At c4c-S, our network is the backbone of our mission to advance paediatric drug development. Our network is composed of two main components: Expert Groups and National Hubs. These components work together to provide comprehensive support for paediatric clinical trials across Europe.
Patient and Public Involvement (PPI) is a cornerstone of the c4c-S network. PPI ensures that the needs and perspectives of patients and their families are integrated into paediatric clinical trials. By involving PPI, c4c-S aims to create patient-centred studies that are more likely to meet the needs of the paediatric population and improve the overall quality and relevance of clinical trials.
Expert groups
The Expert Groups and their Experts are core to our Expert Advice service. We have access to over 450 clinical, methodological, and Patient and Public Involvement (PPI) experts across more than 25 medical specialties. These groups provide high-quality, independent advice on all aspects of paediatric drug development, ensuring that study designs are patient-centred and meet regulatory standards.
The roles of Experts include, but are not limited to:
- Providing expertise Offering insights and recommendations on study designs, optimal study populations, outcomes or endpoints, and regulatory responses.
- Regulatory guidance Assisting with the preparation and response to regulatory inquiries and submissions.
- Reviewing assessments Evaluating the feasibility and acceptability of study designs to ensure they meet scientific and regulatory standards.
- Involving Patients and Parents Developing tailor-made plans describing patient-parent activities, defining and developing patient-parent activities in collaboration with the sponsor, and chairing patient-parent activities.
List
Adolescent medicine
A multidisciplinary team devoted to facilitating the design and development of research and clinical trials enrolling adolescents.
Strength:
- Familiar with adolescence particularities from clinical and research perspectives
- Involved in clinical trials design and development
- Commitment to promotion of working with adolescents together with PPIs
- Development of work supporting inclusion of adolescents in adult clinical trials
- Participation in working group with EFGCP
- Activities with i-ACT
- Able to provide advice that will allow:
- Tailoring research protocols for including adolescents’ needs
- Providing advice on appropriate outcome measures for this age- and developmental- group
- Enhancing recruitment
- Diminishing attrition in research trials in this challenging group
Adolescent medicine
Cardiology
Experts in clinical paediatric cardiology and research from major European centres, covering all major areas of expertise in paediatric cardiology, including but not limited to heart failure, arrhythmias, thromboembolic events
Strength:
- Fully integrated in the sole learned society fully dedicated to paediatric cardiology: Association for European Paediatric and congenital cardiology (AEPC)
- Excellent relations with EU regulatory bodies.
Cardiology
Dermatology
The Paediatric Dermatology Expert Group brings together healthcare professionals with specialized knowledge in diagnosing, managing, and treating skin conditions in children and adolescents.
Dermatology
Developmental pharmacology
A dedicated, multidisciplinary group of experts in the field of developmental pharmacology, aiming to improve pharmacotherapy for each child, considering developmental aspects.
Strength:
- Very complementary expertise across a heterogenous group of experts with preclinical and clinical background.
- Provide advice and share the latest knowledge on the impact of maturation on drug disposition (PK) and drug effects (PD) throughout the entire neonatal and paediatric age range, of relevance for implementation in drug development initiatives or clinical trials.
- Ability to bridge to learned societies and networks in developmental pharmacology because of active involvement in those bodies by experts.
Developmental pharmacology
Endocrinology & Diabetes
Experts cover different European countries and have ample experience studying new approaches to treat growth, puberty, sexual development problems and other disorders of the hormone producing glands of the body. These include diabetes, thyroid and adrenal gland problems, early and late puberty, bone conditions and growth hormone deficiency including rare forms of these conditions.
Strength:
- Experience in paediatric clinical trials phase I to IV, development of PIP
- Interaction with EMA, FDA and national regulatory bodies
- Relations to paediatric disease registries, clinical trial networks including centre accreditation
- Network administration or development of master protocols
- Connections with relevant European scientific societies and guideline development
- Links to other innovative medicine initiatives
Endocrinology & Diabetes
ENT
Description coming soon
ENT
Ethics
Approximately 26 experts from 17 countries help with the challenges of ethics reviews bringing in their different backgrounds in paediatrics and clinical trials combined with experience in research ethics in biomedicine. Several Experts are members of EUREC (European Network of Research Ethics Committees).
Strength:
This group combines experience in ethics review with expertise in the below areas, ensuring to provide adequate advice in the various aspects of ethics review:
- A great variety of paediatric (sub)specialties
- Early paediatric drug development
- Study design
- (Global) ethical guidance and regulation
- Data protection
- Communication with parents and patients
Ethics
Formulations
International members from academia, pharmaceutical industry and consultancy, working at the forefront of paediatric medicine research and development. They aim to improve formulations for children and are able to provide advice on children’s drug product development.
