US-FDA Guidelines for clinical trials

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By: nikkuyadav17 (7 month(s) ago)

Excellent presentation, could I please have a copy to teach my CLINICAL RESEARCH DEPARTMENT about the FDA, thanks you regards Ms Nikku yadav Sender nikku.yadav@asu.apeejay.edu

By: gkaseri (21 month(s) ago)

I am Dr. G. K. Aseri (gkaseri@gmail.com) from India and I have seen your presentation today, it is very impressive and gives all basics thinks for Pharmacy students so I will be happy if you could provide me for my students. Regards

By: satishsmahajan (21 month(s) ago)

Very nice presentation Dr. Amit, It would be great if you could send this presentation. My e-mail id is - satishsmahajan@gmail.com Thanks a lot in advance for the help.

By: amolingle23 (24 month(s) ago)

Respected Sir Can you send me the presentation “US-FDA Guidelines for clinical trials” which was published in Author stream. my email-id is amolingle23@gmail.com.

By: malay.ph (25 month(s) ago)

Dear Dr Amit, Can you send me the presentation “US-FDA Guidelines for clinical trials” which was published in Author stream. my email-id is malay.ph@gmail.com.

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Presentation Transcript

US-FDA : 

US-FDA By -Dr Amit Bhatt 9/16/2009 1

FDA : 

FDA The Food and Drug Administration (FDA or USFDA) is an agency of the United States Department of Health and Human Services and is responsible for regulating and supervising the safety of foods, dietary supplements, drugs, vaccines, biological medical products, blood products, medical devices, radiation-emitting devices, veterinary products, and cosmetics. 9/16/2009 2

FDA-Organizations : 

FDA-Organizations The Office of the Commissioner (OC) The Center for Drug Evaluation and Research (CDER) The Center for Biologics Evaluation and Research (CBER) The Center for Food Safety and Applied Nutrition (CFSAN) The Center for Devices and Radiological Health (CDRH) The Center for Veterinary Medicine (CVM) The National Center for Toxicological Research (NCTR) The Office of Regulatory Affairs (ORA) The Office of Criminal Investigations (OCI) 9/16/2009 3

FDA-Legal authoritys : 

FDA-Legal authoritys 1902 – Biologics Control Act 1906 – Pure Food and Drug Act 1938 – Federal Food, Drug, and Cosmetic Act 1944 – Public Health Service Act 1951 – Food, Drug, and Cosmetics Act Amendments 1962 – Food, Drug, and Cosmetics Act Amendments 1966 – Fair Packaging and Labeling Act 1976 – Medical Device Regulation Act 1987 – Prescription Drug Marketing Act 9/16/2009 4

FDA-Legal authoritys : 

FDA-Legal authoritys 1988 – Anti–drug Abuse Act 1990 – Nutrition Labeling and Education Act 1992 – Prescription Drug User Fee Act 1994 – Dietary Supplement Health and Education Act 1997 – Food and Drug Modernization Act 2002 – Bioterrorism Act 2002 – Medical Device User Fee and Modernization Act (MDUFMA) 2003 – Animal Drug User Fee Act 2007 – Food and Drug Administration Amendments Act of 2007 9/16/2009 5

FDA-Regulates : 

FDA-Regulates The FDA regulates almost every face of prescription drugs, including testing, manufacturing, labeling, advertising, marketing, efficacy and safety FDA regulation of cosmetics is focused primarily on labeling and safety. 9/16/2009 6

CFR Title 21 : 

CFR Title 21 CFR Title 21 (Code Of Federal Regulation) - Food and Drugs: Parts 1 to 1499 different types of parts to food, drug , cosmetic and medical devices and etc For Conducting a clinical research on IND different imp parts is their 9/16/2009 7

FDA Guidelines to conduct clinical trials : 

