Professional Documents
Culture Documents
Good Clinical Practices: Guilin, PRC
Good Clinical Practices: Guilin, PRC
Practices
Guilin, PRC
Dr AJ van Zyl
for
Quality Assurance and Safety: Medicines
Medicines Policy and Standards
Health Technology and Pharmaceuticals Cluster
World Health Organization
Program
Thursday:
Presentation on guidelines:
GCP, GLP, CRO
Group sessions
Clinical and bio-analytical
Friday:
Presentation on GMP
Group sessions
Presentation on GMP
Group sessions
Outline of presentation
Bio-equivalence studies
Good Clinical Practices (GCP)
Good Practices for Quality Control
Laboratories (GPQCL)
Good Laboratory Practices (GLP)
Good Practices for Contract Research
Organizations (GPCRO)
Guidelines
GCP
GLP
UNDP/World Bank/WHO
Special Programme for Research and Training in
Tropical Diseases (TDR)
HANDBOOK GOOD LABORATORY PRACTICE (GLP)
CRO
GCP
4. RESPONSIBILITIES OF THE INVESTIGATOR
4.1 Medical care of trial subjects
4.2 Qualifications
4.3 Selection of trial subjects
4.4 Compliance with the protocol
4.5 Information for subjects and informed consent 4.6The
investigational product
4.7 The trial site
4.8 Notification of the trial or submission to the DRA 4.9
Review by an ethics committee
4.10 Serious adverse events or reactions
4.11 Financing
4.12 Monitoring, auditing and inspection
4.13 Record-keeping and handling of data
4.14 Handling of and accountability for pharmaceutical
products for trial
4.15 Termination of trial
4.16 Final report
4.17 Trials in which the investigator is the sponsor
GCP
5. RESPONSIBILITIES OF THE SPONSOR
5.1 Selection of the Investigator(s)
5.2 Delegation of responsibilities
5.3 Compliance with the protocol and procedures 5.4
Product information
5.5 Safety information
5.6 Investigational product
5.7 Trial management and handling of data
5.8 Standard operating procedures
5.9 Compensation for subjects and investigators 5.10
Monitoring
5.11 Quality assurance
5.12 Study reports
5.13 Handling of adverse events
5.14 Termination of trial
GCP
6. RESPONSIBILITIES OF THE MONITOR
6.1 Qualifications
6.2 Assessment of the trial site
6.3 Staff education and compliance
6.4 Data management
6.5 Case-report forms
6.6 Investigational product
6.7 Communication
6.8 Notification of the trial or submission to the
regulatory authority
6.9 Reports
7. MONITORING OF SAFETY
7.1 Handling and recording adverse events
7.2 Reporting adverse events
8. RECORD-KEEPING AND HANDLING OF DATA
8.1 Responsibilities of the investigator
8.2 Responsibilities of the sponsor and the monitor
8.3 Archiving of data
GCP
9. STATISTICS AND CALCULATIONS
9.1 Experimental design
9.2 Randomization and blinding
9.3 Statistical analysis
10. HANDLING OF AND ACCOUNTABILITY FOR
PHARMACEUTICAL PRODUCTS
10.1 Supply and storage
10.2 Investigational labelling and packaging
10.3 Responsibilities of the investigator
10.4 Responsibilities of the sponsor and the monitor
11. ROLE OF THE DRUG REGULATORY AUTHORITY
11.1 General responsibilities
11.2 On-site inspections
12. QUALITY ASSURANCE FOR THE CONDUCT OF A
TRIAL
CLINICAL
GPQCL
GLP
CHARACTERIZATION6
The test item
Test system
DOCUMENTATION RAW DATA AND DATA COLLECTION
Carrying out procedures and recording observations
Records and recording
QUALITY ASSURANCE UNIT
Protocol (or study plan) review
SOP review
Planning (Master schedule, inspection plan)
Audits and inspections
Quality assurance statement
QAU inspections of suppliers and contractors
The distribution and archiving of QAU files and reports
Guidelines
This presentation will focus on guidelines for
CROs, then GCP and GLP
What is a CRO:
WHO: "any organization involved in the
conduct or analysis of in vivo
bioequivalence studies".
