Medical Writing Medical Writing in Paediatrics Challenges of paediatric drug development and impact of paediatric legislation

Volume 21, Issue 2 - Medical Writing in Paediatrics

Challenges of paediatric drug development and impact of paediatric legislation

Abstract

Medical writers are increasingly involved in designing and documenting overall plans in paediatric drug development, e.g. EU PIPs (Paediatric Investigation Plans) and individual components, e.g. protocols and study reports. It is essential to differentiate between the overall process and the individual components that together constitute paediatric drug development. Paediatric drug development does not mirror the development of drugs for adults. Drugs are developed by commercial companies. Paediatric drug development was triggered by laws dating back to 1997 (USA) and 2007 (EU) to give children better access to pharmaceutical progress. The active players are the regulatory authorities, the respective company, and the professionals involved in the planning and execution of defined development activities. For companies, participation is partially voluntary in the USA but compulsory in Europe. Key elements are assessing epidemiology and existing therapies in children, and all elements of adult drug development adapted to children's different anatomy, metabolism, and developmental stage. Paediatric drug development might include, for example, developing liquid formulations for children (vs. tablets), doing studies in juvenile animals, and paediatric clinical studies. Most key components of the paediatric drug development plan are negotiated between authority and company, and executed by paediatricians, clinical pharmacologists, and others.

