Development of a pediatric relative bioavailability/bioequivalence database and identification of putative risk factors associated with evaluation of pediatric oral products

Research output: Contribution to journalArticlepeer-review


  • Fang Wu
  • Liang Zhao (Contributor)
  • Lanyan Fang (Contributor)
  • Gilbert Burckart (Contributor)
  • Kairui Feng (Contributor)
  • Youssef Mousa (Contributor)
  • Franci Naumann (Contributor)
  • Hannah Batchelor

Colleges, School and Institutes

External organisations

  • Division of Quantitative Methods and Modelling, Office of Research and Standard, Office of Generic Drug Products, Center for Drug Evaluation and Research, United States Food and Drug Administration, 20993, Silver Spring, Maryland, USA
  • Office of Clinical Pharmacology, Office of Translational Science, Center for Drug Evaluation and Research, United States Food and Drug Administration, Silver Spring, Maryland, 20993, USA
  • University of Strathclyde


Generally, bioequivalence (BE) studies of drug products for pediatric patients are conducted in adults due to ethical reasons. Given the lack of direct BE assessment in pediatric populations, the aim of this work is to develop a database of BE and relative bioavailability (relative BA) studies conducted in pediatric populations and to enable the identification of risk factors associated with certain drug substances or products that may lead to failed BE or different pharmacokinetic (PK) parameters in relative BA studies in pediatrics. A literature search from 1965 to 2020 was conducted in PubMed, Cochrane Library, and Google Scholar to identify BE studies conducted in pediatric populations and relative BA studies conducted in pediatric populations. Overall, 79 studies covering 37 active pharmaceutical ingredients (APIs) were included in the database: 4 bioequivalence studies with data that passed BE evaluations; 2 studies showed bioinequivalence results; 34 relative BA studies showing comparable PK parameters, and 39 relative BA studies showing differences in PK parameters between test and reference products. Based on the above studies, common putative risk factors associated with differences in relative bioavailability (DRBA) in pediatric populations include age-related absorption effects, high inter-individual variability, and poor study design. A database containing 79 clinical studies on BE or relative BA in pediatrics has been developed. Putative risk factors associated with DRBA in pediatric populations are summarized.


Original languageEnglish
Article number57
JournalAAPSJ (An Official Journal of the American Association of Pharmaceutical Scientists)
Publication statusPublished - 21 Apr 2021