OFF-LABEL TREATMENT IN PEDIATRICS – ASSOCIATIONS, LATEST RECOMMENDATIONS

Urtė Oniūnaitė, Lina Jankauskaitė
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Abstract

Off-label treatment is often seen in pediatrics, especially in pediatric intensive care and neonatal departments. It is linked to a broad range of factors, including restriction of pharmacological studies for ethical reasons, different pharmacokinetic and pharmacodynamic properties of medicines due to age and physiological differences in children, and the difficulty of manufacturing and do­sage determination. These gaps increase the likelihood of adverse reactions. Various measures are being taken to avoid unnecessary risks to children without depriving them of potentially effective pharmacotherapy. This study aimed to analyse the studies reported in literature on the relationship between off-label prescribing, the latest recommendations, and the impact of this treatment on the pediatric population. The literature shows that off-label are often prescribed due to children’s younger age, respiratory or rare dise­ases. Relevant groups of commonly misused medicines are as follows anti-infectives, respiratory medicines or treatment for neurological conditions. It has been ob­served that the most common off-label prescriptions are related to inappropriate dosage, patient age or indications for use. To deal with the problem, researchers are en­couraging the research community to find new, scienti­fically supported and effective treatments by increasing the sharing of high-quality research and data. This is to achieve trustworthy, evidence-based medical care and to protect children from ineffective or even harmful treat­ments. For off-label treatment, the European Academy of Paediatrics and the European Society of Perinatal and Paediatric Pharmacology have issued new guidelines to ensure the safest possible care for children.
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儿科标示外治疗--关联、最新建议
标签外治疗在儿科,尤其是儿科重症监护室和新生儿科经常出现。这与多种因素有关,包括出于伦理原因对药理学研究的限制、儿童的年龄和生理差异导致药物的药代动力学和药效学特性不同,以及生产和剂量测定的困难。这些差距增加了不良反应发生的可能性。目前正在采取各种措施,以避免给儿童带来不必要的风险,同时又不剥夺他们接受可能有效的药物治疗的权利。本研究旨在分析文献中报道的标示外处方、最新建议之间的关系,以及这种治疗方法对儿科人群的影响。文献显示,标示外处方通常是由于儿童年龄较小、患有呼吸道疾病或罕见疾病而处方的。常见的滥用药物包括以下几类:抗感染药物、呼吸系统药物或神经系统疾病治疗药物。据观察,最常见的标签外处方与用量不当、患者年龄或使用适应症有关。为解决这一问题,研究人员鼓励研究界通过加强共享高质量的研究成果和数据,寻找新的、有科学依据的有效治疗方法。这是为了实现值得信赖的循证医疗,保护儿童免受无效甚至有害治疗的伤害。对于标签外治疗,欧洲儿科学会和欧洲围产期和儿科药理学会已经发布了新的指导方针,以确保为儿童提供最安全的治疗。
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