Carlo Giaquinto

University of Padova, Padua, Veneto, Italy

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Publications (266)1722.58 Total impact

  • 11/2015; DOI:10.1055/s-0035-1566246
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    ABSTRACT: Background and objectives: Acute otitis media (AOM) not only affects childhood quality of life (QoL), but can also affect parental QoL. We adapted a previously published questionnaire on the effect of childhood recurrent ear, nose and throat infections on parental QoL for use with AOM and used it in an observational, multicentre, prospective study of children with AOM. Methods: The AOM-specific parental QoL questionnaire grouped 15 items into emotional, daily disturbance, total and overall parental QoL impact scores. The questionnaire was assessed using item-convergent and item-discriminant validity criteria and internal consistency reliability; and then used with parents of children aged <6 years diagnosed with AOM at 73 practices in Germany, Italy, Spain, Sweden and the UK. Bivariate analyses explored the differences in mean parental QoL impact scores by various characteristics. Results: The questionnaire demonstrated good to excellent internal consistency reliability for the various components (Cronbach's α 0.82-0.97). There were 1419 AOM episodes among 5882 healthy children over 1 year, of which 1063 episodes (74.9 %) among 852 children had a questionnaire. Parents reported interrupted sleep (68.4 %), worry (51.0 %), altered daily schedule (44.6 %) and less leisure time (41.5 %) with a score ≥3 (1 = least to 5 = most impact). Factors that adversely affected parental QoL included: increased parental perception of AOM severity, younger child age and multiple AOM episodes. Conclusions: The AOM-specific parental QoL questionnaire demonstrated good performance across five European countries. Parental QoL was affected by childhood AOM proportionally to severity, number of episodes and younger child age.
    Clinical Drug Investigation 09/2015; 35(10). DOI:10.1007/s40261-015-0319-1 · 1.56 Impact Factor

  • European Respiratory Journal 09/2015; 46(suppl 59):PA4083. DOI:10.1183/13993003.congress-2015.PA4083 · 7.64 Impact Factor

  • European Respiratory Journal 09/2015; 46(suppl 59):PA4082. DOI:10.1183/13993003.congress-2015.PA4082 · 7.64 Impact Factor
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    ABSTRACT: From the use of antiretroviral therapy to prevent mother-to-child transmission to the possibility of HIV cure hinted at by the Mississippi baby experience, paediatric HIV infection has been pivotal to our understanding of HIV pathogenesis and management. Daily medication and indefinite antiretroviral therapy is recommended for children infected with HIV. Maintenance of life-long adherence is difficult and the incidence of triple-class virological failure after initiation of antiretroviral therapy increases with time. This challenge shows the urgent need to define novel strategies to provide long-term viral suppression that will allow safe interruption of antiretroviral therapy without viral rebound and any associated complications. HIV-infected babies treated within a few days of birth have a unique combination of a very small pool of integrated viruses, a very high proportion of relatively HIV resistant naive T cells, and an unparalleled capacity to regenerate an immune repertoire. These features make this group the optimum model population to investigate the potential efficacy of immune-based therapies. If successful, these investigations could change the way we manage HIV infection. Copyright © 2015 Elsevier Ltd. All rights reserved.
    The Lancet Infectious Diseases 07/2015; 15(9). DOI:10.1016/S1473-3099(15)00052-3 · 22.43 Impact Factor
  • Miguel O'Ryan · Carlo Giaquinto · Bernd Benninghoff ·
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    ABSTRACT: A decade after licensure of the human rotavirus vaccine (HRV), a wealth of evidence supports a reduction of rotavirus (RV) gastroenteritis-associated mortality and hospitalizations following HRV inclusion in national immunization programs. Nevertheless, the majority of real-world data has been generated in high- or middle-income settings. Clinical efficacy trials previously indicated RV vaccine performance may be lower in less-developed countries compared with wealthier counterparts. Using recently published data from Africa, we examine the effectiveness and impact of HRV in resource-deprived areas, exploring whether vaccine performance differs by socioeconomic setting and the potential underlying factors. HRV vaccine effectiveness in early adopting African countries has proven to be similar or even superior to the efficacy results observed in pre-licensure studies.
