Off Label Use as an Indicator of Therapeutic Need in Pediatrics

S. Cammarata
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Abstract

There are therapeutic areas where the unauthorized use of a medicine is very wide, for example the pediatric field. The spread of off-label use in the pediatric field derives mainly from the difficulty in starting trials in this context, situation which it has long been reflected in a social and ethical paradigm. The pediatric population should be protected from research, but the difficulty in starting trials involving this population makes it “orphan” of authorized therapies. Ethical and, sometimes, methodological and economic issues make the pediatric trials “unattractive”. Furthermore, children are not a homogeneous population; in fact, within this category it is possible to distinguish different groups based on age groups characterized by biological diversity and for which starting a trial would be an expensive and complex process [2].
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标签外使用作为儿科治疗需求的指标
在一些治疗领域,未经授权使用药物的情况非常普遍,例如儿科领域。说明书外用药在儿科领域的蔓延主要源于在这种情况下开始试验的困难,这种情况长期以来一直反映在社会和伦理范式中。儿科人群应该受到保护,不受研究的影响,但开始涉及这一人群的试验的困难使其成为授权治疗的“孤儿”。伦理问题,有时还有方法学和经济问题,使得儿科试验“没有吸引力”。此外,儿童并不是一个单一的群体;事实上,在这一类别中,可以根据以生物多样性为特征的年龄组区分不同的群体,而开始试验将是一个昂贵而复杂的过程[2]。
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