{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:18:12Z","timestamp":1787919492980,"version":"build-2784847793"},"reference-count":103,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"abstract":"Children have distinct therapeutic needs arising from age\u2010dependent physiology, disease epidemiology, formulation requirements, dosing considerations, and safety vulnerabilities. Despite substantial reductions in childhood mortality over the past three decades, nearly 5 million children under five died in 2023, with infectious diseases continuing to contribute substantially to preventable morbidity and mortality. Long\u2010acting therapeutics (LATs) may help address selected pediatric health priorities by sustaining therapeutic or prophylactic exposure, reducing dosing frequency, and improving adherence and implementation feasibility. This review synthesizes insights from the pediatric health session of the Community of Practice for Long\u2010acting Therapeutics for Maternal and Paediatric Health workshop. The session considered priority pediatric conditions in which existing or emerging LAT approaches could have clinical or public health impact, including lower respiratory tract infections, malaria, tuberculosis, HIV, and syphilis, as well as selected noninfectious indications such as childhood cancer and growth hormone deficiency. We then examine clinical pharmacology and safety considerations central to pediatric LAT development, including developmental pharmacokinetics, absorption\u2010limited disposition and flip\u2010flop kinetics, pharmacokinetic tailing, dose selection, model\u2010informed development, and injection\u2010site tolerability. The review also discusses long\u2010acting technology platforms with potential pediatric applications, route\u2010of\u2010administration considerations, excipient safety, formulation design, acceptability, and implementation challenges. Finally, we propose recommendations to support pediatric LAT development, including early integration of developmental pharmacology, age\u2010 and weight\u2010informed dosing, standardized acceptability assessment, product\u2010attribute frameworks, regulatory engagement, and equitable access planning. Realizing the potential of LATs for children will require coordinated, child\u2010centered, and equity\u2010driven approaches that address evidence generation, formulation suitability, implementation context, and affordability from the outset.<\/jats:p>","DOI":"10.1002\/cpt.70458","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:01:31Z","timestamp":1787918491000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Acting Therapeutics in Pediatric Health: Bridging Innovation and Access"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6867-9413","authenticated-orcid":false,"given":"Prajith","family":"Venkatasubramanian","sequence":"first","affiliation":[{"name":"Centre of Excellence for Long\u2010acting Therapeutics University of Liverpool Liverpool UK"},{"name":"Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3082-9234","authenticated-orcid":false,"given":"Moherndran","family":"Archary","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, African Health Research Institute, University of KwaZulu\u2010Natal Victoria Mxenge Hospital Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8120-6507","authenticated-orcid":false,"given":"Daniel B.","family":"Hawcutt","sequence":"additional","affiliation":[{"name":"Alder Hey Research Division and NIHR Alder Hey Clinical Research Facility Alder Hey Children's NHS Foundation Trust Liverpool UK"},{"name":"Department of Women's and Children's Health University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8884-2658","authenticated-orcid":false,"given":"Rachel","family":"Daley","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Long\u2010acting Therapeutics University of Liverpool Liverpool UK"},{"name":"Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1630-0505","authenticated-orcid":false,"given":"Edmund","family":"Capparelli","sequence":"additional","affiliation":[{"name":"Skaggs School of Pharmacy and Pharmaceutical Sciences University of California San Diego La Jolla California USA"},{"name":"Rady Children's Hospital San Diego San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6588-5749","authenticated-orcid":false,"given":"Adeniyi","family":"Olagunju","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Long\u2010acting Therapeutics University of Liverpool Liverpool UK"},{"name":"Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_2_13_1_1","unstructured":"UN Inter\u2010agency Group for Child Mortality Estimation (UN IGME) \u2013 UNICEF DATA. 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