Strength:
- Offers a wide range of complementary experience and expertise in paediatric R&D and drug delivery, i.e.,:
- Formulation design: how to build a paediatric Quality Target Product Profile, and to develop age-appropriate dosage forms,
- Acceptability of medicines, palatability assessment (preclinical and during CTs),
- Formulation dosing considerations including co-administration with food or other vehicles and administration device assessment,
- Excipients risk assessment,
- In vitro drug release testing (biorelevant and Quality Control) and biopharmaceutics,
- Commercial manufacturing and global product launch.
- Good understanding of the CMC and regulatory challenges associated with the development of age-appropriate formulations.
- Work closely with other relevant paediatric formulation initiatives and networks, such as EuPFI, IQ Consortium, GAP-f.
- The large expertise and ramification of connections allows this group to assist at different timings of paediatric formulation programmes and across many therapeutic areas of clinical research.
- Can assist in regulatory aspects related to paediatric product development (e.g. PIP, iPSP).
Formulations
Gastroenterology & Hepatology
Chief and Principle investigators from academia, specialised in GI, Hepatology and Nutrition conditions, and with knowledge and experience of Phase 1, 2 and 3 trials, trial design and consultancy/advisory boards, and trial delivery in disease areas.
Strength:
- Represent a range of European countries
- Excellent connections / collaborations beyond C4C – ESPGHAN, ECCO, etc
- Clinical (and trial) expertise and experience in all areas of GHN including:
- IBD
- GERD
- Hepatitis
- Cholestatic disease
- Obesity (including NASH)
- Eosinophilic esophagitis
- Constipation
- Coeliac disease
- Intestinal failure
- Metabolic diseases.
Gastroenterology & Hepatology
Genetics & Cell Therapy
The Genetics & Cell Therapy Expert Group comprises clinical geneticists, researchers, genetic counsellors, and allied health professionals focused on genetic disorders in children and on emerging therapies such as cell and gene therapies.
Genetics & Cell Therapy
Health Technology Assessment
A group of Experts with different backgrounds, both clinical and economic-organisational, set up to offer support in identifying the most suitable design to answer the most relevant questions for decision-makers: does it work? Is it worth it?
Strength:
- Experts with different backgrounds
- Clinical and economic professional skills
- Work experiences from public and private sector
Additional information:
In the drug development process, research activities, administrative procedures and compliance with legislation, as well as the correct balancing of the interests at stake, represent a complex system of actors and rules. The HTA process tends to be a bridge between the usual trial activities and the subsequent process used to determine the price of and reimbursement for new medicines. This means that attention steps that are critical to bringing new medicines into daily clinical practice for ensuring equal access to treatments should be considered. The HTA expert group, aims to facilitate paediatric clinical trials, specifically, supporting the needs of clinical trials with the information required by HTA national bodies focusing on the assessment of the “effectiveness”.
Health Technology Assessment
Infectious diseases & Vaccinology
A group of experts with H-index as high as 48, 67, 70 in the areas of infectious diseases and vaccinology, covering a wide range of research needs from prioritization of research needs and protocol design, to study conduct and dissemination of results.
Strength:
- Antimicrobial stewardship and resistance
- Diagnostics
- Anti-infective agents
- Vaccines
- HIV, CMV, HPV, RSV
- Immunology
- Paediatric haematology-oncology
- Design and implementation of RCTs and intervention studies in hospital and community environments
Infectious diseases & Vaccinology
Intensive care
A core group of professionals with expertise in PICU clinical work and research, including a wide spectrum of PICU scenarios, specific to the vast variety of diseases, conditions and needs in the field. This group aims to establish close collaboration with learned societies, networks and other expert groups within c4c-S to facilitate access to the best available knowledge. This approach will support identification of wider international and unmet needs to set priorities for further research and ensure access to PICU specific expertise for multiple stakeholders. The ultimate goal of these efforts
will be improvement of the value and safety of clinical research as well as clinical practice in PICU care.
Strength:
The established experience with research and clinical work allows this group to assist and advice on various aspects (such as methodological and feasibility issues, outcome measures etc) of clinical studies in the PICU environment. Together with the c4c-S network, this group can facilitate access to PICUs with specific expertise and improve involvement of PICU patients in clinical research, thereby improving the level of available information in this vulnerable population. The geographical diversity within the group facilitates recognition and acknowledgment of different perspectives and recruitment of external expertise as required.
Intensive care
Lactation and Nutrition
Description coming soon
Lactation and Nutrition
Medical devices
Description coming soon
Medical devices
Metabolic diseases
We collaborate with MetabERN to provide expert advice.