FDA Guidelines to conduct clinical trials 21 CFR part 11- Electronic submission and Electronic signature 21 CFR part 50- Protection of human subjects 21 CFR part 54- Financial Disclosure by Clinical Investigators 21 CFR part 56- Institutional Review Board 21 CFR part 312- Investigational new drug application 21 CFR part 314- Application for FDA Approval to Market a New Drug 9/16/2009 8

21 CFR part 11 : 

21 CFR part 11 Part 11 covers: All aspects of electronic records, including signatures; integrity and authenticity; record creation; audit trails; and archiving Part 11 requires: Electronic records that are "created, modified, maintained, archived, retrieved, or transmitted, must be protected by procedures and controls to "ensure the authenticity, integrity and the confidentiality of electronic records, and to ensure that the signer cannot readily repudiate the document as not genuine." 9/16/2009 9

21 CFR part 11 : 

21 CFR part 11 Part 11 goals : To ensure electronic records and signatures are at least as authentic and traceable as those on paper. 9/16/2009 10

21 CFR part 50 Human Subject Protection : 

21 CFR part 50 Human Subject Protection subpart A - General Provisions subpart B - Informed Consent of Human Subjects subpart C - (Reserved) subpart D - Additional Safeguards for Children in Clinical Investigations 9/16/2009 11

21 CFR part 50 Subpart A General Provisions : 

21 CFR part 50 Subpart A General Provisions 50.1 - Scope. 50.3 - Definitions. 9/16/2009 12

21 CFR part 50.3 Definitions. : 

21 CFR part 50.3 Definitions. IRB ICF All definitions in content of ICF 9/16/2009 13

21 CFR part 50 Subpart B Informed Consent of Human Subjects : 

21 CFR part 50 Subpart B Informed Consent of Human Subjects 50.20 - General requirements for informed consent. 50.21 - Effective date. 50.23 - Exception from general requirements. 50.24 - Exception from informed consent requirements for emergency research 50.25 - Elements of informed consent. 50.27 - Documentation of informed consent. 9/16/2009 14

21 CFR part 50.20 : 

21 CFR part 50.20 General Requirements Legal & effective Opportunity to decide participation/ask questions Understandable language No exculpatory language No waiver of legal rights Privacy 9/16/2009 15

21 CFR part 50.23 : 

21 CFR part 50.23 Exception from general requirements 9/16/2009 16

21 CFR part 50.24 : 

21 CFR part 50.24 Exception from informed consent requirements for emergency research. 9/16/2009 17

21 CFR part 50.25 : 

21 CFR part 50.25 Elements Study involves research Purpose Duration Procedures Risks or discomforts to the subject Benefits Alternate procedures 9/16/2009 18

21 CFR part 50.25 : 

21 CFR part 50.25 Elements cont… Confidentiality statement Compensation Medical treatment Contact for questions and answers, rights emergencies Voluntary participation 9/16/2009 19

21 CFR part 50.25 : 

21 CFR part 50.25 Additional Elements Statement that the procedure may involve risks that are unforeseeable to subject, fetus Anticipated circumstances of withdraw Additional costs Consequences of early withdraw Significant new findings Number of study subjects No preemption of applicable state, local, federal law 9/16/2009 20

21 CFR part 50.27 : 

21 CFR part 50.27 Documentation Written consent approved by the IRB Signed by patient or legal representative Copy given to subject Contains all relevant elements 9/16/2009 21

21 CFR 50 Subpart D Additional Safeguards for Children in Clinical Investigations : 

21 CFR 50 Subpart D Additional Safeguards for Children in Clinical Investigations 50.50 - IRB duties. 50.51 - Clinical investigations not involving greater than minimal risk. 50.52 - Clinical investigations involving greater than minimal risk but presenting the prospect of direct benefit to individual subjects. 50.53 - Clinical investigations involving greater than minimal risk and no prospect of direct benefit to individual subjects, but likely to yield generalizable knowledge about the subjects` disorder or condition. 50.54 - Clinical investigations not otherwise approvable that present an opportunity to understand, prevent, or alleviate a serious problem affecting the health or welfare of children. 50.55 - Requirements for permission by parents or guardians and for assent by children. 50.56 - Wards. 9/16/2009 22