    Expert Review of Vaccines 06/2015; 14(8):1-14. DOI:10.1586/14760584.2015.1059282 · 4.21 Impact Factor
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    ABSTRACT: Objectives: To describe use of treatment for chronic hepatitis C virus (HCV) infection in HIV/HCV co-infected children and young people living in Europe and to evaluate treatment outcomes. Methods: HCV treatment data on children and young people aged <25 years with HIV/HCV co-infection were collected in a cohort collaboration of 11 European paediatric HIV cohorts. Factors associated with receipt of HCV treatment and with sustained virological response 24 weeks after treatment completion (SVR24) were explored. Results: Of 229 HIV/HCV co-infected patients, 22% had a history of AIDS and of 55 who were treated for HCV, 47 (85%) were receiving combined antiretroviral therapy. The overall HCV treatment rate was 24% (n =55) but it varied substantially between countries, with the highest rate being in Russia at 61% (30/49). Other factors associated with treatment receipt were older age [adjusted odds ratio (AOR) 5.24, 95% confidence interval (CI) 1.9–14.4, for 18–24-year-olds vs 11–17-year-olds, P =0.001] and advanced fibrosis (AOR 5.5, 95% CI 1.3–23.7; for ≥9.6 vs ≤7.2 kPa, P =0.02). Of 50 patients with known treatment outcomes, 50% attained SVR24. Of these, 16 (80%) had genotype (GT) 2,3 and 8 (29%) had GT 1,4 (P <0.001). After adjusting for genotype (GT 1,4 vs GT 2,3), females (P =0.003), patients with non-vertical HCV acquisition (P =0.002) and those with shorter duration of HCV (P =0.009) were more likely to have successful treatment outcomes. Conclusion: Only half of the HIV/HCV co-infected youth achieved an HCV cure. HCV treatment success appears to be lower in the context of HIV co-infection than in HCV mono-infection, underscoring the urgent need to speed up approvals of new direct-acting antiviral combinations in children.

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    ABSTRACT: B> Background. The use of raltegravir in human immunodeficiency virus (HIV)–infected pregnant women is important in the prevention of mother-to-child HIV transmission, especially in circumstances when a rapid decline of HIV RNA load is warranted or when preferred antiretroviral agents cannot be used. Physiological changes during pregnancy can reduce antiretroviral drug exposure. We studied the effect of pregnancy on the pharmacokinetics of raltegravir and its safety and efficacy in HIV-infected pregnant women. Methods. An open-label, multicenter, phase 4 study in HIV-infected pregnant women receiving raltegravir 400 mg twice daily was performed (Pharmacokinetics of Newly Developed Antiretroviral Agents in HIV-Infected Pregnant Women Network). Steady-state pharmacokinetic profiles were obtained in the third trimester and postpartum along with cord and maternal delivery concentrations. Safety and virologic efficacy were evaluated. Results. Twenty-two patients were included, of which 68% started raltegravir during pregnancy. Approaching delivery, 86% of the patients had an undetectable viral load (<50 copies/mL). None of the children were HIV-infected. Exposure to raltegravir was highly variable. Overall area under the plasma concentration-time curve (AUC) and plasma concentration at 12 hours after intake (C<SUB>12h</SUB>) plasma concentrations in the third trimester were on average 29% and 36% lower, respectively, compared with postpartum: Geometric mean ratios (90% confidence interval) were 0.71 (.53–.96) for AUC<SUB>0–12h</SUB> and 0.64 (.34–1.22) for C<SUB>12h</SUB>. The median ratio of raltegravir cord to maternal blood was 1.21 (interquartile range, 1.02–2.17; n = 9). Conclusions. Raltegravir was well tolerated during pregnancy. The pharmacokinetics of raltegravir showed extensive variability. The observed mean decrease in exposure to raltegravir during third trimester compared to postpartum is not considered to be of clinical importance. Raltegravir can be used in standard dosages in HIV-infected pregnant women. Clinical Trials Registration. NCT00825929 .