Per ICH Tripartite Harmonized Guidelines: "a
person or an organization (commercial,
academic or other) contracted by the
sponsor to perform one or more of a
sponsor's trial-related duties and
functions"
Research Organizations
Scope: Guidance to organizations involved
in the conduct and analysis of in vivo
bioequivalence (BE) studies
Note:
BE studies should be performed in
compliance with:
General regulatory requirements
Good practices in the WHO bioequivalence guideline,
Good clinical practice (GCP)
Good laboratory practices (GLP)
Research Organizations
Guideline provides information on:
-
Research Organizations
ORGANIZATION & MANAGEMENT
COMPUTER SYSTEMS
Hardware
Software
Data Management
ARCHIVE FACILITIES
PREMISES
CLINICAL PHASE
CLINICAL LABORATORY
PERSONNEL
QUALITY ASSURANCE
Research Organizations
ETHICS COMMITTEE
Informed Consent
MONITORING
INVESTIGATORS
RECEIVING, STORAGE AND HANDLING
OF INVESTIGATIONAL DRUG PRODUCTS
CASE REPORT FORMS
VOLUNTEERS, RECRUITMENT METHODS
DIETING
Research Organizations
SAFETY, ADVERSE EVENTS, ADVERSE
EVENT REPORTING
SAMPLE COLLECTION, STORAGE AND
HANDLING OF BIOLOGICAL MATERIAL
LABORATORY PHASE (BIOANALYTICAL
DATA)
DOCUMENTATION
PHARMACOKINECTIC & STATISTICAL
CALCULATIONS
CLINICAL STUDY REPORT
Research Organizations
Organization and management
Legal requirements
Organization chart
Key positions, names,
authorized
Job descriptions and
responsibilities
List of signatures
Research Organizations
Computer systems
Hardware
Sufficient
Data entry and handling,
calculations, reports
Capacity and memory
Access control
Software
Suitable program
Written procedures: program,
virus tests, archiving, back-ups
Research Organizations
Software can manage:
Word processing,
Data entry,
Databases,
Graphics,
Pharmacokinetics and
Statistical programmes
Computer systems validated
Research Organizations
Data management:
Research Organizations
ARCHIVE FACILITIES
Sufficient and appropriately secure storage
space, fire proof, archiving trial-related
documentation and product samples
SOP for archiving.
Access to areas restricted and
controlled
Archiving period
- documentation including raw data
- product samples retained
- defined in the SOP
Research Organizations
PREMISES
Conditions to ensure (consideration)
adequate safety for the subjects
stage of development of the product
potential risk involved
Sufficient space (personnel and activities)
Adequate facilities, including laboratories
Clinical phase:
Areas well organized, activities in
order
Entry restricted and controlled
logical
Research Organizations
Laboratories with sufficient space to avoid mixups, contamination and cross-contamination,
adequate, suitable storage space for samples,
standards, solvents, reagents and records.
Alarm system or adequate monitoring system
to control the temperature of the critical stage
areas.
Automatic alarm system tested regularly
Daily monitoring and all the alarm checks
should be documented.
Access to telephone, E-mail and facsimile
facilities to ensure proper communication and
necessary office equipment (printer, copymachine) to perform the required activities
Research Organizations
Clinical Phase
Sufficient space
Where appropriate, beds should be
available (overnight stay/ type of trial/
investigational drug)
Facilities for:
changing and storing clothes
Washing and toilets - easily
accessible and appropriate
Research Organizations
Research organizations
CLINICAL LABORATORY
A qualified clinical laboratory for analysing
the screening samples.
As per protocol: Haematological tests,
urine analysis and other tests
Information about analytical methods used,
a dated list of laboratory normal ranges
and accreditation certificate of the
laboratory, if available.
