HHS, NIH to enhance transparency of clinical trial results
The U.S. Department of Health and Human Services has issued a Notice of Proposed Rulemaking (NPRM), which proposes regulations to reporting requirements for clinical trials subject to Title VIII of the Food and Drug Administration Amendments Act of 2007 (FDAAA).
The proposed rule clarifies requirements to clinical researchers for registering clinical trials and submitting summary trial results information to ClinicalTrials.gov, a publicly accessible database operated by the National Library of Medicine, part of the NIH. A major proposed change from current requirements is the expansion of the scope of clinical trials required to submit summary results to include trials of unapproved, unlicensed and uncleared products.
"Medical advances would not be possible without participants in clinical trials," said Francis S. Collins, M.D., Ph.D., NIH director. "We owe it to every participant and the public at large to support the maximal use of this knowledge for the greatest benefit to human health. This important commitment from researchers to research participants must always be upheld."
ClinicalTrials.gov currently contains registration information for more than 178,000 clinical trials and summary results for more than 15,000. These numbers include trials that are not subject to FDAAA. Among the primary benefits of registering and reporting results of clinical trials, including both positive and negative findings, is that it helps researchers prevent unnecessary duplication of trials, particularly when trial results indicate that a product under study may be unsafe or ineffective, and it establishes trust with clinical trial participants that the information from their participation is being put to maximum use to further knowledge about their condition.
Developed by NIH in close coordination with the FDA, the proposed rule details procedures for meeting the requirements established by FDAAA to improve public access to clinical trial information. FDAAA and the proposed rule apply to certain interventional studies of drugs, biological products and devices regulated by the FDA but, generally, not to phase I trials of drugs and biological products and small feasibility studies of devices. The proposed rule specifies how data collected and analyzed in a clinical trial would be required to be submitted to ClinicalTrials.gov. It would not affect requirements for the design or conduct of clinical trials or for the data that must be collected during clinical trials.
"This proposed rule would close an important gap, making additional information about clinical studies of investigational drugs, medical devices and biological products available to the public," said Margaret A. Hamburg, M.D., FDA commissioner. "It would help eliminate unnecessary duplicative trials, advance biomedical innovation and provide the public with a much richer understanding about the clinical trials for these products."
Notable changes from current requirements and practice outlined in the proposed rule include:
- A streamlined approach for determining which trials are subject to the proposed regulations and who is responsible for submitting required information
- Expansion of the set of trials subject to summary results reporting to include trials of unapproved products
- Additional data elements that must be provided at the time of registration (not later than 21 days after enrolling the first participant) and results submission (generally not later than 12 months after completion)
- Clarified procedures for delaying results submission when studying an unapproved, unlicensed or uncleared product or a new use of a previously approved, licensed or cleared product, and for requesting extensions to the results submission deadline for good cause
- More rapid updating of several data elements to help ensure that users of ClinicalTrials.gov have access to accurate, up-to-date information about important aspects of a clinical trial
- Procedures for timely corrections to any errors discovered by the responsible party or by the agency as it processes submissions prior to posting.