    Clinical Infectious Diseases 05/2015; 61(5). DOI:10.1093/cid/civ366 · 8.89 Impact Factor
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    ABSTRACT: Recent estimates indicate an increase in the prevalence of skin diseases in children. Few large epidemiologic studies have examined prevalence trends in Europe. This study evaluated the incidence and prevalence of frequently occurring pediatric skin diseases (PSDs) in Italy as seen by family pediatricians (FPs). Data were retrospectively extracted from the Pedianet database (2006-2012) in children ages 0 to 14 years presenting with a skin disease at their FP. The incidence and prevalence estimates were calculated per year and stratified according to sex, age, and geographic area. A mean of 145,233 children (52.1% male) across five Italian regions were registered with their participating FP for a total of 913,253 person-years of follow-up. The majority of patients were from the northeast (44.6%) and 37.7% were ages 5-9 years. Incidence estimates (new cases/1,000 person-years) for most PSDs increased from 2006 to 2012, the highest being for atopic dermatitis (AD) (14.1 vs 16.5), acute urticaria (10.1 vs 11.6), and contact dermatitis (9.3 vs 10.8), whereas psoriasis remained unchanged over the 7 years (0.61 vs 0.57). In contrast, prevalence estimates (cases/100 patients) increased two to three times for several PSDs, including AD (2.7% vs 8.5%), seborrheic dermatitis (0.5% vs 1.6%), chronic urticaria (0.4% vs 0.8%), and psoriasis (0.09% vs 0.22%). Differences in prevalence according to age range and geographic area were observed for psoriasis, AD, and urticaria. This study provides comprehensive evidence of the increasing prevalence and incidence of PSDs across Italy. Additional causality studies to address this important clinical and psychosocial problem are recommended. © 2015 Wiley Periodicals, Inc.
    Pediatric Dermatology 04/2015; 32(5). DOI:10.1111/pde.12568 · 1.02 Impact Factor
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    ABSTRACT: The first evidence-based recommendations for rotavirus vaccination in Europe were prepared at the time of licensure of two live oral rotavirus vaccines (Rotarix™, GlaxoSmithKline, and RotaTeq®, Sanofipasteur-MSD) in 2006 and published in 2008. Since then several countries in Europe and more globally have adopted universal rotavirus vaccination of all healthy infants as part of their national immunization programs (NIP). The experience from these NIPs has produced a wealth of post-introduction effectiveness data that, together with the evidence from pre-licensure efficacy trials presented in the 2008 Recommendations, support the case of rotavirus vaccination in Europe.The prelicensure safety trials of Rotarix™ and RotaTeq®, each in populations of more than 60.000 infants, did not reveal risk of intussusception (IS), but post-vaccination surveillance in several countries, particularly Australia and Mexico, has established that the risk of IS for both vaccines after the first dose might be between 1:50.000 and 1:80.000. While it may be argued that the risk is acceptable vis-àis the great benefits of rotavirus vaccination, this argument alone may not suffice, and every effort should be made to reduce the risk of IS. Considerable evidence, including post-vaccination surveillance data from Germany, suggests that the risk of IS can be reduced by early administration of the first dose of oral rotavirus vaccine. The previous ESPID/ESPGHAN recommendations held that the first dose of oral rotavirus vaccine should be given between 6 and 12 weeks of age; this recommendation is sustained but with an emphasis towards the lower range of the recommended age, i.e. preferably between 6 to 8 weeks of age. At the time of the earlier recommendations experience of rotavirus vaccination in premature infants and other special target groups was limited. It is now recommended with greater confidence than before that prematurely born infants should be vaccinated according to their calendar age as recommended for full term infants. It is now strongly recommended that all HIV-infected or HIV-exposed infants be vaccinated with oral rotavirus vaccine. While specific information on many immunodeficiencies is lacking, infants with known severe combined immunodeficiency should not receive live rotavirus vaccine.
    The Pediatric Infectious Disease Journal 04/2015; 34(6). DOI:10.1097/INF.0000000000000683 · 2.72 Impact Factor
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    ABSTRACT: By January 2015, rotavirus vaccination has been implemented in national vaccination programs in 75 countries worldwide. Two live oral rotavirus vaccines are internationally available: human, monovalent vaccine and human-bovine pentavalent reassortant vaccine. Since January 2014, another live, oral human-bovine monovalent vaccine has been available in India. After implementation of rotavirus vaccines in childhood immunization programs, over 90% reduction of rotavirus hospitalizations has been observed in industrialized and resource deprived countries. Additionally, in Latin America, significant reduction of rotavirus-associated deaths has been observed. Still, numerous countries do not recommend rotavirus mass vaccination because of assumed lack of cost-effectiveness and potential risk of intussusception which is estimated at 1 per 50-70,000 doses of rotavirus vaccines. Cost-effectiveness of vaccination is affected in some countries by high price. Inclusion of herd protection and indirect costs in calculations for cost effectiveness results in clear benefit: costs saved by health systems due to reduced rotavirus gastroenteritis hospitalizations exceed by far costs for implementation of rotavirus vaccination. There have been objections that high rotavirus vaccination coverage could put selective pressure on certain rotavirus strains against which protection after vaccination is less distinct. However, data now strongly suggest that even if there might be a relative increase of some specific genotypes after the use of rotavirus vaccines, this is not an absolute increase in incidence from certain genotypes and does not affect the overall effectiveness of rotavirus mass vaccination which resulted in a major decrease of severe cases of rotavirus gastroenteritis in both industrialized and resource deprived countries. Copyright © 2015. Published by Elsevier Ltd.