Curriculum vitae of the responsible analyst
Actual original results (including raw-data)
of all the tests performed should be
documented and should be included in the
CRFs
Research organizations
PERSONNEL
Sufficient number of qualified personnel
Key persons with appropriate responsibilities:
Medical/Scientific director
Principal investigator
Quality assurance manager
Technical manager
Quality Control manager
Research organizations
QUALITY ASSURANCE
Appropriate quality assurance (QA) system
QA unit responsible for:
Verifying all activities;
The CRO should allow the sponsor to monitor the studies and to
perform audits of the clinical and analytical study and sites
Research organizations
ETHICS COMMITTEE
Trials approved beforehand
Independent from the promoter, the investigator, the
CRO
Discussions, recommendations and decisions in
detailed minutes of the meeting
Sufficient time for reviewing protocols and ICFs
Informed consent
Language and a level understandable
Both orally and in writing
Given by the subject, documented, before start
Participation is voluntary, the right to withdraw without
having to give a reason
Compensation paid pro rata temporis
If reasons given, included in the study records
Subject access to information about insurance, and
other procedures for compensation or treatment
Research organizations
MONITORING
Note: Monitoring is an essential part of the clinical trial.
Qualified monitor
Ensure compliance with the protocol, GCP, GLP and
applicable ethical and regulatory requirements
Completion of CRFs and verification of the accuracy of
data obtained
Pre- and post-study visit as well as a monitoring visit
during the conduct of the trial
Written report after each site visit
CRO: SOPs concerning the visit procedures, extent of
source data verification, drug accountability and
adherence to the protocol.
Monitor: SOPs (with checklists)
- initiation visit, routine monitoring visits and a closing
visit
Research organizations
INVESTIGATORS
Research organizations
RECEIVING, STORAGE AND HANDLING OF INVESTIGATIONAL
DRUG PRODUCTS
Records:
for receipt, storage, handling and accountability of
investigational and comparator products all stages of the
trial.
Information about:
the shipment, delivery, receipt, storage (including storage
conditions), dispensing, administration, reconciliation, return
and/or destruction
Product used:
dosage form and strength, lot number, expiry date, and other
coding that identifies the specific characteristics of the product
tested.
Research organizations
RECEIVING, STORAGE AND HANDLING OF
INVESTIGATIONAL DRUG PRODUCTS
Research organizations
CASE REPORT FORMS
Research organizations
VOLUNTEERS, RECRUITMENT METHODS
Note: Pool of healthy volunteers - medically tested and selected.
Informed consent for any screening procedures
required to determine eligibility for the study, in
addition to informed consent for participation in
the research portion of the study.
Subject selection criteria (inclusion and exclusion
criteria) and recruitment procedures should be
described in the clinical trial protocol.
Research organizations
DIETING
Meals can significantly affect absorption of drugs
Research organizations
SAFETY, ADVERSE EVENTS, ADVERSE EVENT REPORTING
Research organizations
SAMPLE COLLECTION, STORAGE AND HANDLING OF
BIOLOGICAL MATERIAL
Research organizations
SAMPLE COLLECTION, STORAGE AND HANDLING OF
BIOLOGICAL MATERIAL
System failure.
Storage and retrieval of samples
Duplicate or backup samples - stored and
shipped separately.
Local requirements for the handling and
destruction
Research organizations
BIOANALYTICAL DATA (LABORATORY PHASE)
Note: Same CRO or contracted to another laboratory or CRO
Research organizations
Research Organizations
DOCUMENTATION
All original analytical raw data (e.g. calculations,
chromatograms, etc.) documented
Research Organizations
PHARMACOKINETIC AND STATISTICAL CALCULATIONS
Research Organizations
CLINICAL STUDY REPORT
Research Organizations
CLINICAL STUDY REPORT
Research Organizations
GCP
WHO Technical Report Series, No. 850, 1995 (pp.
97-137)
GLP
OECD Principles on Good Laboratory Practice (as
revised in 1997). Organization for Economic
Co-operation and Development.
ENV/MC/CHEM(98)17. 26.Jan, 1998
International Conference on Harmonization (ICH)
Guidelines. Tripartite Harmonized Guidelines
on Good Clinical Practice, Step 4, May 1996.
Program
Group sessions
Clinical
Bio-analytical