21 CFR part 54 Financial Disclosure : 

21 CFR part 54 Financial Disclosure 54.1 - Purpose. 54.2 - Definitions. 54.3 - Scope. 54.4 - Certification and disclosure requirements. 54.5 - Agency evaluation of financial interests. 54.6 - Record keeping and record retention. 9/16/2009 23

21 CFR part 54- Financial Disclosure : 

21 CFR part 54- Financial Disclosure FDA requires financial disclosure from Principal Investigators, Sub-investigators and their spouses and dependent children, if applicable. If you are listed on the 1572, you will be asked to complete a financial disclosure form at the beginning of the trial (and update the information as relevant, including one year following study completion). 9/16/2009 24

Investigator/Site Responsibilities : 

Investigator/Site Responsibilities FORM FDA 1572: Conduct the study in accordance with the protocol. Notify sponsor otherwise… Personally conduct or supervise the study. Explain the study and possible risks and benefits to subjects and obtain written informed consents prior to subjects’ participation in the study. Inform ALL staff participating in the conduct of the study of their responsibilities. 9/16/2009 25

Investigator/Site Responsibilities : 

Investigator/Site Responsibilities FORM FDA 1572 Cont’d Read and understand ALL relevant study information the protocol the investigator’s brochure, the package inserts Promptly report adverse events to the sponsor and the IRB. Maintain adequate and accurate records and make those available for inspection 9/16/2009 26

Investigator/Site Responsibilities : 

Investigator/Site Responsibilities FORM FDA 1572 Cont’d: Ensure that an IRB complies with the requirements including initial and continuing review and approval Report all changes in research and all unanticipated problems involving risks to the IRB. Will not implement changes in research without IRB approval, except where necessary to eliminate harm to subjects. 9/16/2009 27

Slide 28: 

9/16/2009 28

21 CFR Part 56-Institutional Review Boards : 

21 CFR Part 56-Institutional Review Boards Subpart A - General Provisions Subpart B - Organization and Personnel Subpart C - IRB Functions and Operations Subpart D - Records and Reports Subpart E - Administrative Actions for Noncompliance 9/16/2009 29

21 CFR Part 56 Subpart A General Provisions : 

21 CFR Part 56 Subpart A General Provisions 56.101 - Scope.  56.102 - Definitions.  56.103 - Circumstances in which IRB review is required.   56.104 - Exemptions from IRB requirement.   56.105 - Waiver of IRB requirement. 9/16/2009 30

21 CFR Part 56 Subpart B Organization and Personnel : 

21 CFR Part 56 Subpart B Organization and Personnel 56.107 - IRB membership. 9/16/2009 31

21 CFR Part 56 Subpart C IRB Functions and Operations : 

21 CFR Part 56 Subpart C IRB Functions and Operations 56.108 - IRB functions and operations.    56.109 - IRB review of research.    56.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research.    56.111 - Criteria for IRB approval of research.    56.112 - Review by institution.    56.113 - Suspension or termination of IRB approval of research.    56.114 - Cooperative research. 9/16/2009 32

21 CFR Part 56 Subpart D Records and Reports : 

21 CFR Part 56 Subpart D Records and Reports 56.115 - IRB records. 9/16/2009 33

21 CFR Part 56 Subpart E Administrative Actions for Noncompliance : 

21 CFR Part 56 Subpart E Administrative Actions for Noncompliance 56.120 - Lesser administrative actions.    56.121 - Disqualification of an IRB or an institution.    56.122 - Public disclosure of information regarding revocation.    56.123 - Reinstatement of an IRB or an institution.    56.124 - Actions alternative or additional to disqualification 9/16/2009 34