    Clinical Microbiology and Infection 02/2015; 21(8). DOI:10.1016/j.cmi.2015.01.027 · 5.77 Impact Factor
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    ABSTRACT: The 2015 Paediatric European Network for Treatment of AIDS (PENTA) guidelines provide practical recommendations on the management of HIV-1 infection in children in Europe and are an update to those published in 2009. Aims of treatment have progressed significantly over the last decade, moving far beyond limitation of short-term morbidity and mortality to optimizing health status for adult life and minimizing the impact of chronic HIV infection on immune system development and health in general. Additionally, there is a greater need for increased awareness and minimization of long-term drug toxicity. The main updates to the previous guidelines include: an increase in the number of indications for antiretroviral therapy (ART) at all ages (higher CD4 thresholds for consideration of ART initiation and additional clinical indications), revised guidance on first- and second-line ART recommendations, including more recently available drug classes, expanded guidance on management of coinfections (including tuberculosis, hepatitis B and hepatitis C) and additional emphasis on the needs of adolescents as they approach transition to adult services. There is a new section on the current ART 'pipeline' of drug development, a comprehensive summary table of currently recommended ART with dosing recommendations. Differences between PENTA and current US and World Health Organization guidelines are highlighted and explained. © 2015 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.
    HIV Medicine 02/2015; DOI:10.1111/hiv.12217 · 3.99 Impact Factor
  • J.S.F. Lee · M. Penazzato · M. Lallemant · C. Giaquinto ·
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    ABSTRACT: Over a period of 25 years only 1 % of new drugs were approved specifically for so-called neglected diseases, which represent over 12 % of the global disease burden in terms of mortality and chronic disability. The authors briefly describe the Drugs for Neglected Diseases initiative (DNDi) model set up to address this gap, and give an example of the paediatric HIV project that has been undertaken in support of the needed HIV response. The role that research networks (such as PENTA, IMAACT and GRIP), public-private partnerships and strategic mobilization of key stakeholders have played in drug development and drug/formulation access for children has been highlighted. The effective achievements obtained in scaling up deployment of antiretroviral drugs in resource limited settings show the importance of consolidating public and private partnership (WHO, innovative research intensive and generic pharmaceutical companies and international agencies working with partners from countries where diseases are endemic).
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    ABSTRACT: Objectives: To describe the pharmacokinetics of darunavir in pregnant HIV-infected women in the third trimester and post-partum. Patients and methods: This was a non-randomized, open-label, multicentre, Phase IV study in HIV-infected pregnant women recruited from HIV treatment centres in Europe. HIV-infected pregnant women treated with darunavir (800/100 mg once daily or 600/100 mg twice daily) as part of their combination ART were included. Pharmacokinetic curves were recorded in the third trimester and post-partum. A cord blood sample and maternal sample were collected. The study is registered at under number NCT00825929. Results: Twenty-four women were included in the analysis [darunavir/ritonavir: 600/100 mg twice daily (n=6); 800/100 mg once daily (n=17); and 600/100 mg once daily (n=1)]. Geometric mean ratios of third trimester versus post-partum (90% CI) were 0.78 (0.60-1.00) for total darunavir AUC0-tau after 600/100 mg twice-daily dosing and 0.67 (0.56-0.82) for total darunavir AUC0-tau after 800/100 mg once-daily dosing. The unbound fraction of darunavir was not different during pregnancy (12%) compared with post-partum (10%). The median (range) ratio of darunavir cord blood/maternal blood was 0.13 (0.08-0.35). Viral load close to delivery was <300 copies/mL in all but two patients. All children were tested HIV-negative and no congenital abnormalities were reported. Conclusions: Darunavir AUC and Cmax were substantially decreased in pregnancy for both darunavir/ritonavir regimens. This decrease in exposure did not result in mother-to-child transmission. For antiretroviral-naive patients, who are adherent, take darunavir with food and are not using concomitant medication reducing darunavir concentrations, 800/100 mg of darunavir/ritonavir once daily is adequate in pregnancy. For all other patients 600/100 mg of darunavir/ritonavir twice daily is recommended during pregnancy.