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References

  1. Rodriguez W, Maldonado S. United States paediatric legislation impact on paediatric drug studies. In: Rose K, van den Anker JN (eds.) Guide to paediatric drug development and clinical research. Basel: Karger; 2010. p. 12.
  2. Regulation (EC) No 1901/2006 of the European Parliament and of The Council of 12 December 2006 on medicinal products for paediatric use and amending Regulation (EEC) No 1768/92, Directive 2001/20/EC, Directive 2001/83/EC and Regulation (EC) No 726/2004 [document on the internet]. 2006 [cited 2012 Jan 13]. Available from: http://ec.europa.eu/health/files/eudralex/vol-1/reg_2006_1901/reg_2006_1901_en.pdf
  3. Medicines for Children. [document on the internet]. Available from: http://www.ema.europa.eu/ema/index.jsp?curl=pages/special_topics/general/general_content_000302.jsp&murl=menus/special_topics/special_topics.jsp&mid=WC0b01ac058002d4ea
  4. Stoetter H. Paediatric drug development: historical background of regulatory initiatives. In: Rose K, van den Anker JN (eds.) Guide to Paediatric Clinical Research. Basel: Karger; 2007. p. 25.
  5. AACP White Paper. Interprofessional education: principles and application. A framework for clinical pharmacy. Pharmacotherapy 2009;29(3):145e–164e.
  6. Orme M. Clinical pharmacology in research, teaching and health care. Considerations by IUPHAR, the International union of basic and clinical pharmacology. Basic Clin Pharmacol Toxicol 2010;107:531–59.
  7. Kearns GL, Abdel-Rahman SM, Alander SW, Blowey DL, Leeder JS, Kauffman RE. Developmental pharmacology – drug disposition, action, and therapy in infants and children. N Engl J Med 2003;349:1157–67.
  8. Wright E, Rose K: European Union paediatric regulation: theory and practice. In: Rose K, van den Anker JN (eds.) Guide to paediatric drug development and clinical research. Basel: Karger; 2010. p. 6.
  9. Clinical investigation of medicinal products in the paediatric population (ICH E11) [document on the internet]. 2000 [cited 2012 Jan 13]. Available from: http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Efficacy/E11/Step4/E11_Guideline.pdf
  10. Paediatric medicine development [document on the internet] [cited 2012 Feb 14] Available from: http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/general/general_content_000023.jsp&mid=WC0b01ac05800240cd
  11. EMA/PDCO summary report template with internal guidance text (for information). [document on the internet] [cited 2012 Feb 14]. Available from: http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000293.jsp&murl=menus/regulations/regulations.jsp&mid=WC0b01ac0580025b91
  12. Order of the President of the court of first instance of 24 April 2009 – Nycomed Danmark v EMEA (Case T-52/09 R). [document on the internet] [cited 2012 Feb 14]. Available from: http://curia.europa.eu/juris/document/document.jsf?text=&docid=73453&pageIndex=0&doclang=EN&mode=lst&dir=&occ=first&part=1&cid=327397
  13. Judgment of the General Court (Third Chamber) 14 December 2011. [document on the internet] [cited 2012 Feb 14]. Available from: http://curia.europa.eu/juris/document/document.jsf?text=&docid=116583&pageIndex=0&doclang=EN&mode=doc&dir=&occ=first&part=1&cid=234507
  14. 2010 Report to the European Commission on rewards and Incentives Under the Paediatric Regulation. [document on the internet] [cited 2012 Feb 14]. Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Report/2011/05/WC500106262.pdf
  15. FDA Guidance: How to comply with the Pediatric Research Equity Act. [document on the internet]. 2005 [cited 2012 Feb 14]. Available from: http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/DevelopmentResources/UCM077855.pdf
  16. European nNetwork of Paediatric Research at the European Medicines Agency (Enpr-EMA) [cited 2012 Jan 13] Available from: http://www.ema.europa.eu/ema/index.jsp?curl=pages/partners_and_networks/general/general_content_000303.jsp&mid=WC0b01ac05801df74a
  17. Henry MM. Central laboratory in paediatric clinical trials. In: Rose K, van den Anker JN (eds.) Guide to paediatric clinical research. Karger; 2007. p. 78–86.
  18. European Medicines Agency decision P/345/2010 of 20 December 2010 on a class waiver on condition(s) in accordance with Regulation (EC) No 1901/2006 of the European Parliament and of the Council. [document on the internet]. 2010 [cited 2012 Jan 13]. Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Other/2009/11/WC500011500.pdf
  19. European Medicines Agency decision P/265/2011 of 28 October 2011 on the acceptance of a modification of an agreed paediatric investigation plan for ipilimumab (Yervoy) (EMEA-000117-PIP02-10-M01) in accordance with Regulation (EC) No 1901/2006 of the European Parliament and of the Council [document on the internet]. 2011 [cited 2012 Feb 14]. Available from: http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/pips/EMEA-000117-PIP02-10-M01/pip_000717.jsp&mid=WC0b01ac058001d129
  20. European Medicines Agency decision P/91/2011of 8 April 2011 on the agreement of a paediatric investigation plan and on the granting of a deferral for propane-1-sulfonic acid {3-[5-(4-chlorophenyl)-1H-pyrrolo[2,3-b]pyridine-3-carbonyl]-2,4-difluoro-phenyl}-amide (RO5185426), (EMEA-000978-PIP01-10) [document on the internet]. 2011 [cited 2012 Feb 14] Available from: http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/pips/EMEA-000978-PIP01-10/pip_000701.jsp&mid=WC0b01ac058001d129
  21. European Medicines Agency P/211/2011 of 2 September 2011 on the acceptance of a modification of an agreed paediatric investigation plan for brivaracetam (EMEA-000332-PIP01-08-M04) in accordance with Regulation (EC) No 1901/2006 of the European Parliament and of the Council. [document on the internet]. 2011 [cited 2012 Feb 14]. Available from: http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/pips/EMEA-000332-PIP01-08-M04/pip_000404.jsp&mid=WC0b01ac058001d129
  22. Oral communication by Agnes Saint-Raymond at the Joint DIA/EFGCP/EMA Paediatrics Forum 2011: The paediatric regulation in its 5th year: Transition from toddler to school age. 26 & 27 September 2011 I De Vere Venues Canary Wharf, London, UK. Conference program on the internet. Available from: http://www.efgcp.eu/Downloads/confDocuments/DIA-EFGCP-EMA%20Paed.%20Conf%202011%20-%20Preliminary%20Programme.pdf

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Articles

Medical writing in paediatrics: Children and the future
Message from the President
Challenges of paediatric drug development and impact of paediatric legislation
Writing applications for Paediatric Investigation Plans and waivers
Preparing the Paediatric Investigation Plan application
ADHD: A true neurodevelopmental disorder?
Medicines information for patients: Insights into research and practice for medical writers
The MHRA perspective on the new pharmacovigilance legislation
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Forgive me for repeating myself: Self-plagiarism in the medical literature
In the Bookstores
Journal Watch
The Webscout
Manuscript Writing
Regulatory Writing
English Grammar and Style
Out On Our Own

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