Considering The Patient In Pediatric Drug Development

Considering the Patient in Pediatric Drug Development: How Good Intentions Turned into Harm addresses a fundamental challenge in drug development and healthcare for young patients. In clinical trials and clinical practice, the term "children" is used ambiguously to confer physiological characteristics to a chronological age limit, which in reality does not exist. This book outlines why the United States (US) and European Union's (EU) regulatory authorities, pediatric academia, and the pharmaceutical industry demand, support and perform pediatric drug studies, along with the key flaws of this demand that blurs the different administrative and physiological meanings of the term "child." In addition, the book covers why most pediatric regulatory studies lack medical sense and many even harm young patients and the conflicts of interest behind pediatric drug studies. It includes relevant information about the maturation of the human body regarding absorption, distribution, metabolism and excretion of food and drugs as well as key differences between newborns, infants, older children and adolescents. Explains relevant information about the maturation of the human body regarding absorption, distribution, metabolism and excretion of food and drugs, including key differences between newborns, infants, older children and adolescents Discusses historical roots of separate drug approval in officially labeled "children" and conflicts of interest in performing and publishing "pediatric" research Helps to decipher justifications for pediatric studies to help people navigate the relevance of the information

Pediatric Drug Development: Concepts and Applications is designed as a reference and textbook and is meant to address the science of differences between the pediatric and adult subject in the development of pharmaceutical products. Considered are the ethics and medical needs of proper understanding the pediatric and adult differences, the business case for proper development of drugs for children, as well as the technical feasibility studies and processes that are necessary for a proper pediatric drug development program. The applications of these approaches will benefit all stakeholders and ultimately not only educate but also provide better and safer drugs for pediatric patients.

Pediatric Drug Development: Concepts and Applications is designed as a reference and textbook and is meant to address the science of differences between the pediatric and adult subject in the development of pharmaceutical products. Considered are the ethics and medical needs of proper understanding the pediatric and adult differences, the business case for proper development of drugs for children, as well as the technical feasibility studies and processes that are necessary for a proper pediatric drug development program. The applications of these approaches will benefit all stakeholders and ultimately not only educate but also provide better and safer drugs for pediatric patients.

The Best Pharmaceuticals for Children Act (BPCA) and the Pediatric Research Equity Act (PREA) were designed to encourage more pediatric studies of drugs used for children. The FDA asked the IOM to review aspects of pediatric studies and changes in product labeling that resulted from BPCA and PREA and their predecessor policies, as well as assess the incentives for pediatric studies of biologics and the extent to which biologics have been studied in children. The IOM committee concludes that these policies have helped provide clinicians who care for children with better information about the efficacy, safety, and appropriate prescribing of drugs. The IOM suggests that more can be done to increase knowledge about drugs used by children and thereby improve the clinical care, health, and well-being of the nation's children.

Intellectually Impaired People: The Ongoing Battle addresses challenges against the background of history, changing societal environments, and current intellectual approaches and attitudes toward persons with disabilities. The book discusses national and international conventions, societal attitudes, sheltered workshops, the right of intellectually impaired persons for self-responsibility and its limitations, and the place of mentally impaired persons in the public image. Additionally, the book attempts to capture the forces that drive the changes of our conceptual frameworks. The US Tuskegee study which withheld antibiotics from black men with syphilis was not ended by scientific criticism but by a courageous man, press reports, and a changed social perception. The non-hiding of handicapped children is not the result of government orders, there are many non-resolvable dilemmas and tension between supporting, understanding, and patronizing a complex situation with many potential future avenues. Recognizes how contradictory feelings and attitudes toward impaired persons have a complex historical background Sheds light on society and our institutions that deal with disabled people and the limitations of an isolated medical approach Covers national and international conventions of mentally impaired persons

Pediatric Drug Development, Second Edition, encompasses the new regulatory initiatives across EU, US and ROW designed to encourage improved access to safe and effective medicines for children. It includes new developments in biomarkers and surrogate endpoints, developmental pharmacology and other novel aspects of pediatric drug development.

The COVID-19 Pandemic: A Global High-Tech Challenge at the Interface of Science, Politics, and Illusions discusses COVID-19 as the first pandemic in the Internet era and our current reality of continuous reports, news, and updates. Since its beginning, we were daily bombarded with news of what was happening around the world. There was no global political leadership. The United States was politically partially paralyzed. Russia and China hoped to gain diplomatic profile worldwide, but their vaccines are of limited efficacy, and trust in their clinical data is rightly low. The European Union did not order enough vaccines in time, but sued a large manufacturer for delivery delays. Now it is setting up yet another bureaucratic institution. At least the pharmaceutical or life science industry paved the way out, but is not enthusiastically praised for it. It would be too easy and superficial to blame mistakes of governments and leaders on stupidity. Idiocy exists, but we have to go deeper to understand how illusions and blind spots in today’s common perception and science, inertia, arrogance, conflicts of interest, competition of individuals, and states and institutions for public recognition have contributed to a multitude of flawed assessments and direct mistakes. Healthcare professionals and anyone interested in an in-depth understanding of humankind’s response to the COVID-19 challenge will not get around the key conclusions of this book. Outlines key elements of modern civilization, public health, and drug and vaccine development on the background of the COVID-19 pandemic Discusses the historical roots of separate drug approval of vaccines and drugs in administratively classified "children" (of whom many are bodily mature long before their 16th or 18th birthday), and why the belated approval of vaccines against COVID-19 in minors is not based on science, but on blurs and conflicts of interest Outlines key elements we need to address to become better prepared for future global health challenges. In the first place, we do not need new institutions, but to overcome intellectual barriers and blind spots

With the emergence of effective drugs and observed drug toxicities in babies, two mantras emerged: that children are therapeutic orphans, and that children are not small adults. US and EU laws demand pediatric studies as a condition for the approval of new drugs in adults. This is called “Pediatric Drug Development” (PDD). Although apparently reasonable, there are catches. Children are vulnerable at birth, but they grow and become bodily mature with puberty, well before coming of age. Minors are not another species. The 18th birthday, an administrative/ legal limit, does not correspond to a physiological change. Drugs treat the body, not the legal status. PDD results in pointless studies in bodily mature adolescents, and in exaggerated studies in younger minors. An originally well-intentioned concept results in thousands of questionable studies worldwide. This book draws attention to conflicts of interest and ethical dilemmas of PDD and questions its applicability for adolescents and minors that are no longer babies.