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Study designs in paediatric pharmacoepidemiology

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Abstract

Purpose

Few data on the efficacy and safety of drugs in children are available as in the past, these children were not included in randomized controlled trials (RCTs). Data on the efficacy and safety of drugs in children are extrapolated from adults. The EMA recognizes the need for long-term safety studies on various drugs, a need that can best be answered by pharmacoepidemiological studies. In this article, we provide currently available information on study designs within the field of paediatric drug research.

Methods

A PubMed search was conducted on all pharmacoepidemiological studies in children. In addition, data from handbooks on pharmacoepidemiology were consulted. Data were reviewed and the relevant literature on study designs in paediatric pharmacoepidemiology is described.

Results

The various study designs in pharmacoepidemiology have their specific indications, all with their specific limitations. Case reports and case series are mainly used for signal detection of safety issues whereas case control and cohort studies are used for safety hypothesis testing. Observational studies can be conducted using data from automated databases that guarantee large sample size and long-term follow-up, which is ideal for safety studies, especially in case of rare events.

Conclusion

Pharmacoepidemiological studies are crucial in research on the safety of drugs in children. Knowledge of the different pharmacoepidemiological methods is important to guarantee optimal use and correct interpretation of the data.

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Conflict of interest

As employees of Erasmus MC, MCJMS and KMCV have been involved as project leader and in analyses contracted by various pharmaceutical companies, and received unconditional research grants from Pfizer, Merck, Johnson&Johnson, Amgen, Roche, GSK, Boehringer, Yamanouchi and Altana, none of which are related to the subject of this paper.

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Correspondence to Katia Verhamme.

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On behalf of the TEDDY European Network of Excellence

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Verhamme, K., Sturkenboom, M. Study designs in paediatric pharmacoepidemiology. Eur J Clin Pharmacol 67 (Suppl 1), 67–74 (2011). https://doi.org/10.1007/s00228-010-0930-2

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  • DOI: https://doi.org/10.1007/s00228-010-0930-2

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