    Journal of Antimicrobial Chemotherapy 10/2014; 70(2). DOI:10.1093/jac/dku400 · 5.31 Impact Factor

  • Open Journal of Hematology 10/2014; 5:1. DOI:10.13055/ojhmt_5_1_7.141007
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    ABSTRACT: The European Paediatric Regulation mandated the European Commission to fund research on off-patent medicines with demonstrated therapeutic interest for children. Responding to this mandate, five FP7 project calls were launched and 20 projects were granted. This paper aims to detail the funded projects and their preliminary results. Publicly available sources have been consulted and a descriptive analysis has been performed. Twenty Research Consortia including 246 partners in 29 European and non-European countries were created (involving 129 universities or public-funded research organisations, 51 private companies with 40 SMEs, 7 patient associations). The funded projects investigate 24 medicines, covering 10 therapeutic areas in all paediatric age groups. In response to the Paediatric Regulation and to apply for a Paediatric Use Marketing Authorisation, 15 Paediatric Investigation Plans have been granted by the EMA-Paediatric Committee, including 71 studies of whom 29 paediatric clinical trials, leading to a total of 7,300 children to be recruited in more than 380 investigational centres. Conclusion: Notwithstanding the EU contribution for each study is lower than similar publicly funded projects, and also considering the complexity of paediatric research, these projects are performing high-quality research and are progressing towards the increase of new paediatric medicines on the market. Private–public partnerships have been effectively implemented, providing a good example for future collaborative actions. Since these projects cover a limited number of off-patent drugs and many unmet therapeutic needs in paediatrics remain, it is crucial foreseeing new similar initiatives in forthcoming European funding programmes.
    European Journal of Pediatrics 09/2014; 174(4). DOI:10.1007/s00431-014-2398-z · 1.89 Impact Factor
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    ABSTRACT: Background: Twice-daily darunavir/ritonavir is indicated in treatment-experienced children (≥3 years). This study assessed once-daily administration in treatment-naïve adolescents. Methods: Phase 2, 48-week, open-label, single-arm study evaluating pharmacokinetics, safety and efficacy of once-daily darunavir/ritonavir 800/100 mg in treatment-naïve, HIV-1-infected adolescents (≥12 to <18 years, ≥40 kg) with zidovudine/lamivudine or abacavir/lamivudine. Results: Twelve patients (67% female; median 14.4 years) were enrolled. After 24 and 48 weeks, respectively, 11 of 12 (92%) and 10 of 12 (83%) patients achieved viral load <50 copies/mL (intent-to-treat time-to-loss of virologic response); all had ≥1 log10 drop in viral load versus baseline. Median CD4 cell count increased by 175 and 221 cells/mm (intent-to-treat-noncompleter = failure) after 24 and 48 weeks, respectively. Eighty-three percent of patients were adherent to darunavir/ritonavir. One patient was never suppressed and 1 patient rebounded. No patients developed darunavir resistance-associated mutations or lost phenotypic susceptibility to any commercially available protease inhibitor or any background nucleoside reverse transcriptase inhibitor. Eleven patients (92%) reported ≥1 adverse event (AE), considered in 2 patients to be at least possibly related to darunavir (gastrointestinal-related events and dizziness). Four patients had ≥1 serious AE. Three patients reported ≥1 grade 3/4 AE; no serious or grade 3/4 AEs were considered darunavir related. No patients discontinued because of AEs. Conclusions: Over 48 weeks, once-daily darunavir/ritonavir 800/100 mg plus NRTIs was effective and well-tolerated for treatment of HIV-1-infected, antiretroviral-naïve adolescents (≥12 to <18 years). These findings support use of once-daily darunavir/ritonavir 800/100 mg in this population.
