Abstract

OBJECTIVE: The Accelerating Innovation for Mothers project established a new database of candidate medicines under development between 2000-2021 for five pregnancy-related conditions, including fetal growth restriction. The objective was to assess medicines for fetal growth restriction and their potential for clinical use globally. DESIGN: Landscape analysis SETTING: Global (focus on low and middle-income countries (LMICs)). METHODS: A research pipeline database of medicines was created via a search on Adis Insight, PubMed and various grant and clinical trial databases. Analysis of clinical and preclinical candidates were descriptive. MAIN OUTCOMES MEASURES: Fetal growth restriction candidates in clinical development were identified and ranked as high, medium or low potential based on prespecified criteria, including efficacy, safety and accessibility RESULTS: Of the 444 unique candidates in the database across all five pregnancy-related conditions, 63 were for fetal growth restriction. Of these, 31 were in clinical development (Phases I, II or III) and 32 in preclinical development. Three candidates, aspirin, L-arginine and vitamin D, were ranked as high potential as preventive agents. There were no high potential candidates for treating fetal growth restriction, though five candidates were medium potential (United Nations International Multiple Micronutrient Antenatal Preparation [UNIMMAP], allylestrenol, dalteparin, omega-3 fatty acids, and tadalafil). CONCLUSION: Aspirin, L-arginine and vitamin D are promising, high potential preventative agents for fetal growth restriction. Based on the medicines pipeline, new pharmacological agents for fetal growth restriction are unlikely to emerge in the near future.

Link to publisher’s web site