Current Good Clinical Practice guidelines are bureaucratic and should align with less burdensome examples of international trial policy
Clinical trials must be conducted in ways that protect participants and produce reliable results. Both are central tenets of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) Good Clinical Practice (GCP) guideline.1 The ICH GCP guideline was developed to harmonise the conduct of trials across world regions and, since the mid‐1990s, its core principles have provided the bedrock for trial conduct. However, the devil is in the detail and, in the case of the ICH GCP guideline, that detail (and the interpretation of each word) has far‐reaching consequences.
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 1. International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use. ICH Harmonised Guideline: Integrated addendum to ICH E6 (R1): guideline for good clinical practice E6 (R2). ICH, 2016. https://database.ich.org/sites/default/files/E6_R2_Addendum.pdf (viewed Dec 2020).
- 2. Yusef S, Bosch J, Devereaux PJ, et al. Sensible guidelines for the conduct of large randomized trials. Clin Trials 2008; 5: 38–39.
- 3. Rule S, Legouill S. Bureaucracy is strangling clinical research. BMJ 2019; 364: 1097.
- 4. