CTTI Publishes Findings on Stakeholder Perceptions of IND Reporting Process in Oncology Trials

CTTI has published its findings on remaining barriers and potential solutions to full implementation of the FDA final rule on IND safety reporting by investigators, clinical research staff, and sponsors.

In 2010, the FDA final rule established new reporting requirements for serious and unexpected suspected adverse events occurring in clinical trials conducted under an IND. Follow-up FDA guidance clarified sponsors’ role and that they should not submit expedited safety reports for individual cases of serious adverse events for which it does not appear the drug caused the event. It was anticipated that these changes could increase the interpretability of safety reports while decreasing the volume and burden of reporting.

Through a series of surveys and interviews, the results of which were published in the journal Clinical Trials, CTTI discovered that while all groups agreed on the intention of the final rule in increasing early communication of safety signals, they also indicated that the rule was not being strictly implemented. Interviewees reported that the major challenges included lack of global harmonization in reporting rules, difficulties determining causality, and fear of regulatory repercussions, some of which could be improved with increased interaction with the FDA itself.

These findings, which resulted from CTTI’s IND Safety Reporting Project, support recommendations developed by CTTI and underpin educational materials created for sponsors to increase compliance with the final rule, and to facilitate discussion between sponsors, investigators, and FDA representatives. CTTI gathered input on these findings and their impact in a multi-stakeholder expert meeting (a meeting summary is available for additional context) and hosted a webinar to provide guidance on handling a variety of safety reporting situations.

CTTI would like to thank the interview participants and project team members who contributed to this work.

Webinar Recording Now Available: CTTI Recommendations for Improving Pediatric Antibacterial Drug Trials

Do you struggle with enrolling babies and children in clinical trials? Are you tired of not having the evidence you need to treat kids with serious infections?

A recording is now available of CTTI’s webinar discussing the new CTTI recommendations on improving antibacterial drug trials for children. Experts from FDA, academia, and pharma described the challenges of conducting pediatric antibacterial drug trials, along with practical, evidence-based strategies to improve the quality and efficiency of these trials. These strategies were developed with input from multiple stakeholders and can be used by research sponsors, investigators, and site staff to make pediatric trials more successful.

View the recording to learn ideas on how you can create better clinical trials for children, such as:

  • Importance of engaging with regulators early and throughout medical product development
  • Methods of streamlining trial design to decrease burden on sites and families
  • Special considerations for conducting trials with neonates
  • Approaches for improving the informed consent process
  • Ways to increase engagement with healthcare providers

 

These recommendations are a result of CTTI’s ABDD Peds Trials Project.

To view recordings of other CTTI webinars, click here.

CTTI Releases New Recommendations to Improve Studies of Antibacterial Drugs for Children

CTTI has released new recommendations to improve the quality and efficiency of research studies used to develop antibacterial drugs for children. In addition, many of the suggested strategies and practices could be applied to streamline clinical trials of other types of drugs and medical devices for children.

“Medically, children are not just little adults, and they need access to treatments that have undergone appropriate evaluation for safety and efficacy in children,” said Daniel Benjamin Jr., MD, PhD, MPH, a pediatric infectious diseases specialist at Duke University. “The CTTI recommendations address many of the common challenges of conducting this research, and if applied widely, can help deliver much-needed information and treatments to benefit our young patients.”

These recommendations resulted from a collaborative effort among research sponsors, parents, investigators, clinicians, and regulators from the US and the EMA (European Medicines Agency), who provided practical suggestions for the timing of pediatric trials, streamlining trial design, facilitating informed consent, and fostering global and community partnerships to conduct trials that can improve children’s health.

The time from approval of a new antibacterial drug for use in adults to pediatric labeling can be 5 years or longer, potentially delaying appropriate use of medicines for this vulnerable group. Antibacterial resistance is on the rise in children, and the very young can be particularly susceptible to severe illness or death from these pathogens. Despite the great need for more treatment options, many trial sponsors have challenges enrolling pediatric patients in antibacterial drug trials.

“These recommendations encourage consultation with the FDA on pediatric study plans early in drug development and emphasize the potential utility of global study networks and streamlining trials,” said Sumathi Nambiar, MD, MPH, Director of the Division of Anti-Infective Products at the U.S. Food & Drug Administration (FDA). “Our mutual goal is to provide data in the drug labeling that will better inform the safe and effective use of antibacterial drugs in children.”

The CTTI recommendations are meant to  help researchers design trials that are less burdensome for families, as well as to support  improved practices for approaching parents for consent during the stressful time of a child’s illness. These recommendations are based on research that showed 80% of clinicians surveyed identified parent concerns about their child participating in research to be a barrier for completing research studies with children. This emphasizes the need for better engagement with parents throughout a clinical trial, including during the initial design stage. “This work matters to the lives of families like mine,” said Breck Gamel, a parent participant in the CTTI effort. CTTI studied other clinician concerns as well, which helped to identify educational gaps in pediatric labeling and the need for better engagement with other healthcare providers.