21 CFR 312 Investigational new drug application : 

21 CFR 312 Investigational new drug application Subpart A - General Provisions Subpart B - Investigations New Drug Application (IND) Subpart C - Administrative Actions Subpart D - Responsibilities of Sponsors and Investigators Subpart E - Drugs Intended to Treat Life Threatening and Severely Debilitating Illnesses Subpart F - Miscellaneous Subpart G - Drugs for Investigational Use in Laboratory Research Animals or in Vitro Tests 9/16/2009 35

21 CFR 312 Subpart A General Provisions : 

21 CFR 312 Subpart A General Provisions 312.1 - Scope.  312.2 - Applicability.  312.3 - Definitions and interpretations.  312.6 - Labeling of an investigational new drug.  312.7 - Promotion and charging for investigational drugs.  312.10 - Waivers. 9/16/2009 36

21 CFR 312 Subpart BInvestigations New Drug Application (IND) : 

21 CFR 312 Subpart BInvestigations New Drug Application (IND) 312.20 - Requirement for an IND. 312.21 - Phases of an investigation. 312.22 - General principles of the IND submission. 312.23 - IND content and format. 312.30 - Protocol amendments. 312.31 - Information amendments. 312.32 - IND safety reports. 312.33 - Annual reports. 312.34 - Treatment use of an investigational new drug. 312.35 - Submissions for treatment use. 312.36 - Emergency use of an investigational new drug. 312.38 - Withdrawal of an IND. 9/16/2009 37

21 CFR 312 Subpart C Administrative Actions : 

21 CFR 312 Subpart C Administrative Actions 312.40 - General requirements for use of an investigational new drug in a clinical investigation. 312.41 - Comment and advice on an IND. 312.42 - Clinical holds and requests for modification. 312.44 - Termination. 312.45 - Inactive status. 312.47 - Meetings. 312.48 - Dispute resolution. 9/16/2009 38

21 CFR 312 Subpart D Responsibilities of Sponsors and Investigators : 

21 CFR 312 Subpart D Responsibilities of Sponsors and Investigators 312.50 - General responsibilities of sponsors. 312.52 - Transfer of obligations to a contract research organization. 312.53 - Selecting investigators and monitors. 312.54 - Emergency research under Sec. 50.24 of this chapter. 312.55 - Informing investigators. 312.56 - Review of ongoing investigations. 312.57 - Recordkeeping and record retention. 312.58 - Inspection of sponsor`s records and reports. 312.59 - Disposition of unused supply of investigational drug. 9/16/2009 39

21 CFR 312 Subpart D Responsibilities of Sponsors and Investigators : 

21 CFR 312 Subpart D Responsibilities of Sponsors and Investigators 312.60 - General responsibilities of investigators. 312.61 - Control of the investigational drug. 312.62 - Investigator recordkeeping and record retention. 312.64 - Investigator reports. 312.66 - Assurance of IRB review. 312.68 - Inspection of investigator's records and reports. 312.69 - Handling of controlled substances. 312.70 - Disqualification of a clinical investigator. 9/16/2009 40

21 CFR 312 Subpart E Drugs Intended to Treat Life Threatening and Severely Debilitating Illnesses : 

21 CFR 312 Subpart E Drugs Intended to Treat Life Threatening and Severely Debilitating Illnesses 312.80 - Purpose. 312.81 - Scope. 312.82 - Early consultation. 312.83 - Treatment protocols. 312.84 - Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and severely-debilitating illnesses. 312.85 - Phase 4 studies. 312.86 - Focused FDA regulatory research. 312.87 - Active monitoring of conduct and evaluation of clinical trials. 312.88 - Safeguards for patient safety. 9/16/2009 41

Section 312.87 Active Monitoring of Conduct and Evaluation of Clinical Trials : 

Section 312.87 Active Monitoring of Conduct and Evaluation of Clinical Trials For drugs covered under this section, the Commissioner and other agency officials will monitor the progress of the conduct and evaluation of clinical trials and be involved in facilitating their appropriate progress. 9/16/2009 42

