Impact of Drug Approval Pathways for Paediatric Inflammatory Bowel Disease.


Journal

Journal of Crohn's & colitis
ISSN: 1876-4479
Titre abrégé: J Crohns Colitis
Pays: England
ID NLM: 101318676

Informations de publication

Date de publication:
23 Feb 2022
Historique:
pubmed: 12 8 2021
medline: 25 2 2022
entrez: 11 8 2021
Statut: ppublish

Résumé

Timely access to approved medications is a priority in paediatric inflammatory bowel disease [IBD]. To date, the timing of drug studies in paediatric IBD has been suboptimal, with most studies conducted long after approval has been granted for adult IBD. This delay in approval leads to extensive off-label prescribing of medications in children, often without clear guidance on optimal dosing. The European Medicines Agency [EMA] and U.S. Food and Drug Administration [FDA] have implemented drug development frameworks in an attempt to address these challenges. However, access to information on these regulatory pathways in paediatric IBD is limited. We summarised the time from adult to paediatric approval of IBD therapies, outlining the regulatory approval pathway between the EMA and FDA, with the goal of identifying areas for improvement. We reviewed publicly accessible data from the EMA and the FDA to identify therapeutic agents approved over 2005-2021 for paediatric IBD. Five drugs are currently approved for use in the paediatric IBD population, with long interval delays after adult approval. The impact of these drug development processes in paediatric IBD is awaited. Further consideration needs to be given to the age of enrolment along with novel, more efficient trial designs in an effort to improve access for paediatric IBD patients to newer therapies.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Timely access to approved medications is a priority in paediatric inflammatory bowel disease [IBD]. To date, the timing of drug studies in paediatric IBD has been suboptimal, with most studies conducted long after approval has been granted for adult IBD. This delay in approval leads to extensive off-label prescribing of medications in children, often without clear guidance on optimal dosing. The European Medicines Agency [EMA] and U.S. Food and Drug Administration [FDA] have implemented drug development frameworks in an attempt to address these challenges. However, access to information on these regulatory pathways in paediatric IBD is limited. We summarised the time from adult to paediatric approval of IBD therapies, outlining the regulatory approval pathway between the EMA and FDA, with the goal of identifying areas for improvement.
METHODS METHODS
We reviewed publicly accessible data from the EMA and the FDA to identify therapeutic agents approved over 2005-2021 for paediatric IBD.
RESULTS AND CONCLUSIONS CONCLUSIONS
Five drugs are currently approved for use in the paediatric IBD population, with long interval delays after adult approval. The impact of these drug development processes in paediatric IBD is awaited. Further consideration needs to be given to the age of enrolment along with novel, more efficient trial designs in an effort to improve access for paediatric IBD patients to newer therapies.

Identifiants

pubmed: 34379112
pii: 6348023
doi: 10.1093/ecco-jcc/jjab140
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

331-335

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

Eileen Crowley (E)

Department of Pediatrics, Division of Pediatric Gastroenterology & Hepatology, Children's Hospital Western Ontario, Western University, London, ON, Canada.
Alimentiv Inc. [formerly Robarts Clinical Trials, Inc.], London, ON, Canada.

Christopher Ma (C)

Alimentiv Inc. [formerly Robarts Clinical Trials, Inc.], London, ON, Canada.
Division of Gastroenterology & Hepatology, Department of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Marija Andic (M)

Alimentiv Inc. [formerly Robarts Clinical Trials, Inc.], London, ON, Canada.

Brian G Feagan (BG)

Alimentiv Inc. [formerly Robarts Clinical Trials, Inc.], London, ON, Canada.
Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
Department of Medicine, Division of Gastroenterology, Western University, London, ON, Canada.

Anne M Griffiths (AM)

Division of Gastroenterology, Hepatology & Nutrition, Department of Paediatrics and IBD Centre, SickKids Hospital, University of Toronto, Toronto, ON, Canada.

Vipul Jairath (V)

Alimentiv Inc. [formerly Robarts Clinical Trials, Inc.], London, ON, Canada.
Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
Department of Medicine, Division of Gastroenterology, Western University, London, ON, Canada.

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