- Provision of evidence-based information about the numbers of people who would be eligible for research studies
- Identification of potential participants to studies
- Judgements about the best inclusion / exclusion criteria for research studies
- Experience-based opinion about information about standard care and variations in standard care
- Evidence-based
- Rigorous prioritisation of research goals (including what to study when there are numerous molecules and limited patients
Metabolic diseases
Neonatology
- With this background, this group is a skilled and committed to assist and advise on clinical studies in neonates. Based on our common networks, they can facilitate access to learned societies, information or clusters of neonatal units with specific experience, in concertation with the existing c4c-S.
- This group focuses on efforts to accelerate safe and effective therapies and to create impact and improve outcome for neonates and families.
Neonatology
Nephrology
- Expertise covers all types of kidney disease in children:
- Glomerular disorders: Glomerulonephritis, nephrotic syndrome
- Thrombotic microangiopathies
- Tubulopathies
- Acute kidney injury
- Chronic kidney disease
- Urinary tract infections
- Long-standing track records in pharma consulting
- Ample practical expertise in conducting clinical trials
- Group members well connected in specialist research networks (ESCAPE, ERKNet, etc.)
Nephrology
Neuromuscular diseases
- Several members of the NMD Expert Group are involved in the neuromuscular network TREAT-NMD and the TREAT-NMD Advisory Committee for Therapeutics (TACT). Through TACT, members have had had over ten years of experience providing advice to sponsors, from both industry and academia, on the drug development pathway within the neuromuscular field. The c4c NMD Expert Group has adopted an innovative de-risking approach to foster development of therapeutics in paediatric neuromuscular diseases.
- Expert members can provide disease specific advice in: Duchenne Muscular Dystrophy (DMD), Spinal Muscular Atrophy (SMA), Congenital Myotonic Dystrophies (CMD)
- If you have a request for advice in an area not specifically mentioned here, please do not hesitate to contact c4c-S. All requests for advice will be considered.
Neuromuscular diseases
Neuroscience & Epilepsy
- Neuropaediatric diseases
- Neuroinflammatory diseases
- Neurometabolic and Neuroimmune diseases
- Neurodegeneration
- Ataxias
- Paediatric Epilepsy, Epileptic Encephalopathy and rare Epilepsies
- Migraine & headache
- Paediatric insomnia, sleep disorders and sleep medicine
- Neurodevelopment
- Biomarker research
Neuroscience & Epilepsy
Oncology & (benign) Haematology
- Leukemia
- Brain tumors
- Sarcoma
- Tumor biology
- Neuroblastoma
- Haematology
- Preclinical research & early phase trials
- PIPs
Oncology & (benign) Haematology
Patient and Public Involvement (PPI)
PPI experts engage with Young Persons Advisory Groups, patients, and parent groups in advice meetings and study designs.
- Customized approach to every clinical study, considering the population to be involved (patients or caregivers from different European countries) and adapted methodology.
- Working with European Patient Organizations and Expert centres to find the best candidate for each advice.
- Study of the patient’s involvement impact in terms of ROI and ROE
Patient and Public Involvement (PPI)
Pharmacogenomics & other OMICS Technologies
This is a diverse group of professionals whose expertise covers but is not limited to:
- Paediatric Pharmacovigilance
- Drug safety
- Causality & avoidability assessments
- Pharmacoepidemiology
- Organ maturation
- Comparator selection
- Drug-drug interaction
- Paediatric pharmacokinetics
- Characterization of adverse drug reactions in children
- Regulatory requirements
- Clinical trial methodology
Pharmacogenomics & other OMICS Technologies
Pharmacometrics
- Experts on Pharmacometrics modelling and simulation covering approximately 10 countries.
- The group can provide high quality advice incorporating the latest knowledge on Pharmacometrics and innovative approaches into paediatric drug development. The group understands the challenges regarding involvement of children in clinical trials and their advice could facilitate research in paediatric whilst maximizing the use of data and minimizing the burden for participating patients.
