SynthesisJAMA pediatrics2015
Drug Dosing and Pharmacokinetics in Children With Obesity: A Systematic Review.
Synthesis in JAMA pediatrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 55 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
55 citing papers in PubMed, 4 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- Nutritional status, body composition and chemotherapy dosing in children and young people with cancer: a systematic review by the SIOP nutrition network.British journal of cancer · 2025Pooled it
- Bispecific antibodies combined with chemotherapy in solid tumor treatment, the path forward?Frontiers in immunology · 2025Pooled it
- Vancomycin Dosing in Children With Overweight or Obesity: A Systematic Review and Meta-analysis.Hospital pediatrics · 2020Pooled it
- Gaps in Drug Dosing for Obese Children: A Systematic Review of Commonly Prescribed Emergency Care Medications.Clinical therapeutics · 2015Pooled it
- Obese Children Require Lower Doses of Pantoprazole Than Nonobese Peers to Achieve Equal Systemic Drug Exposures.The Journal of pediatrics · 2018Trial
- Pharmacokinetics of Clindamycin in Obese and Nonobese Children.Antimicrobial agents and chemotherapy · 2017Trial
- Advancing Pediatric Dose Scaling: Strategies, Modeling Approaches, and Clinical Applications.Pharmaceuticals (Basel, Switzerland) · 2026Review
- The Economic and Clinical Burden of Pediatric Obesity Within a Universal Health Coverage System in Thailand: A 9-Year Nationwide Analysis of 14.5 Million Hospitalizations.Diseases (Basel, Switzerland) · 2026Article
- Dosing Strategies for High-Alert Medications in Obese Pediatric Patients: A Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Anthropometric indicators and risk of relapse or second malignant neoplasms in childhood cancer survivors: a scoping review.BMC public health · 2026Article
- Dosing and Discontinuation of Methylphenidate Medication in Relation to Weight Status in Children and Adolescents.Paediatric drugs · 2026Article
- Pharmacokinetics and Childhood Obesity: Pathophysiological Basis and Challenges in Choosing the Ideal Body Size Descriptor.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Dosing chemotherapy in children with obesity: literature review and evaluation of local practices.Cancer chemotherapy and pharmacology · 2025Review
- Dosing of antidepressants in relation to body weight in children and adolescents with overweight.International journal of obesity (2005) · 2025Article
- Pharmacokinetics of Dexamethasone in Children and Adolescents with Obesity.Journal of clinical pharmacology · 2024Article
- Assessment of Dosing Strategies for Pediatric Drug Products.Clinical pharmacology and therapeutics · 2024Review
- Evaluation of Obesity-Related Physiological Changes on Pantoprazole Clearance in Children Using a Population Pharmacokinetic Approach.Journal of clinical pharmacology · 2024Article
- Physiologically-based pharmacokinetic modeling of pantoprazole to evaluate the role of CYP2C19 genetic variation and obesity in the pediatric population.CPT: pharmacometrics & systems pharmacology · 2024Article
- The Impact of Paediatric Obesity on Drug Pharmacokinetics: A Virtual Clinical Trials Case Study with Amlodipine.Pharmaceutics · 2024Article
- Need for Representation of Pediatric Patients with Obesity in Clinical Trials.Children (Basel, Switzerland) · 2023Article
Corrections and comments
- Commented on by
- Erratum issuedBecker, Kristian [corrected to Becker, Kristian C]
Authors and funding
13 authors at 4 institutions in 1 country.
Funding
Abstract
importanceObesity affects nearly one-sixth of US children and results in alterations to body composition and physiology that can affect drug disposition, possibly leading to therapeutic failure or toxic side effects. The depth of available literature regarding obesity's effect on drug safety, pharmacokinetics, and dosing in obese children is unknown.
objectiveTo perform a systematic literature review describing the current evidence of the effect of obesity on drug disposition in children. EVIDENCE REVIEW: We searched the MEDLINE, Cochrane, and EMBASE databases (January 1, 1970-December 31, 2012) and included studies if they contained data on drug clearance, volume of distribution, or drug concentration in obese children (aged ≤18 years). We compared exposure and weight-normalized volume of distribution and clearance between obese and nonobese children. We explored the association between drug physicochemical properties and clearance and volume of distribution.
findingsTwenty studies met the inclusion criteria and contained pharmacokinetic data for 21 drugs. The median number of obese children studied per drug was 10 (range, 1-112) and ages ranged from newborn to 29 years (1 study described pharmacokinetics in children and adults together). Dosing schema varied and were either a fixed dose (6 [29%]) or based on body weight (10 [48%]) and body surface area (4 [19%]). Clinically significant pharmacokinetic alterations were observed in obese children for 65% (11 of 17) of the studied drugs. Pharmacokinetic alterations resulted in substantial differences in exposure between obese and nonobese children for 38% (5 of 13) of the drugs. We found no association between drug lipophilicity or Biopharmaceutical Drug Disposition Classification System class and changes in volume of distribution or clearance due to obesity. CONCLUSIONS AND RELEVANCE: Consensus is lacking on the most appropriate weight-based dosing strategy for obese children. Prospective pharmacokinetic trials in obese children are needed to ensure therapeutic efficacy and enhance drug safety.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.