Comments invited on a concept paper on changes intended to support best practices
The European Medicines Agency (EMA), in cooperation with the European Commission and the Member States of the European Union (EU), is proposing changes to current guidance on first-in-human clinical trials to improve strategies to identify and mitigate risks to trial participants.
These changes are outlined in a new concept paper released for public consultation. Comments should be sent to FIHfirstname.lastname@example.org by 30 September.
Clinical trials are essential for the development of medicines and without them patients cannot gain access to new potentially life-saving medicines, the Agency says. EU and international guidelines are in place to ensure that first-in-human clinical trials are conducted as safely as possible.
The guidelines include the requirement for extensive studies, including in animals, to gather information about a medicine before it is given to humans.
This concept paper and the comments received from stakeholders will form the basis for an update of the guideline
The release of the concept paper is part of a review of the EMA guideline published in 2007 that provides advice on first-in-human clinical trials, in particular on the data needed to enable their appropriate design and allow the initiation of treatment in trial participants.
This review identified those parts of the current guideline which need to be amended to take into account the evolution of practices in the conduct of these studies since 2007. It also takes into account the lessons learned from the tragic incident which took place during a Phase I first-in-human clinical trial in Rennes, France, in January 2016.
In recent years, the practice for conducting first-in-human clinical trials has evolved towards a more integrated approach, with sponsors conducting several steps of clinical development within a single clinical trial protocol (e.g. to assess single and multiple ascending doses, food interactions, or different age groups). This responds to the need for a structured approach to the conduct of these trials, with incremental decisions on next steps based on the data collected at each previous step. This enables an approach designed for the specificities of each medicine, its mechanism of action, and intended therapeutic use.
The concept paper, setting out the proposed changes to the guideline, was prepared by an EU-wide expert group that includes experts from the national competent authorities who authorise clinical trials in the EU and it was adopted by the Committee for Medicinal Products for Human Use (CHMP). It addresses the increased complexity of the protocols of first-in-human clinical trials.
This concept paper and the comments received from stakeholders will form the basis for an update of the guideline. A draft revised guideline is expected to be published before the end of 2016 for consultation.