Pharmacometrics
Pharmacovigilance
This is a diverse group of professionals whose expertise covers but is not limited to:
- Paediatric Pharmacovigilance
- Drug safety
- Causality & avoidability assessments
- Pharmacoepidemiology
- Organ maturation
- Comparator selection
- Drug-drug interaction
- Paediatric pharmacokinetics
- Characterization of adverse drug reactions in children
- Regulatory requirements
- Clinical trial methodology
Pharmacovigilance
Psychiatry
- Disruptive behaviour disorders
- Conduct disorders, Autism and ADHD
- Depression
- Electroconvulsive therapy
- Psychosis and antipsychotics
- Tourette and tic disorders
- Psychopharmacology
- Adherence
- Clinical trial methodology
Psychiatry
Respiratory (incl. pulmonology)
- Cystic fibrosis
- Asthma & bronchiolitis
- Pulmonology
- Allergy diseases
- Immunology diseases and disorders
- Rare lung diseases
- Bronchopulmonary dysplasia
- Sleep-disordered breathing, Sleep medicine
- Respiratory viruses
- NIV
- Regulatory requirements, DSMB, outcomes
Respiratory (incl. pulmonology)
Rheumatology & Autoimmune diseases
- This group is represented by Experts in the treatment and study of paediatric rheumatic diseases. It can provide high quality advice, incorporating the latest knowledge on epidemiology, methodology and innovative treatment approaches of paediatric rheumatic diseases.
- This group can offer expertise in designing and conducting innovative clinical trials and providing robust competence in the drafting/revision of paediatric investigation plan (PIP) or paediatric study plan (PSP) for new drugs (e.g. biologics, small molecules etc).
- The group is fully integrated with the Paediatric Rheumatology European Society (PReS at www.pres.eu), the only international learned society of the specialty, and the Paediatric Rheumatology International Trials Organisation (PRINTO at www.printo.it), one of the most prominent international not-for-profit research network of the field.
Rheumatology & Autoimmune diseases
RSV
- Extensive RSV expertise in clinics
- Enormous track record on clinical research and trials
- RSV knowledge and expertise in both Paediatrics and (older) Adults
- Strong collaboration with ReSViNET Foundation
- Experience in working with Regulatory authorities and local ethical committees
RSV
Study design & Clinical trial methodology
- (Bio)Statistics
- Bayesian design
- Innovative study design
- Extrapolation
- Outcome measures
- Regulatory requirements
- Early clinical development
- Biomarker development
- Use of external controls
- Data
Study design & Clinical trial methodology
National hubs
The National Hubs are an integral part of c4c-S and its services. Currently, 16 countries are under contract with c4c-S,
with more countries to follow.
- NORWAY
NORPEDMED - DENMARK
DanPedMed - THE NETHERLANDS
PEDMED-NL - IRELAND
In4kids - BELGIUM
BPCRN - FRANCE
PEDSTART - SPAIN
RECLIP - PORTUGAL
STAND4KIDS - SWITZERLAND
SwissPedNet - ITALY
INCIPIT - SWEDEN
SWEDPEDMED - ESTONIA
Estonian Paediatric Research Group - GERMANY
GermanNetPaet - POLAND
POLPEDNET - HUNGARY
MCRN – Hungary - GREECE
HELPNET
National Hubs collaborate with c4c-S and its network to achieve the objectives of c4c-S and facilitate the development and availability of new drugs and other health interventions for the paediatric population. They function as c4c-S’s local point of contact and coordinate c4c-S activities in their country, such as study information review, site identification and feasibility, and trial setup and conduct.
Their roles include, but are not limited to:
Local intelligence:
Providing local knowledge and insights to refine study designs and address country-specific challenges.
National coordination:
Collaborating with local sponsor teams, overseeing clinical sites in their country, and ensuring appropriate communication and dissemination within their site network.
Regulatory support:
Offering guidance and support for national regulatory submissions and compliance with local regulations.
National Hubs have made significant contributions to the success
of paediatric clinical trials across Europe.
Here are some of their key achievements:
National Hubs have made significant contributions to the success of paediatric clinical trials across Europe. Here are some of their key achievements:
- Efficient trial conduct: National Hubs have successfully facilitated the efficient conduct of numerous paediatric clinical trials across Europe, ensuring high-quality outcomes and adherence to regulatory standards.
- High patient retention: Through effective recruitment and retention strategies, National Hubs have achieved high patient retention rates in clinical trials, contributing to the reliability and validity of study results.
- Collaboration and integration: National Hubs have fostered collaboration and integration among various stakeholders, including sponsors, sites, and investigators, creating a cohesive and supportive environment for paediatric clinical trials.
Investigators and sites
Investigators and sites play a crucial role in the c4c-S network by conducting high-quality paediatric clinical trials. They work closely with National Hubs and Expert Groups to ensure that trials are designed and conducted in alignment with the current standard of care. They are responsible for implementing study protocols, recruiting participants, and ensuring the integrity and accuracy of trial data. The expertise and dedication of investigators and sites are essential to the success of c4c-S’s mission to advance paediatric drug development.
By leveraging our extensive network of Experts and National Hubs, c4c-S is committed to advancing paediatric drug development and ensuring that well-studied drugs are accessible to paediatric patients across Europe.