Pharmacoethics and pregnancy: Overcoming the therapeutic orphan stigma

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. Pregnan...

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Bibliographic Details
Published in:British journal of clinical pharmacology 2023-02, Vol.89 (2), p.483-490
Main Authors: Kazma, Jamil M., Van Den Anker, John, Ahmadzia, Homa K.
Format: Article
Language:English
Subjects:
Child
Clinical Decision-Making
Female
fetotoxicity
Humans
pharmacology
Pregnancy
Pregnancy Complications - drug therapy
Pregnant Women
teratogenicity
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Summary: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.
ISSN:0306-5251
1365-2125
DOI:10.1111/bcp.15173