Evidence map›Paper›PMID 34258467›Full record

ArticleContemporary clinical trials communications2021

Challenges in conducting paediatric trials with off-patent drugs.

S S Haslund-Krog, I M Jorgensen, T B Henriksen, K Dalhoff, N M Debes, J van den Anker, H Holst

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Article in Contemporary clinical trials communications, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact, top 91% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 3 countries.

S S Haslund-KrogDepartment of Clinical Pharmacology, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.
I M JorgensenDepartment of Paediatric and Adolescent Medicine, Nordsjællands University Hospital, Hillerød, Dyrehavevej 29, 3400, Hillerød, Denmark.
T B HenriksenNeonatal Intensive Care Unit, Department of Paediatrics, Aarhus University Hospital, Palle Juul- Jensens Boulevard 99, 8200, Aarhus N, Denmark.
K DalhoffDepartment of Clinical Pharmacology, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.
N M DebesDepartment of Paediatric and Adolescent Medicine, Herlev Hospital, Borgmester Ib Juuls Vej 25C, 2730, Herlev, Denmark.
J van den AnkerDivision of Clinical Pharmacology, Children's National Hospital, Washington, DC, 20010, USA.
H HolstDepartment of Clinical Pharmacology, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.
Nordsjællands Hospital · DKAarhus University Hospital · DKHerlev Hospital · DKUniversity Children’s Hospital Basel · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFor more than two decades several initiatives have emerged to increase recruitment of paediatric patients in drug trials. While trials of newly approved drugs have successfully included paediatric patients in their drug development plan, the collection of safety and efficacy data in paediatric patients treated with off-patent drugs poses a major challenge.

aimThis paper aims to draw attention to problems and solutions across countries in investigator-initiated trials with off-patent drugs and recommendations for improvement. DISCUSSION: Off-patent drugs represent a particular challenge when they are included in a paediatric trial; these trials are frequently investigator-initiated and have limited resources, off-patent drugs are used in clinical settings and the trial protocol must accommodate e.g. flexible dosing and specimen sampling schedules, off-patent drugs typically exist in few formulations and concentrations which necessitates special or imported formulations. Paediatric trials are in some countries confined by e.g. consent from both parents, regardless of whether the Investigational Medicinal Product (IMP) is a well-known drug or a new experimental drug.

conclusionFacilitation of research in off-patent drugs can improve evidence-based and safe treatment for the paediatric population. The following supportive initiatives are recommended: Harmonised regulatory change that improves the consent process in low risk trials to prevent inadequate recruitment. Pharmaceutical expertise should be prioritized to secure the best choice of IMP and supply. Constant focus on flexibility in design to accommodate a multifaceted paediatric population and ensure that trial protocols fit in well with routine clinical care and family life.

Indexed as

Clinical trial managementInformed consentOff-patent drugsPediatric clinical trials

Identifiers

PMID34258467
PMCPMC8253945
OpenAlexW3176005525

What OpenQuestion holds

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Registered trials

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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.