Analysis of a maternal health medicines pipeline database 2000-2021: New candidates for the prevention and treatment of fetal growth restriction.

Autor: Lim S; Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia., McDougall ARA; Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia., Goldstein M; Policy Cures Research, Sydney, New South Wales, Australia., Tuttle A; Policy Cures Research, Sydney, New South Wales, Australia., Hastie R; Department of Obstetrics and Gynaecology, University of Melbourne, Heidelberg, Victoria, Australia., Tong S; Department of Obstetrics and Gynaecology, University of Melbourne, Heidelberg, Victoria, Australia., Ammerdorffer A; Concept Foundation, Geneva, Switzerland., Rushwan S; Concept Foundation, Geneva, Switzerland., Ricci C; Public Health Agency of Canada, Ottawa, Ontario, Canada., Gülmezoglu AM; Concept Foundation, Geneva, Switzerland., Vogel JP; Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: BJOG : an international journal of obstetrics and gynaecology [BJOG] 2023 May; Vol. 130 (6), pp. 653-663. Date of Electronic Publication: 2023 Feb 05.
DOI: 10.1111/1471-0528.17392
Abstrakt: Objective: The Accelerating Innovation for Mothers project established a new database of candidate medicines under development between 2000 and 2021 for five pregnancy-related conditions, including fetal growth restriction. The objective was to assess medicines for fetal growth restriction and their potential for clinical use globally.
Design: Landscape analysis.
Setting: Global (focus on low- and middle-income countries, LMICs).
Sample: Drugs, dietary supplements and biologics under investigation for prevention or treatment of fetal growth restriction.
Methods: A research pipeline database of medicines was created through searching AdisInsight, PubMed and various grant and clinical trial databases. Analysis of clinical and preclinical candidates were descriptive.
Main Outcomes Measures: Fetal growth restriction candidates in clinical development were identified and ranked as high, medium or low potential based on prespecified criteria, including efficacy, safety and accessibility.
Results: Of the 444 unique candidates in the database across all five pregnancy-related conditions, 63 were for fetal growth restriction. Of these, 31 were in clinical development (phases I, II or III) and 32 were in preclinical development. Three candidates, aspirin, l-arginine and vitamin D, were ranked as having high potential as preventive agents. There were no high-potential candidates for treating fetal growth restriction, although five candidates were ranked as having medium potential: allylestrenol, dalteparin, omega-3 fatty acids, tadalafil, and United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP).
Conclusions: l-Arginine, aspirin and vitamin D are promising, high-potential preventative agents for fetal growth restriction. Based on the medicines pipeline, new pharmacological agents for fetal growth restriction are unlikely to emerge in the near future.
(© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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