Transcript By: Kris Traver and Nitin Jain Goals and Objectives  To understand:  The affect of Good Clinical Practices on institutions conducting.

By: Kris Traver and Nitin Jain
Goals and Objectives
 To understand:
 The affect of Good Clinical Practices on institutions conducting Clinical
Research
 To discuss:
 What is GCP
 Guidelines for GCP
 The history of Good Clinical Practices
 Basic principles
 Practices and strategy for staying compliant with Good Clinical Practices.
What Is GCP?
Good Clinical Practice (GCP) is defined as a
‘standard for the design, conduct, performance,
monitoring, auditing, recording, analyses and
reporting of clinical trials that provides
assurance that the data and reported results
are credible and accurate, and that the rights,
integrity and confidentiality of trial subjects are
protected’
Good Clinical Practice Guidelines
 Are mainly focused on the protection of human rights
in clinical trial.
 Provide assurance of the safety of the newly developed
compounds.
 Provide standards on how clinical trials should be
conducted.
 Define the roles and responsibilities of clinical
sponsors, clinical research investigators, Clinical
Research Associates, and monitors.
Good Clinical Practice Guidelines
(Continued)
 GCPs are generally accepted, international best practices for
conducting clinical trials and device studies
 They are defined as an international ethical and
scientific standard for designing, conducting, recording
and reporting trials that involve the participation of
human subjects
 Compliance with GCPs provide public assurance that the
rights and safety of participants in human subject
research are protected and that the data that arises from
the study is credible
The Core of the Consolidated GCP
Guidance
1 Clinical trials should be conducted in accordance with the ethical
principles that have their origin in the Declaration of Helsinki, and that
are consistent with GCP and the applicable regulatory requirements
2 Before a trial is initiated, foreseeable risks and inconveniences should
be weighed against the anticipated benefit for the individual trial
subject and society. A trial should be initiated and continued only if the
anticipated benefits justify the risks
3 The rights, safety, and well-being of the trial subjects are the most
important considerations and should prevail over interests of science
and society
4 The available non clinical and clinical information on an investigational
product should be adequate to support the proposed clinical trial
5 Clinical trials should be scientifically sound, and described in a clear,
detailed protocol
6 A trial should be conducted in compliance with the protocol that has
received prior institutional review board (IRB)/independent ethics
committee (IEC) approval/favorable opinion
7 The medical care given to, and medical decisions made on behalf of,
subjects should always be the responsibility of a qualified physician or,
when appropriate, of a qualified dentist
Thirteen principles of GCP
Guidance
8 Each individual involved in conducting a trial should be
qualified by education, training, and experience to perform his
or her respective tasks
9 Freely given informed consent should be obtained from every
subject prior to clinical trial participation
10 All clinical trial information should be recorded, handled, and
stored in a way that allows its accurate reporting, interpretation,
and verification
11 The confidentiality of records that could identify subjects should
be protected, respecting the privacy and confidentiality rules in
accordance with the applicable regulatory requirements
12 Investigational products should be manufactured, handled, and
stored in accordance with applicable good manufacturing
practice (GMP). They should be used in accordance with the
approved protocol
13 Systems with procedures that assure the quality of every aspect of
the trial should be implemented
History of Good Clinical Practice
 Prior to an actual set of guidelines to follow for good
clinical practice, clinical studies were dangerous and
could result in serous disease, or possibly death
 The Nuremburg Code of 1947
Experiments performed in germany during WWII opened the eyes of the world for
guidance for clinical testing on humans.
 The code did set ethical guidelines, but it lacked legislation to back it up.

 Declaration of Helsinki

In 1964, the World Medical Association established recommendations
guiding medical doctors in biomedical research involving human
subjects. These guidelines influenced national legislation, but there was
no set standard between nations
History of Good Clinical Practice
(Continued)
 The formation of the International Conference on
Harmonization (ICH) led to the creation of the Consolidated
Guidance on GCP
 The ICH consisted of the governments of the United
States, EU and Japan coming together to develop
common regulations for the pharmaceutical markets
among member countries
Mission of the GCP Program
 The Good Clinical Practice Program is the focal point
within FDA regarding issues in human research trials
regulated by FDA. The Good Clinical Practice Program:
 Coordinates FDA policies
 Contributes to leadership and direction through participation
in FDA's Human Subject Protection/Bioresearch Monitoring
Council
 Coordinates FDA's Bioresearch Monitoring program with
respect to clinical trials, working together with FDA's Office
of Regulatory Affairs (ORA)
 Contributes to international Good Clinical Practice
harmonization activities
 Plans and conducts training and outreach programs
Under GCP, the FDA Requires That
People be Informed:
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The study involves research of an unproven drug, the purpose
of the research
How long the participant will be expected to participate in the
study
What will happen in the study
Possible risks/benefits to the participant
Participation is voluntary and that participants can quit the
study at any time without penalty or loss of benefits to which
they are otherwise entitled.
Procedures During a Clinical Trial?
 New drug research starts by studying how the body functions at
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

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its most basic levels.
The first series of tests are on performed on Human enzymes and
proteins to observe the basic effect.
Next, the drug must be tested in living animals to ensure safety
for human consumption.
With this, drug companies make every effort to use as few
animals as possible and ensure they are properly cared for.
Then a protocol is created to map out what study procedures will
be done, by whom, and why within a clinical trial.
What Happens in a Clinical Trial?
(Continued)
 The trials are conducted in 4 phases.
 Phase 1 trials are for determining dosing, document
how a drug is metabolized and identify side effects.
 Phase 2 trials gather further safety data and evidence
of the drug's efficacy.
 Phase 3 further tests the product's effectiveness on a
greater number of participants, and monitors side
effects.
 Phase 4 trials can be conducted after a product is
already approved and on the market to find out more
about the treatment's long-term risks
What Happens in a Clinical Trial?
(Continued)
 It is estimated that only 5 in 5,000 compounds that
enter preclinical testing make it to human testing, and
only 1 of those 5 may be safe and effective enough to
reach pharmacy shelves.
Further Information
 http://www.youtube.com/watch?v=ZiTBO8I9oBY.
References
 http://www.fda.gov/
 http://en.wikipedia.org/wiki/ICH-GCP
 http://www.youtube.com/watch?v=ZiTBO8I9oBY.
Questions?
That’s Enough For Today