Transl Clin Pharmacol.  2014 Dec;22(2):64-69. 10.12793/tcp.2014.22.2.64.

Geriatric clinical pharmacology and clinical trials in the elderly

• Chung JY

• KMID: 2050938
• DOI: http://doi.org/10.12793/tcp.2014.22.2.64

Abstract

The aging process is linked to changes in the physiological function of organs and changes in body composition that alter the pharmacokinetics of drugs and pharmacodynamic responses. Comorbidity and polypharmacy in the elderly decreases tolerability of drugs, leading to greater vulnerability to adverse drug reactions than that observed in younger adults. In geriatric pharmacotherapy, the general recommendation is dose reduction and slow titration, which is based on pharmacokinetic considerations and concern for adverse drug reactions, rather than clinical trial data. Older patients are under-represented in clinical trials. In the absence of evidence, extrapolation of risk-benefit ratios from younger adults to geriatric populations is not necessarily valid. Sound evidence through prospective clinical trials is essential, and geriatric societies, governments, and patient advocacy groups should collaborate to promote the inclusion of older people in clinical trials. It is believed that all involved in clinical trials have both an obligation and an opportunity to eliminate age discrimination in clinical trial practice.

Keyword

clinical trials; clinical pharmacology; geriatrics; elderly

MeSH Terms

Adult
Aged*
Ageism
Aging
Body Composition
Comorbidity
Drug Therapy
Drug-Related Side Effects and Adverse Reactions
Geriatrics
Humans
Patient Advocacy
Pharmacokinetics
Pharmacology, Clinical*
Polypharmacy

Reference

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