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Pharmacokinetics of Understudied Drugs Administered to Children Per Standard of Care

Completed
Conditions
Bacterial Septicemia
General Anesthesia
Gynecologic Infections
Migraines
Seizures
Anxiolysis
Benzodiazepine
Bone and Joint Infections
Cytomegalovirus Retinitis
Infantile Hemangioma
Registration Number
NCT01431326
Lead Sponsor
Daniel Benjamin
Brief Summary

Understudied drugs will be administered to children per standard of care as prescribed by their treating caregiver and only biological sample collection during the time of drug administration will be involved. A total of approximately 7000 children aged \<21 years who are receiving these drugs for standard of care will be enrolled and will be followed for up a maximum of 90 days. The goal of this study is to characterize the pharmacokinetics of understudied drugs for which specific dosing recommendations and safety data are lacking. The prescribing of drugs to children will not be part of this protocol. Taking advantage of procedures done as part of routine medical care (i.e. blood draws) this study will serve as a tool to better understand drug exposure in children receiving these drugs per standard of care. The data collected through this initiative will also provide valuable pharmacokinetic and dosing information of drugs in different pediatric age groups as well as special pediatric populations (i.e. obese).

Detailed Description

The purpose of this study is to characterize the PK ( Pharmacokinetics) of understudied drugs administered to children per standard of care as prescribed by their treating caregiver. This will be accomplished by the collection of biological samples during the time of drug administration per standard of care as prescribed by the caregiver. The prescribing of drugs to children will not be part of this protocol.

Aim #1: Evaluate the PK of understudied drugs currently being administered to children.

Hypothesis #1: The PK of understudied drugs in children will differ from adults and within children according to pediatric age groups or special population.

Aim #2: Explore the pharmacodynamics (PD) of understudied drugs currently being administered to children.

Hypothesis #2: The PD of targeted drugs in children will differ from adults.

Aim #3: Evaluate the influence of genetic factors, metabolic and protein profiles on therapeutic exposure.

Hypothesis #3: Genetic polymorphisms in drug metabolizing enzymes and metabolic and proteomic profiles will impact drug exposure in children.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
3520
Inclusion Criteria
    1. Children (< 21 years of age) who are receiving understudied drugs of interest per standard of care as prescribed by their treating caregiver
Exclusion Criteria
    1. Failure to obtain consent/assent (as indicated)
    1. Known pregnancy as determined via interview or testing if available.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Composite of pharmacokinetic outcomes for understudied drugs in childrenData will be collected throughout the hospital or outpatient stay up to 90 days

As appropriate for each study drug, the following additional PK parameters will be estimated:

* maximum concentration (Cmax)

* time to achieve maximum concentration (Tmax)

* absorption rate constant (ka)

* elimination rate constant (kel)

* half-life (t1/2)

* area under the curve (AUC)

Penetration into body fluids will be determined by comparing exposure (i.e. AUC, Cmax) ratios between the body fluid and plasma or comparison of concentrations in paired samples.

Secondary Outcome Measures
NameTimeMethod
Composite pharmacodynamic outcomes of understudied drugs in childrenData will be collected throughout the hospital or outpatient stay up to 90 days

When applicable, Monte Carlo simulations will be performed to evaluate therapeutic target attainment rates (pharmacodynamics) in the population of interest. The final PK model and parameters estimated in the population PK analysis will be used to perform these simulations.

Biomarkers associated with understudied drugs in childrenData will be collected throughout the hospital or outpatient stay up to 90 days

The dosing, sampling, and demographic information recorded on the electronic data collection forms will be merged with the bioanalytical information to create a biomarker dataset for each study drug. Biomarkers will be identified using metabolomics/proteomics and pharmacogenomics methodologies. Samples for biomarker analysis will be stored for future use in a PTN designated biorepository. Associations between biomarkers and drug exposure will be explored by visual inspection (i.e. scatter plots) and statistical comparisons as needed.

Trial Locations

Locations (52)

Alaska Native Medical Center

🇺🇸

Anchorage, Alaska, United States

Arkansas Children's Hospital

🇺🇸

Little Rock, Arkansas, United States

University of California at San Diego Medical Center

🇺🇸

La Jolla, California, United States

Axis Clinical Trials

🇺🇸

Los Angeles, California, United States

University of California, Los Angeles Medical Center

🇺🇸

Los Angeles, California, United States

The Children's Hospital Colorado

🇺🇸

Aurora, Colorado, United States

Yale New Haven Children's Hospital

🇺🇸

New Haven, Connecticut, United States

Alfred I. DuPont Hospital for Children

🇺🇸

Wilmington, Delaware, United States

Children's National Medical Center

🇺🇸

Washington, District of Columbia, United States

University of Florida Jacksonville Shands Medical Center

🇺🇸

Jacksonville, Florida, United States

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Alaska Native Medical Center
🇺🇸Anchorage, Alaska, United States

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