Sec. 312.88 Safeguards for patient safety. : 

Sec. 312.88 Safeguards for patient safety. All of the safeguards incorporated within parts 50, 56, 312, 314, and 600 of this chapter designed to ensure the safety of clinical testing and the safety of products following marketing approval apply to drugs covered by this section. This includes the requirements for informed consent (part 50 of this chapter) and institutional review boards (part 56 of this chapter). These safeguards further include the review of animal studies prior to initial human testing (Sec. 312.23), and the monitoring of adverse drug experiences through the requirements of IND safety reports (Sec. 312.32), safety update reports during agency review of a marketing application (Sec. 314.50 of this chapter), and postmarketing adverse reaction reporting (Sec. 314.80 of this chapter). 9/16/2009 43

21 CFR 312 Subpart F Miscellaneous : 

21 CFR 312 Subpart F Miscellaneous 312.110 - Import and export requirements. 312.120 - Foreign clinical studies not conducted under an IND. 312.130 - Availability for public disclosure of data and information in an IND. 312.140 - Address for correspondence. 312.145 - Guidance documents. 9/16/2009 44

21 CFR 312 Subpart G Drugs for Investigational Use in Laboratory Research Animals or in Vitro Tests : 

21 CFR 312 Subpart G Drugs for Investigational Use in Laboratory Research Animals or in Vitro Tests 312.160 - Drugs for investigational use in laboratory research animals or in vitro tests. 9/16/2009 45

21 CFR part 314 : 

21 CFR part 314 APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG 9/16/2009 46

21 CFR part 314 Applications For FDA Approval To Market A New Drug : 

21 CFR part 314 Applications For FDA Approval To Market A New Drug Subpart A - General Provisions Subpart B - Applications Subpart C - Abbreviated Applications Subpart D - FDA Action on Applications and Abbreviated Applications Subpart E - Hearing Procedures for New Drugs Subpart F - [Reserved] Subpart G - Miscellaneous Provisions Subpart H - Accelerated Approval of New Drugs for Serious or Life-Threatening Illnesses 9/16/2009 47

21 CFR part 314 Subpart A General Provisions : 

21 CFR part 314 Subpart A General Provisions 314.1 - Scope of this part. 314.2 - Purpose. 314.3 - Definitions. 9/16/2009 48

21 CFR part 314 Subpart B Applications : 

21 CFR part 314 Subpart B Applications 314.50 - Content and format of an application. 314.52 - Notice of certification of invalidity or no infringement of a patent. 314.53 - Submission of patent information. 314.54 - Procedure for submission of an application requiring investigations for approval of a new indication for, or other change from, a listed drug. 314.55 - Pediatric use information. 314.60 - Amendments to an unapproved application. 9/16/2009 49

21 CFR part 314 Subpart B Applications : 

21 CFR part 314 Subpart B Applications 314.65 - Withdrawal by the applicant of an unapproved application. 314.70 - Supplements and other changes to an approved application. 314.71 - Procedures for submission of a supplement to an approved application. 314.72 - Change in ownership of an application. 314.80 - Postmarketing reporting of adverse drug experiences. 314.81 - Other postmarketing reports. 314.90 - Waivers. 9/16/2009 50

21 CFR part 314 Subpart C Abbreviated Applications : 

21 CFR part 314 Subpart C Abbreviated Applications 314.92 - Drug products for which abbreviated applications may be submitted. 314.93 - Petition to request a change from a listed drug. 314.94 - Content and format of an abbreviated application. 314.95 - Notice of certification of invalidity or noninfringement of a patent. 9/16/2009 51

