Evidence map›Paper›PMID 40697166›Full record

ReviewCPT: pharmacometrics & systems pharmacology2025

State-of-the-Art on Model-Informed Drug Development Approaches for Pediatric Rare Diseases.

Rajesh Krishna, Amitava Mitra, Matthew L Zierhut, Lilly East, Chandra Durairaj

Abstract readReview
In one paragraph

Review in CPT: pharmacometrics & systems pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
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

11 citing papers in PubMed.

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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

5 authors.

Rajesh KrishnaCertara Scientific Innovation, Certara USA, Inc, Radnor, Pennsylvania, USA.ORCID 0000-0002-3127-9732
Amitava MitraClinical Pharmacology, Kura Oncology, Boston, Massachusetts, USA.
Matthew L ZierhutCertara Scientific Innovation, Certara USA, Inc, Radnor, Pennsylvania, USA.ORCID 0000-0002-5221-9157
Lilly EastClinical Pharmacology, Sarepta Therapeutics, Inc, Cambridge, Massachusetts, USA.
Chandra DurairajQuantitative Clinical Pharmacology, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA.ORCID 0009-0005-2216-7009

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pediatric rare diseases present unique challenges for drug development due to small patient populations, ethical constraints on clinical trial design, and limited prospectively defined natural history data. Model-Informed Drug Development (MIDD) has emerged as a powerful paradigm to address these challenges by leveraging quantitative methods to enhance decision-making across all stages of drug development. This paper reviews the state-of-the-art MIDD approaches being applied to pediatric rare disease therapeutics, including the traditional pharmacometrics methodologies of population pharmacokinetic/pharmacodynamic (PK/PD) modeling, physiologically based pharmacokinetic (PBPK) modeling, disease progression modeling, and more future-facing Bayesian trial designs, and real-world data integration. We highlight how these methods facilitate dose optimization, support extrapolation from adult or other pediatric data, and enable more efficient and ethical clinical trial strategies. Case studies from recent regulatory submissions illustrate the growing acceptance of MIDD in pediatric rare disease contexts. Finally, we discuss the technological and regulatory advances driving this field forward, as well as current limitations and future opportunities for expanding the impact of MIDD on accelerating safe and effective treatments for children with rare diseases.

Indexed as

Drug DevelopmentModels, BiologicalRare DiseasesBayes TheoremChildClinical Trials as TopicHumansPediatricscaregiver‐reported outcomesmodel‐informed drug developmentpediatricsquantitative medicinerandomized clinical trialsrare diseases

Identifiers

PMID40697166
PMCPMC12625129

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.