatment options. Despite intense research efforts, limited understanding of the underlying disease pathobiology and disease projection continues in the context of a computable phenotype. It will be important to determine if: 1) a large, multisource aggregation of real-world data (RWD) will allow identification of validated risk factors and surrogate endpoints for BPD, and 2) the inclusion of these simulations will identify risk factors and surrogate endpoints for studies to prevent or treat BPD and its related long-term complications. The overall goal is to develop qualified, fit-for-purpose disease progression models which facilitate credible trial simulations while quantitatively capturing mechanistic relationships relevant for disease progression and the development of future treatments. The extent to which neonatal RWD can inform these models is unknown and its appropriateness cannot be guaranteed. A component of this approach is the critical evaluation of the various RWD sources for context-of use (COU)-driven models. The present manuscript defines a landscape of the data including targeted literature searches and solicitation of neonatal RWD sources from international stakeholders; analysis plans to develop a family of models of BPD in neonates, leveraging previous clinical trial experience and real-world patient data is also described.
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Affiliation(s)
- Jeffrey S. Barrett
- Critical Path Institute, Tucson, AZ, United States
- *Correspondence: Jeffrey S. Barrett,
| | | | - Timothy Knab
- Metrum Research Group, Tariffville, CT, United States
| | | | - Jack Beusmans
- Metrum Research Group, Tariffville, CT, United States
| | - Eric Jordie
- Metrum Research Group, Tariffville, CT, United States
| | | | - Jonathan Michael Davis
- Tufts Medical Center and the Tufts Clinical and Translational Science Institute, Boston, MA, United States
| | - Klaus Romero
- Critical Path Institute, Tucson, AZ, United States
| | - Michael Padula
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Bernard Thebaud
- Department of Pediatrics, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Mark Turner
- Department of Women’s and Children’s Health Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
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