Investigators from Multiple U.S. Organizations Collaborate on First Embedded Pragmatic Clinical Trial Using National Health Plans’ Data

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CTTI Project: Electronic Healthcare Data

Today, at the ESC Congress 2020 – The Digital Experience, a group of U.S. investigators from several organizations announced their collaborative findings from the Implementation of a randomized controlled trial to imProve treatment with oral AntiCoagulanTs in patients with Atrial Fibrillation (IMPACT-AFib), the first trial to use the U.S. Food and Drug Administration’s (FDA) FDA-Catalyst System network of electronic health data from a diverse group of national health plan data partners.

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CTTI to Support NIH Workgroup in Developing Evaluation Plan for Single IRB Policy

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CTTI Project: Single IRB

The National Institutes of Health (NIH) has selected the Clinical Trials Transformation Initiative (CTTI) to support a workgroup that will develop a comprehensive plan for assessing the NIH’s new single institutional review board (sIRB) policy. The policy, which became effective in January, requires U.S. sites participating in nonexempt multicenter human subjects research funded by the NIH to use a sIRB for ethical review, with the goal of improving the quality and efficiency of clinical research.

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Use of Central IRBs for Multi-center Clinical Trials

APRIL 25, 2012 TO APRIL 26, 2012

CTTI Project: Single IRB

Meeting Background:

The willingness of institutions to defer full local institutional review board (IRB) review and approval to a central IRB in multi-center trials continues to vary, despite a 2006 U.S. Food and Drug Administration (FDA) guidance and a more recent endorsement by the U.S. Office for Human Research Protections recommending this approach. The goal of the CTTI project is to identify potential solutions to address barriers to the adoption of central IRBs for multi-center clinical trials.

Meeting Objectives:

  • Present research findings from the CTTI project entitled, Use of Central IRBs for Multi-center Clinical Trials
  • Discuss research findings among experts present at the meeting
  • Solicit additional feedback to refine proposed solutions

Meeting Location:

Hilton Washington DC/Rockville Executive Meeting Center, Rockville, MD

Meeting Materials:

Meeting Summary

Meeting Agenda

List of meeting attendees

*The views and opinions expressed in this presentation are those of the individual presenter and should not be attributed to the Clinical Trials Transformation Initiative, or any organization with which the presenter is employed or affiliated.

Expert Meeting: CTTI IND Safety Advancement Project

JULY 21, 2015 TO JULY 22, 2015

CTTI Project: Safety Reporting

Meeting Objectives

  • Present findings and conclusions from the project evidence gathering activities
  • Discuss opportunities for improving the efficiency and value of the expedited IND safety reporting process
  • Understand opportunities for educating stakeholders on expedited IND safety reporting best practices

Meeting Location:

DoubleTree by Hilton Hotel Washington, D.C., Silver Spring, MD

Meeting Presentations:

Click here to view the presentation slides from this meeting.

The views and opinions expressed in this presentation are those of the individual presenter and should not be attributed to the Clinical Trials Transformation Initiative, or any organization with which the presenter is employed or affiliated.

Expert Meeting: IND Safety Assessment and Communication

FEBRUARY 28, 2012 TO FEBRUARY 29, 2012

CTTI Project: Safety Reporting

Meeting Background:

Since its inception, the Clinical Trials Transformation Initiative (CTTI) has had an interest in improving the quality and efficiency of safety reporting for serious adverse events (SAE) in studies performed under investigational new drug applications (INDs). CTTI’s first project on this topic focused on expedited safety reporting of serious, unexpected and possibly related SAEs to site investigators in multi-center trials. At the project’s conclusion, CTTI recommended that sponsors decrease the volume of uninterpretable and irrelevant safety reports to investigators, and instead supply investigators with meaningful reports that would improve investigators’ understanding of a drug’s benefit-risk profile. These recommendations were developed immediately prior to the FDA issuing a new final rule on safety reporting for drugs being studied under INDs.

FDA’s new IND safety reporting rule, published in the Federal Register on September 29, 2010, became effective on March 28, 2011. The intent of the new rule is to improve the quality of safety reports by minimizing the number of uninterpretable reports that sponsors submit to FDA and investigators. This is consistent with CTTI’s recommendations described above. However, CTTI members have expressed concern that there may be some uncertainty about the best methods to implement the new rule. For this reason, CTTI formed a new project entitled “IND Safety Assessment and Communication,” with the goal of promoting responsible oversight of safety for pre-market drug products consistent with the intent of the FDA’s new IND safety rule. The project objectives are as follows:

  • To obtain a deeper understanding of sponsors’ current practices for assessing safety of a pre-market drug product across all trials and sources of safety information and for communicating potential safety signals
  • To facilitate an informed discussion of practices and challenges in assessing and communicating IND safety information
  • To issue recommendations for future approaches that will support the intent of the IND safety reporting rule effective March 2011

The project team first surveyed industry sponsors to obtain a deeper understanding of their current practices. CTTI then distributed anonymized survey results to a group of experts that included representatives from each sponsor organization that completed the survey, government (NIH, Department of Veterans’ Affairs, and FDA), academia, and patient advocacy. These experts participated in a meeting convened on February 28-29, 2012 in Bethesda, MD. A subgroup of attendees at this meeting were members of a biostatistics workgroup that the CTTI project team formed to advise on the methodological dilemmas related to implementing the new IND Safety Reporting rule.

Meeting Objectives:

  • Findings from the survey of sponsor practices
  • Companies’ strategies for implementing the new IND safety reporting rule
  • Challenges in implementing the new rule

Meeting Location:

Bethesda, Maryland