Yasuyuki_Sahara

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MHLW’s Measures to Ensure
the Reliability of Investigator-Initiated
Clinical Trials

Ministry
 of
 Health,
 Labour
 and
 Welfare
 
For
 people,
 for
 life,
 for
 the
 future
 
Yasuyuki
 Sahara
 (MD,
 MPH)
 
Director,
 Research
 and
 Development
 Division,
 
 
Health
 Policy
 Bureau
 
Ministry
 of
 Health,
 Labour
 and
 Welfare,
 JAPAN
 
28
 February
 
 -­‐1
 March,
 2013,
 Tokyo,
 Japan

Health
 Research

Overview
 of
 Japanese
 Regula3ons
 on
 Health
 Research
 
 
 
IntervenOonal
 studies
 intended
 for
 
applicaOon
 for
 markeOng
 approval
 of
 
drugs
 and
 medical
 devices;
 under
 
PharmaceuOcal
 Affairs
 Law
 (PAL)

• IntervenOonal
 studies
 
 
• ObservaOonal
 studies
 
• Human
 Genome/Gene
 Analysis
 
Registration Purpose
Academic Purpose (other than Registration)

Clinical
 Trials

InvesOgator-­‐iniOated
 
Health
 Research
 
Investigator-
initiated
CTs
Company-
initiated
CTs

Clinical
 Trials
 
 under
 PAL

2

J-­‐GCP*
 
 
based
 on
 ICH-­‐GCP
 

 
Major
 Guidelines
 for
 Health
 Research
 in
 Japan
 

Is
 the
 purpose
 collecOng
 data
 for
 the
 applicaOon
 of
 
markeOng
 approval
 of
 drugs
 or
 medical
 devices?

Clinical
 Research
 outside
 of
 PAL
Clinical
 Trials
 under
 
PharmaceuOcal
 
Affairs
 Law
 (PAL)
Human
 Stem
 
Cell
 Clinical
 
Trials

Yes
No

Gene
 Therapy
 
Clinical
 Trials
 
 
Epidemiol
ogical
 
Research

Other
 
Clinical
 
Research

Guidelines
 
on
 Clinical
 
Trials
 Using
 
Human
 Stem
 
Cells

Guidelines
 for
 
Gene
 Therapy
 
Clinical
 Trials
 

 Ethical
 
Guidelines
 
for
 
Epidemiol
ogical
 
Studies

Ethical
 
Guidelines
 
for
 Clinical
 
Studies
 
Genome/
Gene
 
Analysis

 Ethical
 
Guidelines
 
for
 
 
Human
 
Genome/
Gene
 
Analysis

*GCP:
 Guideline
 for
 Good
 Clinical
 PracOce
 

4

J-­‐GCP
 
 
based
 on
 ICH-­‐GCP
 

 
Clinical
 Research
 outside
 of
 PAL
Clinical
 Trials
 under
 
PharmaceuOcal
 
Affairs
 Law
 (PAL)
Human
 Stem
 
Cell
 Clinical
 
Trials

Gene
 Therapy
 
Clinical
 Trials
 
 
Epidemiol
ogical
 
Research

Other
 
Clinical
 
Research

Guidelines
 
on
 Clinical
 
Trials
 Using
 
Human
 Stem
 
Cells

Guidelines
 for
 
Gene
 Therapy
 
Clinical
 Trials
 

 Ethical
 
Guidelines
 
for
 
Epidemiol
ogical
 
Studies

Ethical
 
Guidelines
 
for
 Clinical
 
Studies

Genome/
Gene
 
Analysis

 Ethical
 
Guidelines
 
for
 
 
Human
 
Genome/
Gene
 
Analysis

4

InsOtuOonal
 Review
 Board/Ethics
 Review
 Commi]ee
 

review
 by
 MoH
 
review
 by
 MoH

start
 of
 study

Main
 Provisions
 in
 GCP
Main
 Provisions
 in
 Ethical
 GLs

Standards
 for
 Preparing
 CTs

l 
 OperaOng
 Procedures
 
l 
 Protocol
 
l 
 InvesOgator’s
 Brochure
 
l 
 CompensaOon
 to
 Subjects
 

 
Standards
 for
 CT
 Management
 
l 
 InvesOgaOonal
 Product
 Control
 
l 
 InformaOon
 on
 ADRs
 etc.
 
l 
 Monitoring
 
l 
 Audit
 

 -­‐
 
l 
 Clinical
 Trial
 Reports
 
l 
 Record
 Keeping

  

l 
 OperaOng
 Procedures

l  Protocol
 

 X
 
l 
 CompensaOon
 to
 Subjects

 

 

 X
 
l 
 Handling
 of
 Adverse
 Events
 

 X
 

 X
 
l 
 Self-­‐inspecOon
 (if
 necessary)
 
l 
 Report
 of
 result
 summary
 
 
 

 X
 
Comparison
 between
 Japanese
 GCP
 and
 
 
Ethical
 Guidelines
 for
 Clinical
 Studies

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 X : no specific provisions in the Ethical Guidelines
Main
 Provisions
 in
 GCP
Main
 Provisions
 in
 Ethical
 GLs

Standards
 for
 ConducOng
 CTs

(1) 
 InsOtuOonal
 Review
 Board
 
 
 
l 
 Establishment
 and
 Review
 
l 
 InformaOon
 Disclosure
 
l 
 Record
 Keeping
 
(2)
 Medical
 InsOtuOon
 
l 
 ResponsibiliOes
 of
 Head
 
l 
 Clinical
 Trial
 Office
 
l 
 Record
 Keeping
 
(3)
 InvesOgator
 
 
l 
 ResponsibiliOes
 of
 InvesOgator
 
l 
 PreparaOon
 of
 CRF
 
(4)
 Informed
 Consent
 of
 Subjects
 
l 
 Wri]en
 Informed
 Consent

  

(1)
 Ethics
 Commi]ee
 
l 
 Establishment
 and
 Review
 
l 
 InformaOon
 Disclosure
 

 X
 

 
l 
 ResponsibiliOes
 of
 Head
 

 X
 

 X

 
l 
 ResponsibiliOes
 of
 InvesOgator
 

 X
 

 
 
l 
 Wri]en
 Informed
 Consent
 
Comparison
 between
 Japanese
 GCP
 and
 
 
Ethical
 Guidelines
 for
 Clinical
 Studies

 X
 :
 no
 specific
 provisions
 in
 the
 Ethical
 Guidelines
 
Agenda for Revision of the Ethical Guidelines for
Clinical Studies (by summer 2013)
The Issues raised in the Subcommittee
for the Ethical Guidelines for Clinical Studies
u  System for Improving Quality of the Examination of the
Ethics Committee
u  Assurance of Quality of the Clinical Research
   - e.g. Confirmation of the Reliability of Data
u  Method of the Informed Consent
   - especially for the scope and method of general consent etc.
7

Improvement
 in
 ethics
 and
 quality
 of
 
 
clinical
 research
 
Thank
 you
 for
 your
 a]enOon.

8

Ministry
 of
 Health,
 Labour
 and
 Welfare
 
For
 people,
 for
 life,
 for
 the
 future