Designing clinical trials in paediatric inflammatory bowel diseases: a PIBDnet commentary

Dan Turner, Anne M. Griffiths, David Wilson, Diane R. Mould, Robert N. Baldassano, Richard K. Russell, Marla Dubinsky, Melvin B. Heyman, Lissy De Ridder, Jeffrey Hyams, Javier Martin De Carpi, Laurie Conklin, William A. Faubion, Sibylle Koletzko, Athos Bousvaros, Frank M. Ruemmele

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction The optimal trial design for assessing novel therapies in paediatric IBD (PIBD) is a subject of intense ongoing global discussions and debate among the different stakeholders. However, there is a consensus that the current situation in which most medications used in children with IBD are prescribed as off-label without sufficient paediatric data is unacceptable. Shortening the time lag between adult and paediatric approval of drugs is of the upmost importance. In this position paper we aimed to provide guidance from the global clinical research network (Pediatric Inflammatory Bowel Disease Network, PIBDnet) for designing clinical trials in PIBD in order to facilitate drug approval for children. Methods A writing group has been established by PIBDnet and topics were assigned to different members. After an iterative process of revisions among the writing group and one face-to-face meeting, all statements have reached consensus of >80% as defined a priori. Next, all core members of PIBDnet voted on the statements, reaching consensus of >80% on all statements. Comments from the members were incorporated in the text. Results The commentary includes 18 statements for guiding data extrapolation from adults, eligibility criteria to PIBD trials, use of placebo, dosing, endpoints and recommendations for feasible trials. Controversial issues have been highlighted in the text. Conclusion The viewpoints expressed in this paper could assist planning clinical trials in PIBD which are both of high quality and ethical, while remaining pragmatic.

Original languageEnglish
Pages (from-to)32-41
Number of pages10
JournalGut
Volume69
Issue number1
DOIs
StatePublished - 1 Jan 2020

Keywords

  • IBD clinical
  • clinical trials
  • paediatric gastroenterology

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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