    The Pediatric Infectious Disease Journal 09/2014; 33(9):940-5. DOI:10.1097/INF.0000000000000308 · 2.72 Impact Factor
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    ABSTRACT: Background: We studied the effect of pregnancy on atazanavir pharmacokinetics in the presence and absence of tenofovir. Methods: This was a non-randomized, open-label, multicentre Phase IV study in HIV-infected pregnant women recruited from European HIV treatment centres. HIV-infected pregnant women treated with boosted atazanavir (300/100 mg or 400/100 mg atazanavir/ritonavir) as part of their combination antiretroviral therapy (cART) were included in the study. 24 h pharmacokinetic curves were recorded in the third trimester and postpartum. Collection of a cord blood and maternal sample at delivery was optional. Results: 31 patients were included in the analysis, 21/31 patients used tenofovir as part of cART. Median (range) gestational age at delivery was 39 weeks (36-42). Approaching delivery 81% (25 patients) had an HIV viral load <50 copies/ml, all <1,000 copies/ml. Least squares means ratios (90% CI) of atazanavir pharmacokinetic parameters third trimester/postpartum were: 0.66 (0.57, 0.75) for AUC0-24h, 0.70 (0.61, 0.80) for Cmax and 0.59 (0.48, 0.72) for C24h. No statistical difference in pharmacokinetic parameters was found between patients using tenofovir versus no tenofovir. None of the patients showed atazanavir concentrations <0.15 mg/l (target for treatment-naive patients). One baby had a congenital abnormality, which was not likely to be related to atazanavir/ritonavir use. None of the children were HIV-infected. Conclusions: Despite 34% lower atazanavir exposure during pregnancy, atazanavir/ritonavir 300/100 mg once daily generates effective concentrations for protease inhibitor (PI)-naive patients, even if co-administered with tenofovir. For treatment-experienced patients (with relevant PI resistance mutations) therapeutic drug monitoring of atazanavir should be considered to adapt the atazanavir/ritonavir dose on an individual basis. number NCT00825929.
    Antiviral therapy 07/2014; 20(1). DOI:10.3851/IMP2820 · 3.02 Impact Factor
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    M.A. Turner · M. Catapano · S. Hirschfeld · C. Giaquinto ·
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    ABSTRACT: Children deserve medicines that are adapted to their needs. The need to include children in drug development has been recognised increasingly over the past few decades. Legal and regulatory frameworks are well established in the EU and US. The amount of work done to study medicines for children is significantly greater than it was 10years go. Proof-of-concept has been demonstrated for all segments of the paediatric drug development pipeline. It is now time to examine how the practice of developing medicines for children has evolved within those frameworks and to determine how that work should be generalised. This review describes the development of medicines for children and critically appraises the work that has been done within those frameworks. Significant effort is needed to realize the potential provided by the current regulatory framework. Using the work programme of the Global Research in Paediatrics (GRiP) Network of Excellence as a template we outline current work and future growing points.
    Advanced drug delivery reviews 06/2014; 73. DOI:10.1016/j.addr.2014.02.003 · 15.04 Impact Factor

Publication Stats

5k Citations
1,722.58 Total Impact Points


  • 1988-2015
    • University of Padova
      • Department of Pediatrics
      Padua, Veneto, Italy
  • 2014
    • San Raphael of St. Francis Nsambya Hospital
      Kampala, Central Region, Uganda
  • 2006-2014
    • University-Hospital of Padova
      Padua, Veneto, Italy
  • 2011
    • Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
      • Neonatology and Neonatal Intensive Care
      Milano, Lombardy, Italy
  • 2007
    • University of Florence
      Florens, Tuscany, Italy
  • 2005
    • University of Iowa Children's Hospital
      Iowa City, Iowa, United States
    • Pedianet
      Padua, Veneto, Italy
  • 2001-2005
    • Erasmus Universiteit Rotterdam
      • Department of Medical Informatics
      Rotterdam, South Holland, Netherlands
  • 2000
    • St George's, University of London
      Londinium, England, United Kingdom
  • 1998
    • Great Ormond Street Hospital for Children NHS Foundation Trust
      Londinium, England, United Kingdom
  • 1987-1996
    • It-Robotics
      Vicenza, Veneto, Italy
  • 1995
    • University of London
      Londinium, England, United Kingdom
  • 1991
    • University of Milan
      Milano, Lombardy, Italy
  • 1989
    • Karolinska Institutet
      • Department of Medicine, Huddinge
      Сольна, Stockholm, Sweden