Different Scaling Approaches Used in Pediatric Pharmacotherapy as well as Their Proper Implementation in Drug Development and Clinical Use Systematic Review and Meta-Analysis

Abstract

The methods used for extrapolation range from simple age-, weight- or body surface area-based dosing approaches to
complex mechanism or physiologically-based pharmacokinetic pharmacodynamics (PBPKPD) modeling and simulation
approaches (6). The aim of this systematic review was compare Different scaling approaches used in pediatric
pharmacotherapy as well as their proper implementation in drug development and clinical use. MEDLINE, PubMed,
Cochrane Library, Embase, ISI, Google scholar were used as electronic databases to perform a systematic search for
relevant articles published. A commercially available software program (Endnote X9) was used for electronic title
management. Searches were performed with keywords, ―pharmacotherapy‖, ―pharmacodynamics OR PD‖,‖
pharmacokinetics OR PK‖,‖ pharmacokinetic pharmacodynamic OR PBPKPD‖. PBPK model building across different
chemicals and appropriate training material. These needs are a quintessential example for development of strong diverse
PBPK models. Also, most of the models which have been developed for adult and pediatric PBPK are retrospective models
while its main application lies in developing prospective models. These prospective models would help simulate PK
profiles and enable clinicians to develop and recommend appropriate sampling times and better dosing recommendations.
PBPK models can become an important tool for answering clinically relevant questions and decision making in pediatrics.
PBPK modeling is an emerging tool for integrating available knowledge into a physiologically relevant mechanistic model
which can be applied to guide pediatric drug development and dose finding.