The Current States, Challenges, Ongoing Efforts, and Future Perspectives of Pharmaceutical Excipients in Pediatric Patients in Each Country and Region
Jumpei Saito,
Anjali Agrawal,
Vandana Patravale,
Anjali Pandya,
Samuel Orubu,
Min Zhao,
Gavin P. Andrews,
Caroline Petit-Turcotte,
Hannah Landry,
Alysha Croker,
Hidefumi Nakamura,
Akimasa Yamatani,
Smita Salunke
Affiliations
Jumpei Saito
Department of Pharmacy, National Center for Child Health and Development, Okura 2-10-1, Setagaya-ku, Tokyo 157-8535, Japan
Anjali Agrawal
Drug Product Development, Bristol Myers Squibb, 181 Passaic Avenue, Summit, NJ 07901, USA
Vandana Patravale
Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai 400019, India
Anjali Pandya
Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai 400019, India
Samuel Orubu
Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
Min Zhao
Medical Biology Centre, School of Pharmacy, China Medical University-Queen’s University Belfast Joint College (CQC), Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
Gavin P. Andrews
Medical Biology Centre, School of Pharmacy, China Medical University-Queen’s University Belfast Joint College (CQC), Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
Caroline Petit-Turcotte
Therapeutic Products Directorate, Health Canada, Government of Canada, Ottawa, ON K1A 0K9, Canada
Hannah Landry
Office of Pediatrics and Patient Involvement, Health Canada, Government of Canada, Ottawa, ON K1A 0K9, Canada
Alysha Croker
Office of Pediatrics and Patient Involvement, Health Canada, Government of Canada, Ottawa, ON K1A 0K9, Canada
Hidefumi Nakamura
Department of Research and Development Supervision, National Center for Child Health and Development, Tokyo 157-8535, Japan
Akimasa Yamatani
Department of Pharmacy, National Center for Child Health and Development, Okura 2-10-1, Setagaya-ku, Tokyo 157-8535, Japan
Smita Salunke
UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK
A major hurdle in pediatric formulation development is the lack of safety and toxicity data on some of the commonly used excipients. While the maximum oral safe dose for several kinds of excipients is known in the adult population, the doses in pediatric patients, including preterm neonates, are not established yet due to the lack of evidence-based data. This paper consists of four parts: (1) country-specific perspectives in different parts of the world (current state, challenges in excipients, and ongoing efforts) for ensuring the use of safe excipients, (2) comparing and contrasting the country-specific perspectives, (3) past and ongoing collaborative efforts, and (4) future perspectives on excipients for pediatric formulation. The regulatory process for pharmaceutical excipients has been developed. However, there are gaps between each region where a lack of information and an insufficient regulation process was found. Ongoing efforts include raising issues on excipient exposure, building a region-specific database, and improving excipient regulation; however, there is a lack of evidence-based information on safety for the pediatric population. More progress on clear safety limits, quantitative information on excipients of concern in the pediatric population, and international harmonization of excipients’ regulatory processes for the pediatric population are required.