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Bonate PL, Barrett JS, Ait-Oudhia S, Brundage R, Corrigan B, Duffull S, Gastonguay M, Karlsson MO, Kijima S, Krause A, Lovern M, Riggs MM, Neely M, Ouellet D, Plan EL, Rao GG, Standing J, Wilkins J, Zhu H. Training the next generation of pharmacometric modelers: a multisector perspective. J Pharmacokinet Pharmacodyn 2024; 51:5-31. [PMID: 37573528 DOI: 10.1007/s10928-023-09878-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023]
Abstract
The current demand for pharmacometricians outmatches the supply provided by academic institutions and considerable investments are made to develop the competencies of these scientists on-the-job. Even with the observed increase in academic programs related to pharmacometrics, this need is unlikely to change in the foreseeable future, as the demand and scope of pharmacometrics applications keep expanding. Further, the field of pharmacometrics is changing. The field largely started when Lewis Sheiner and Stuart Beal published their seminal papers on population pharmacokinetics in the late 1970's and early 1980's and has continued to grow in impact and use since its inception. Physiological-based pharmacokinetics and systems pharmacology have grown rapidly in scope and impact in the last decade and machine learning is just on the horizon. While all these methodologies are categorized as pharmacometrics, no one person can be an expert in everything. So how do you train future pharmacometricians? Leading experts in academia, industry, contract research organizations, clinical medicine, and regulatory gave their opinions on how to best train future pharmacometricians. Their opinions were collected and synthesized to create some general recommendations.
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Affiliation(s)
| | | | | | - Richard Brundage
- Metrum Research Group, University of Minnesota, Minneapolis, MN, USA
| | | | - Stephen Duffull
- Certara, Princeton, NJ, USA
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | | | | | - Shinichi Kijima
- Office of New Drug V, Pharmaceuticals and Medical Devices Agency (PMDA), Tokyo, Japan
| | | | - Mark Lovern
- Certara, Princeton, NJ, USA
- Certara, Raleigh, NC, USA
| | | | - Michael Neely
- Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | | | | | - Gauri G Rao
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Joseph Standing
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Department of Pharmacy, Great Ormond Street Hospital for Children, London, UK
| | | | - Hao Zhu
- Food and Drug Administration, Silver Springs, MD, USA
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Bies RR, Wright DFB. Perspectives on the past, present, and future of pharmacometrics. Br J Clin Pharmacol 2022; 88:1403-1405. [PMID: 35258119 DOI: 10.1111/bcp.15289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 02/17/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Robert R Bies
- School of Pharmacy and Pharmaceutical Sciences, University of Buffalo, Buffalo, New York, USA
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Freeman WD, Rogers A, Rabinstein A. TeleNeuroICU: Expanding the Reach of Subspecialty Neurocritical Care. Semin Neurol 2022; 42:18-30. [PMID: 35073589 DOI: 10.1055/s-0041-1742093] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Telemedicine is a rapidly growing field of medicine due to a combination of high-speed global telecommunication systems and accessibility of small, fast mobile computing platforms with bidirectional audiovisual camera capabilities. Teleneurology is a subset of telemedicine. TeleNeuroICU, one form of teleneurology, is the practice of virtually consulting on patients in the ICU setting with neurological and neurosurgical conditions. Given the current and future shortage of neurologists and neurointensivists, there is a high demand for TeleNeuroICU services around the globe and this is expected to increase in the future. This review summarizes the state of the art around the TeleNeuroICU practice for practitioners in the field, emerging research in this area, and new technologies and integrations that enhance the value of TeleNeuroICU to health care systems.
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Affiliation(s)
- W David Freeman
- Department of Neurologic Surgery, Neurology, and Critical Care Medicine; Mayo Clinic, Jacksonville, Florida
| | - Ashley Rogers
- Division of Neurocritical Care, Departments of Critical Care Medicine and Neurology, Mayo Clinic, Jacksonville, Florida
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Elzagallaai AA, Rieder MJ. Model Based Evaluation of Hypersensitivity Adverse Drug Reactions to Antimicrobial Agents in Children. Front Pharmacol 2021; 12:638881. [PMID: 33995043 PMCID: PMC8120305 DOI: 10.3389/fphar.2021.638881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/26/2021] [Indexed: 12/25/2022] Open
Abstract
Drug use in children is-in most cases-supported by extrapolation of data generated from clinical trials in adult populations. This puts children at higher risk of developing adverse drug reactions (ADRs) due to "off-label" use of drugs and dosing issues. Major types of ADRs are drug hypersensitivity reactions, an idiosyncratic type of ADRs that are largely unpredictable and can cause high morbidity and mortality in a hard-to-identify specific population of patients. Lack of a complete understanding of the pathophysiology of DHRs and their unpredictive nature make them problematic in clinical practice and in drug development. In addition, ethical and legal obstacles hinder conducting large clinical trials in children, which in turn make children a "therapeutic orphan" where clear clinical guidelines are lacking, and practice is based largely on the personal experience of the clinician, hence making modeling desirable. This brief review summarizes the current knowledge of model-based evaluation of diagnosis and management of drug hypersensitivity reactions (DHRs) to antimicrobial drugs in the pediatric population. Ethical and legal aspects of drug research in children and the effect of different stages of child development and other factors on the risk of DHRs are discussed. The role of animal models, in vitro models and oral provocation test in management of DHRs are examined in the context of the current understanding of the pathophysiology of DHRs. Finally, recent changes in drug development legislations have been put forward to encourage drug developers to conduct trials in children clearly indicate the urgent need for evidence to support drug safety in children and for modeling to guide these clinical trials.
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Affiliation(s)
- Abdelbaset A Elzagallaai
- Department of Paediatrics, London, ON, Canada.,Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Michael J Rieder
- Department of Paediatrics, London, ON, Canada.,Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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