*These recommendations are the result of CTTI’s ABDD Peds Trials Project.

**To read this press release in full, click here.

Webinar February 16: Improving Pediatric Antibacterial Drug Trials

Challenges in conducting antibacterial drug trials for pediatric patients can delay the safe and effective use of treatments for this vulnerable group.  There are now evidence-based, consensus-driven solutions. Are you ready to do better clinical trials for children?

Join us for a special webinar in which CTTI will unveil new recommendations for improving pediatric antibacterial clinical trials:

Add to Calendar

Title: CTTI Recommendations from the Antibacterial Drug Development (ABDD) Peds Trials Project
Date: February 16, 2016 12:00 – 1:00 PM EST (GMT-05:00)
Webinar Link: http://bit.ly/2kYGm7j
Speakers:

  • Sumathi Nambiar, U.S. Food and Drug Administration
  • John Bradley, University of California, San Diego
  • Gary Noel, Johnson and Johnson Pharmaceutical Research and Development

The webinar will include practical, evidence-based strategies that can be applied by research sponsors, investigators, and site staff to improve the quality and efficiency of pediatric antibacterial trials.

Learn these tips and more for making your trials more successful:

  • Importance of engaging with regulators early and throughout medical product development
  • Methods of streamlining trial design to decrease burden on sites and families
  • Special considerations for conducting trials with neonates
  • Approaches for improving the informed consent process
  • Ways to increase engagement with healthcare providers

Although developed in the context of antibacterial drug development, many of the recommendations can be applied to improve pediatric clinical trials in multiple therapeutic areas.

This webinar is open to the public. Please feel free to share this invitation with your colleagues.

Improve Electronic Portals for IND Safety Reporting With CTTI’s Recommendations

CTTI’s latest research indicates that a single, internet-based portal for investigator reporting of expedited IND safety information to sponsors would be better than the current system of each sponsor having a separate portal. However, until use of a central portal is feasible, the recently published findings and CTTI recommendations provide desired attributes that can promote consistent functionality across electronic portals, improving the quality and use of these systems.

Electronic portals can increase efficiency and lower costs associated with processing safety reports in clinical trials, as well as add an element of security. However, there can be challenges associated with use of these systems that prevent successful adoption. CTTI’s IND Safety Advancement Project sought to identify obstacles and to create recommendations for best practices for following FDA requirements and guidance on expedited safety reporting. Electronic portals are one method sites and sponsors can implement to help adhere to FDA requirements and improve the quality of safety reports.

The recommendations for electronic portals for IND safety reporting are based on results from interviews with research staff, along with multi-stakeholder input on how to address the challenges raised. For example, CTTI found that many research staff report difficulties in tracking multiple passwords and managing different interfaces for various sponsor portals. These research staff views helped to inform strategies that could decrease the burden of IND safety reporting in clinical trials.

For those in the clinical trials enterprise seeking to streamline IND safety reporting, additional recommendations are available from CTTI to improve IND safety assessment and communication.

JAMA Publishes CTTI’s Recommendations for Data Monitoring Committees

New PublicationsAn article describing key points from CTTI’s Recommendations for Data Monitoring Committees (DMCs) appears in this week’s edition of JAMA. As independent bodies able to review accumulating data for ongoing clinical trials, DMCs fulfill a unique and vital role in ensuring the scientific integrity and safety of clinical trials.

The article details the following:

  • The unequivocal need for DMCs to review unmasked data
  • The importance of DMCs reviewing safety and efficacy data together
  • Appropriate qualifications for DMC members

With the growing use of DMCs for trial oversight, these evidence-based best practices for DMC establishment and conduct can help ensure proper DMC functioning to fulfill their mission. CTTI is pleased to see these recommendations reach a broad audience and is encouraging widespread implementation.

View CTTI’s complete recommendations for additional consensus-driven best practices for DMCs.

To learn more about CTTI’s DMCs Project, CLICK HERE.

New Insights on Data Monitoring Committees Published in Clinical Trials

New PublicationCTTI has published a new article in Clinical TrialsUnderstanding the Functions and Operations of Data Monitoring Committees: Survey and Focus Group Findings.

This article shares insights gathered from research with clinical trial sponsors, data monitoring committee (DMC) members, regulators, and other stakeholders. The results were used in the development of CTTI’s official recommendations to improve the functioning of DMCs and quality of trial oversight.

Read this publication for key findings in the areas of:

  • The role of DMCs and when they are needed
  • Typical DMC composition and methods for identification of members
  • Practices for DMC charters, member contracts, and meetings
  • Methods for enhancing DMC communications
  • Views on DMC member qualifications and ways to develop training

To learn more about CTTI’s DMCs Project, CLICK HERE.