21 CFR part 314 Subpart C Abbreviated Applications : 

21 CFR part 314 Subpart C Abbreviated Applications 314.96 - Amendments to an unapproved abbreviated application. 314.97 - Supplements and other changes to an approved abbreviated application. 314.98 - Postmarketing reports. 314.99 - Other responsibilities of an applicant of an abbreviated application. 9/16/2009 52

21 CFR part 314 Subpart D FDA Action on Applications and Abbreviated Applications : 

21 CFR part 314 Subpart D FDA Action on Applications and Abbreviated Applications 314.100 - Timeframes for reviewing applications and abbreviated applications. 314.101 - Filing an application and receiving an abbreviated new drug application. 314.102 - Communications between FDA and applicants. 314.103 - Dispute resolution. 314.104 - Drugs with potential for abuse. 314.105 - Approval of an application and an abbreviated application. 314.106 - Foreign data. 9/16/2009 53

21 CFR part 314 Subpart D FDA Action on Applications and Abbreviated Applications : 

21 CFR part 314 Subpart D FDA Action on Applications and Abbreviated Applications 314.107 - Effective date of approval of a 505(b)(2) application or abbreviated new drug application under section 505(j) of the act. 314.108 - New drug product exclusivity. 314.110 - Approvable letter to the applicant. 314.120 - Not approvable letter to the applicant. 314.122 - Submitting an abbreviated application for, or a 505(j)(2)(C) petition that relies on, a listed drug that is no longer marketed 9/16/2009 54

21 CFR part 314 Subpart D FDA Action on Applications and Abbreviated Applications : 

21 CFR part 314 Subpart D FDA Action on Applications and Abbreviated Applications 314.125 - Refusal to approve an application. 314.126 - Adequate and well-controlled studies. 314.127 - Refusal to approve an abbreviated new drug application. 314.150 - Withdrawal of approval of an application or abbreviated application. 314.151 - Withdrawal of approval of an abbreviated new drug application under section 505(j)(5) of the act. 314.152 - Notice of withdrawal of approval of an application or abbreviated application for a new drug. 9/16/2009 55

21 CFR part 314 Subpart D - FDA Action on Applications and Abbreviated Applications : 

21 CFR part 314 Subpart D - FDA Action on Applications and Abbreviated Applications 314.153 - Suspension of approval of an abbreviated new drug application. 314.160 - Approval of an application or abbreviated application for which approval was previously refused, suspended, or withdrawn. 314.161 - Determination of reasons for voluntary withdrawal of a listed drug. 314.162 - Removal of a drug product from the list. 314.170 - Adulteration and misbranding of an approved drug. 9/16/2009 56

21 CFR part 314 Subpart E Hearing Procedures for New Drugs : 

21 CFR part 314 Subpart E Hearing Procedures for New Drugs 314.200 - Notice of opportunity for hearing; notice of participation and request for hearing; grant or denial of hearing. 314.201 - Procedure for hearings. 314.235 - Judicial review. 9/16/2009 57

21 CFR part 314 Subpart G Miscellaneous Provisions : 

21 CFR part 314 Subpart G Miscellaneous Provisions 314.410 - Imports and exports of new drugs. 314.420 - Drug master files. 314.430 - Availability for public disclosure of data and information in an application or abbreviated application. 314.440 - Addresses for applications and abbreviated applications. 314.445 - Guidance documents. 9/16/2009 58

21 CFR part 314 Subpart H - Accelerated Approval of New Drugs for Serious or Life-Threatening Illnesses : 

21 CFR part 314 Subpart H - Accelerated Approval of New Drugs for Serious or Life-Threatening Illnesses 314.500 - Scope. 314.510 - Approval based on a surrogate endpoint or on an effect on a clinical endpoint other than survival or irreversible morbidity. 314.520 - Approval with restrictions to assure safe use. 314.530 - Withdrawal procedures. 314.540 - Postmarketing safety reporting. 314.550 - Promotional materials. 314.560 - Termination of requirements 9/16/2009 59

Slide 60: 

Thanks for patient listening 9/16/2009 60