The Division of Clinical Pharmacology, Toxicology, and Therapeutic Innovation at Children's Mercy Hospital (CMH) in Kansas City, offers one of the largest, most diverse, Pediatric Clinical Pharmacology post-doctoral training programs in the U.S. It is constituted by 20 faculty including 1) clinicians cross-trained in Allergy/Asthma/Immunology, Behavioral Medicine, Cardiology, Gastroenterology, Hematology/Oncology, Infectious Diseases, Maternal/Fetal Medicine, Neonatology, Nephrology, Pharmacy, Rehabilitation Medicine, Rheumatology, and Toxicology, along with 2) basic/translational scientists with experience in analytical chemistry, applied mathematics, genetics, genomics, in vitro biotransformation, and molecular biology. Affiliated faculty contribute additional expertise in the areas of Bioethics, Health Outcomes, Pharmacoepidemiology, and Psychosocial Research. The program has made substantial contributions in the areas of pharmacogenetics, developmental pharmacokinetics, and early phase clinical trial design. The program defined in this application combines robust didactic and experiential training in pharmacogenetics/genomics, metabolomics, pharmacometrics, pharmacoepidemiology, drug discovery, drug development, clinical trial design, and the responsible conduct of research. It also offers unique elective opportunities dedicated to pediatric PBPK-based modeling and simulation (Simcyp/Certara), pediatric regulatory review and approval (FDA), bioinformatics (PharmGKB), and Formulary management (CMH/Medicaid). Two independent Masters programs offered by affiliated medical schools round out the academic program at CMH. All teaching is accomplished by faculty with significant research experience in their respective subject areas. Trainees affiliate with the program for a minimum of three years; the first and second years in Clinical Pharmacology are blended with the second (PGY5) and third (PGY6) years of their subspecialty training and their third year (PGY7) is dedicated to clinical pharmacology. Under the direction of both a junior and senior mentor, fellows will complete both a clinical and translational research project, produce several publications/presentations, compete for a minimum of one research grant, and develop a plan to transition to independence prior to graduation. Quality is continually assured by a robust, multi- input, evaluation strategy and diversity is supported by a comprehensive recruitment strategy. Since its inception, the training program at CMH has graduated 17 pediatric clinical pharmacology fellows (14 pediatricians, 3 clinical pharmacists; 11 female, 2 African American, 1 Hispanic, 1 Native-American, 1 Asian descent) who have collectively delivered 71 scientific presentations, prepared 77 peer-reviewed manuscripts and successfully competed for over $1,000,000 in intramural and extramural funding. The program is one of only two American Board of Clinical Pharmacology accredited training programs dedicated to Pediatric Clinical Pharmacology. Its longstanding record of excellence provides applicants with unparalleled training in Pediatric Clinical Pharmacology.

Public Health Relevance

Clinicians trained in the discipline of pediatric clinical pharmacology remain instrumental to the process of defining and guiding rational medication use in children, armed with the necessary skills to 1) integrate the basic and clinical sciences, 2 design and analyze clinical trials, 3) characterize therapeutic outcomes and/or relevant surrogates, and 4) define dose-exposure- response relationships. The program at Children's Mercy Hospital provides an exemplary environment in which to train the next generation of pediatric clinical pharmacologists and remedy the shortage of clinician scientists who have formal training in pediatric clinical pharmacology.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Institutional National Research Service Award (T32)
Project #
5T32HD069038-09
Application #
9697848
Study Section
Special Emphasis Panel (ZHD1)
Program Officer
Pawlyk, Aaron C
Project Start
2011-05-01
Project End
2021-04-30
Budget Start
2019-05-01
Budget End
2020-04-30
Support Year
9
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Children's Mercy Hosp (Kansas City, MO)
Department
Type
DUNS #
073067480
City
Kansas City
State
MO
Country
United States
Zip Code
64108
Shakhnovich, Valentina; Brian Smith, P; Guptill, Jeffrey T et al. (2018) A Population-Based Pharmacokinetic Model Approach to Pantoprazole Dosing for Obese Children and Adolescents. Paediatr Drugs 20:483-495
McLaughlin, Matthew J; He, Yang; Brunstrom-Hernandez, Janice et al. (2018) Pharmacogenomic Variability of Oral Baclofen Clearance and Clinical Response in Children With Cerebral Palsy. PM R 10:235-243
Shakhnovich, Valentina; Dinwiddie, Darrell; Hildreth, Amber et al. (2017) A Novel Compound-Heterozygous Epithelial Cell Adhesion Molecule Mutation in Tufting Enteropathy. J Pediatr Gastroenterol Nutr 64:e14-e16
Goldman, Jennifer L; Koen, Yakov M; Rogers, Steven A et al. (2016) Bioactivation of Trimethoprim to Protein-Reactive Metabolites in Human Liver Microsomes. Drug Metab Dispos 44:1603-7
Brown, J T; Abdel-Rahman, S M; van Haandel, L et al. (2016) Single dose, CYP2D6 genotype-stratified pharmacokinetic study of atomoxetine in children with ADHD. Clin Pharmacol Ther 99:642-50
Dinh, Jean C; Pearce, Robin E; Van Haandel, Leon et al. (2016) Characterization of Atomoxetine Biotransformation and Implications for Development of PBPK Models for Dose Individualization in Children. Drug Metab Dispos 44:1070-9
Funk, R S; Singh, R; Pramann, L et al. (2016) Nicotinamide Phosphoribosyltransferase Attenuates Methotrexate Response in Juvenile Idiopathic Arthritis and In Vitro. Clin Transl Sci 9:149-57
Shakhnovich, Valentina; Vyhlidal, Carrie; Friesen, Craig et al. (2016) Decreased Pregnane X Receptor Expression in Children with Active Crohn's Disease. Drug Metab Dispos 44:1066-9
Wagner, Jonathan; Abdel-Rahman, Susan M (2015) Oseltamivir-warfarin interaction in hypoplastic left heart syndrome: case report and review. Pediatrics 135:e1333-6
Lewis, T; Dinh, J; Leeder, J S (2015) Genetic determinants of fetal opiate exposure and risk of neonatal abstinence syndrome: Knowledge deficits and prospects for future research. Clin Pharmacol Ther 98:309-20

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