Monitoring drug therapy.

Détails

ID Serval
serval:BIB_9BEE97B6D52F
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Editorial
Collection
Publications
Titre
Monitoring drug therapy.
Périodique
British Journal of Clinical Pharmacology
Auteur(s)
Buclin T., Gotta V., Fuchs A., Widmer N., Aronson J.
ISSN
1365-2125 (Electronic)
ISSN-L
0306-5251
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
73
Numéro
6
Pages
917-923
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish
Résumé
Drug development has improved over recent decades, with refinements in analytical techniques, population pharmacokinetic-pharmacodynamic (PK-PD) modelling and simulation, and new biomarkers of efficacy and tolerability. Yet this progress has not yielded improvements in individualization of treatment and monitoring, owing to various obstacles: monitoring is complex and demanding, many monitoring procedures have been instituted without critical assessment of the underlying evidence and rationale, controlled clinical trials are sparse, monitoring procedures are poorly validated and both drug manufacturers and regulatory authorities take insufficient account of the importance of monitoring. Drug concentration and effect data should be increasingly collected, analyzed, aggregated and disseminated in forms suitable for prescribers, along with efficient monitoring tools and evidence-based recommendations regarding their best use. PK-PD observations should be collected for both novel and established critical drugs and applied to observational data, in order to establish whether monitoring would be suitable. Methods for aggregating PK-PD data in systematic reviews should be devised. Observational and intervention studies to evaluate monitoring procedures are needed. Miniaturized monitoring tests for delivery at the point of care should be developed and harnessed to closed-loop regulated drug delivery systems. Intelligent devices would enable unprecedented precision in the application of critical treatments, i.e. those with life-saving efficacy, narrow therapeutic margins and high interpatient variability. Pharmaceutical companies, regulatory agencies and academic clinical pharmacologists share the responsibility of leading such developments, in order to ensure that patients obtain the greatest benefit and suffer the least harm from their medicines.
Pubmed
Web of science
Open Access
Oui
Création de la notice
23/05/2012 10:28
Dernière modification de la notice
20/08/2019 16:02
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