Pharmacogenetics and paediatric drug development: Issues and consequences to labelling and dosing recommendations

Elke H J Krekels, John N. van den Anker, Paola Baiardi, Massimo Cella, Katharine Y. Cheng, Diana M. Gibb, Hannah Green, Achille Iolascon, Evelyne M. Jacqz-Aigrain, Catherijne A J Knibbe, Gijs W E Santen, Ron H N van Schaik, Dick Tibboel, Oscar E. Della Pasqua

Research output: Contribution to journalArticlepeer-review

Abstract

The area of pharmacogenetics (PGt) is evolving rapidly. However, ongoing efforts in this field are not aligned with the requirements for the inclusion of clinically relevant findings into the label, especially with reference to paediatric indications. Clinical research in children poses unique issues from a practical and technical perspective, but many challenges can be overcome by applying advanced study design and data analysis methods. When investigating the role of PGt factors on treatment effect, all features that influence drug response must be taken into account. Yet, PGt often has a privileged status in research protocols, with PGt factors evaluated independently from other determinants of response, instead of being regarded as other demographic or clinical covariates (e.g., age, renal function). At present, guidelines to incorporate PGt findings into label statements are lacking in part because this is a new and incompletely understood area. This situation is no longer acceptable. To achieve the potential that PGt can offer to drug development and ultimately to drug prescription, academia, industry and regulatory agencies need to pool resources on the revision of study design and data analysis requisites, bringing in model-based methodologies to enable accurate interpretation of results and provide appropriate labelling recommendations.

Original languageEnglish
Pages (from-to)1787-1799
Number of pages13
JournalExpert Opinion on Pharmacotherapy
Volume8
Issue number12
DOIs
Publication statusPublished - Aug 2007

Keywords

  • Drug labelling
  • Paediatric clinical trial
  • Pharmacodynamic
  • Pharmacogenetics
  • Pharmacokinetic
  • Polymorphism
  • Regulatory approval

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

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