Pharmacoethics and pregnancy: Overcoming the therapeutic orphan stigma.
Jamil M KazmaJohn Van Den AnkerHoma Khorrami AhmadziaPublished in: British journal of clinical pharmacology (2021)
There is paucity of evidence to support clinical decision making and counselling related to medication use in pregnancy. Despite multiple efforts from legislative bodies and advocacy groups, the inclusion of pregnant women in clinical drug trials assessing efficacy and safety remains scarce. Pregnancy can be complicated by multiple comorbidities that require pharmacological intervention; these interventions primarily target the pregnant woman but also sometimes have secondary effects for the foetus. The US Food and Drug Administration has issued multiple guidance documents on incorporating pregnant women in clinical trials to aid pharmaceutical companies in designing a protocol to ensure safety and adherence to ethical standards. Advances in paediatric pharmacology studies provide lessons for researchers on the best practice of designing clinical trials with inclusion of patients from special populations. In this review, we present the status of pregnant women in clinical trials, highlighting the ethical stigma and possible future directives.
Keyphrases
- pregnant women
- clinical trial
- pregnancy outcomes
- decision making
- preterm birth
- end stage renal disease
- randomized controlled trial
- mental health
- mental illness
- ejection fraction
- phase ii
- drug administration
- hiv aids
- primary care
- chronic kidney disease
- social support
- healthcare
- newly diagnosed
- peritoneal dialysis
- emergency department
- intensive care unit
- phase iii
- open label
- quality improvement
- study protocol
- double blind
- human immunodeficiency virus
- drug induced
- metabolic syndrome
- skeletal muscle
- adipose tissue
- insulin resistance
- hepatitis c virus
- hiv infected
- case report
- genetic diversity
- adverse drug