The U.S. Food and Drug Administration (FDA) in collaboration with the University of Maryland Center of Excellence in Regulatory Science and Innovation (M-CERSI) hosted a two-day virtual public workshop entitled “Pharmacokinetic Evaluation in Pregnancy” on May 16, 2022 and May 17, 2022. The purpose of this workshop was to engage with stakeholders to assess available science and data gaps to advance the conduct of pharmacokinetic (PK) studies in pregnant individuals.

Most pregnant individuals use prescribed or over-the-counter medications during pregnancy; however, this population has historically been excluded from clinical trials. Therefore, there are important gaps in knowledge about the appropriate dosing for most medications used during pregnancy at the time of approval. In the absence of data, the approved adult dose is typically prescribed to a pregnant individual, but because of the physiologic changes in pregnancy, under dosing or excessive dosing may occur, with potential adverse impacts on safety and efficacy. Further pharmacologic research and collection of PK data during pregnancy are needed to ensure that the appropriate dosing information is available for pregnant individuals. Advancing this field requires identifying key knowledge gaps, barriers to data collection, and potential innovative solutions to improve data generation and analysis.  

Workshop Objectives

  • Review the general landscape of existing regulatory, scientific, and ethical considerations for drug development in pregnant individuals
  • Describe study design considerations for trials collecting PK data in pregnant individuals
  • Discuss key aspects of utilizing modeling and simulation to inform study design and dosing considerations for pregnant individuals
  • Explore innovative approaches to data generation and analysis in pregnant individuals

This workshop is open to the public with no cost to attend and is intended for clinicians, academicians, and drug developers, but registration is required. This virtual public workshop will be available to view via webcast. Registrants will receive the link to access the live webinar following registration. 

To register, visit the M-CERSI registration form. 
 

Monday, May 16
10:00 a.m. – 3:00 p.m. ET

 


Day 1 – Welcome & Introduction                                                                                                                                                  Video

Welcome & Introductory Remarks

Leyla Sahin
U.S. Food and Drug Administration

 

Keynote Address

Robert Califf
Commissioner of Food and Drugs

    


Session 1: Considerations for Conduct of PK Studies in Pregnant Individuals                                                    Video                                         

Introduction of Speakers

Daphne Guinn
U.S. Food and Drug Administration

 

General Landscape of Existing Regulatory Guidance and Drug Labeling in Pregnancy

Leyla Sahin
U.S. Food and Drug Administration


 Slides 
 

Ethical considerations for enrolling pregnant individuals in clinical studies

Anne Lyerly
University of North Carolina

Slides 


Physiologic changes during pregnancy and impact on drug disposition and response

Ahizechukwu Eke
John Hopkins University

Slides 


PK studies in pregnancy – Regulatory experience

Su-Young Choi
U.S. Food and Drug Administration

Slides 


Public health perspective on PK studies in pregnancy

Martina Penazzato
WHO-IMPAACT

Slides 


The conundrum of clinical studies in pregnancy: Industry view

Michael Fossler
Cytel

Slides 

Design considerations for pharmacokinetic studies in pregnant individuals

Mary Hebert
University of Washington

Slides

Panel Discussion
Moderators: Lynne Yao 
(U.S. Food and Drug Administration) and Solange Corriol-Rohou (AstraZeneca)

Panelists
Yodit Belew
U.S. Food and Drug Administration

Christina Bucci-Rechtweg
Novartis

Maged Costantine
Ohio State University

Melanie Kerr
Patient Representative

Aaron Pawlyk
NIH/NICHD

Raman Venkataramanan
University of Pittsburgh

  

Closing Remarks

Elimika Pfuma Fletcher
U.S. Food and Drug Administration

  

 

 

Tuesday, May 17
10:00 a.m. – 2:00 p.m. ET

 


Day 2 – Welcome & Introduction                                                                                                                           Video
Introduction of Speakers: CAPT Anissa Davis-Williams
 

Welcome & Introductory Remarks

Elimika Pfuma Fletcher
U.S. Food and Drug Administration

 


Session 2: Modeling Pregnancy Pharmacokinetics
 

Overview of current modeling approaches to support studies in pregnancy

Jeff Barrett
Critical Path

Slides 

The role of modelling and trial design considerations – regulatory perspective

Susan Cole
MHRA


Slides 
 

Industry perspective on role of PBPK modeling in pregnancy

Amy Cheung
Certara

Slides 


Predicting maternal-fetal exposure to drugs using a mechanistic PBPK model

Jashvant Unadkat
University of Washington

Slides 

Panel Discussion
Moderator: 
Elimika Pfuma Fletcher (U.S. Food and Drug Administration)

Panelists
Karim Azer
Axcella

Gil Burckart
U.S. Food and Drug Administration

Andre Dallmann
Bayer

Sara Quinney
Indiana University

   

BREAK

  

    


Session 3: Data Interpretation & Translation into Dosing Recommendations in Pregnancy
 


Innovative data analytics to inform pharmacokinetics and dosing of drugs in pregnancy

Mathangi Gopalakrishnan
University of Maryland

Slides 


Translating data into dosing recommendations in pregnancy

Brookie Best
University of California San Diego

Slides 


Panel Discussion
Moderator: 
Elimika Pfuma Fletcher (U.S. Food and Drug Administration) and Sara Quinney (Indiana University)

Panelists
Edmund Capparelli
University of California San Diego

Kellie Reynolds
U.S. Food and Drug Administration

Catherine Stika
Northwestern University

Ashley Strougo
Sanofi

Kimberly Struble
U.S. Food and Drug Administration

Raman Venkataramanan
University of Pittsburgh

 


Closing Remarks

Lynne Yao
Director, Division of Pediatrics and Maternal Health, Office of New Drugs, CDER

 


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