Paediatric Clinical Trial Design & Endpoints Workstream

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Dr Sylvia Nikkho (IDDI Leadership Team) and Dr Steve Abman (Co-Chair Paediatric Workstream)

This Workstream aims to improve the health, quality of care, and outcomes for children with PH worldwide by enhancing collaborations among care providers, basic and clinician scientists, experienced pharmaceutical leaders, regulatory experts, patients and their families and other advocates.

Members aim to develop and apply novel strategies for the early recognition and initiation of treatment to reverse, prevent or slow the progression of disease in neonates, infants and children with PVD.  

There are several unique features of paediatric PH which affect:

  • developmental biology of the cardiopulmonary system
  • mechanisms and timing of vascular injury during susceptible periods of growth and adaptation
  • differences in genetic/epigenetic mechanisms, maturational changes in vascular function and growth, co-morbidities, and responsiveness to therapeutic strategies
  • developmental differences in pharmacokinetics and pharmacodynamics, and the potential for adverse effects
  • maturational changes in right and left ventricular function 

We have a limited understanding of the disease-specific mechanisms underlying paediatric Pulmonary Vascular Disease (PVD), and this is further complicated by factors like the heterogeneity of conditions within PVD, treatments for paediatric patients being extrapolated from adult data, and a lack of well-informed guidelines and quality endpoints for assessing clinical courses and paediatric responses to therapy. 

The Workstream comprises an interactive team of clinicians, scientists, pharma colleagues, regulatory experts, and patient advocates who are working to to identify key challenges and to develop successful strategies to improve the outcomes of paediatric PH: 

  • define precise, age-appropriate, disease-specific endpoints and biomarkers
  • analyse datasets from real-world studies so we can understand long-term outcomes and identify disease severity risk factors
  • explore innovative methods for paediatric trial design beyond standard MRCTs
  • develop strategies to better translate data from adult trials to accelerate the care of children
  • extend novel therapeutic strategies at the interface of clinical and laboratory science to enhance the care and outcomes in paediatric PH. 
     

 

Events

Satellite Meeting at PVRI 2026 Dublin

First Joint Paediatric IDDI & Task Force Meeting - Breaking New Collaborative Ground in Paediatric Pulmonary Hypertension (PH)

The inaugural joint session marked an important step toward closer alignment between the Paediatric Task Force and the IDDI Paediatric Workstream, reflecting a shared commitment to breaking silos and strengthening multidisciplinary collaboration in paediatric PH. The meeting brought together clinicians, researchers, drug developers, and patient focused experts to define priority areas, highlight emerging scientific insights, and support future collaborative work.

The session included:

  • Maria Jesús del Cerro emphasising the need for coordinated global collaboration and the complementary strengths of the IDDI and the Paediatric Task Force
  • Maurice Beghetti presented insights from the PHGPS survey, highlighting patient family priorities and unmet needs that should shape future research
  • Megan Griffiths outlined progress toward a harmonised, multi centre paediatric PH risk score based on robust, prospectively collected real world data
  • Sylvia Nikkho discussed how structured extrapolation from adult studies can accelerate paediatric drug development recognising paediatric–adult differences “similar does not mean the same.” 
  • Shahin Moledina introduced emerging MRI and echocardiographic imaging endpoints that enhance feasibility and response assessment
  •  Anne Hilgendorff addressed neonatal PH, underscoring unique challenges and the need for neonatal specific biomarkers, phenotyping, and NICU ready trial designs
  • The session closed with a call from Sylvia Nikkho to strengthen TF–IDDI synergies and continue building a sustainable, collaborative paediatric PH research ecosystem

Watch the recordings here


 

Publications

If you’re interested in joining this Workstream, please get in touch.

Leaders

Steve Abman, University of Colorado
Sylvia Nikkho, Bayer