An agenda for UK clinical pharmacology: Monitoring drug therapy

Details

Serval ID
serval:BIB_A60313C95E34
Type
Article: article from journal or magazin.
Publication sub-type
Editorial
Collection
Publications
Institution
Title
An agenda for UK clinical pharmacology: Monitoring drug therapy
Journal
British Journal of Clinical Pharmacology
Author(s)
Buclin T., Gotta V., Fuchs A., Widmer N., Aronson J.
Publication state
Published
Issued date
2012
Volume
73
Number
6
Pages
917-923
Language
english
Abstract
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
Open Access
Yes
Create date
15/02/2013 12:11
Last modification date
23/06/2021 5:36
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