Despite the raise while in the utilization of M&S as tools for decision-making in pharmaceutical R&D, their benefits as an optimisation and data analysis tool has remained undervalued and sometimes ignored by key stakeholders . This attitude appears contradictory to ethical and scientific tenets, which should underpin the evaluation of the risk?benefit ratio in special populations, such as children. The ethical constraints and practical limitations associated with clinical research clearly impose new alternative methodology to ensure accurate assessment of treatment response in these patients. In that sense, the value of M&S to paediatric research may be even greater than the evidence available so far for drug development in adults. The interest in M&S is also reaching the attention of the regulatory authorities. In April 2008, the European Medicines Agency organised a ?Workshop on Modelling in Paediatric Medicines? . More recently, M&S have been proposed as a framework for the evaluation of drugs by regulators taking into account different clinical scenarios . Clinical research in paediatric diseases As indicated previously, the purpose of the manuscript is to evaluate the usage of M&S as an alternative approach to the design, analysis and interpretation of experiments and clinical protocols in paediatric drug development.
In spite of some limitations, M&S enable systematic, integrated evaluation of drug and disease properties, providing quantitative measures of treatment SRC Inhibitor response across a wide range of clinical and statistical designs, some of which would not be feasible in real-life . Furthermore, M&S can overcome many of the pitfalls associated with using empirical protocols and isolated, sequential developability criteria. One of the greatest challenges in paediatric drug research is to find the appropriate dosing regimen. It should be Wortmannin kinase inhibitor noted that in spite of the ICH E11?s explicit requirement for appropriate evaluation of medicinal products for children, today about 70% of the medicines given to the paediatric population and 93% of the medicines given to critically ill neonates remain unlicensed or used off-label . Even if a large number of studies have been performed in paediatrics over the last few decades, the empiricism upon which clinical drug development is based often results in ineffective or unsafe treatments. To ensure that appropriate dose rationale and dosing regimens are used in paediatric trials, as well as to identify potential subgroups of patients who may be more susceptible to treatment response and/or adverse events, it is essential to characterise the underlying pharmacokinetic?pharmacodynamic relationships .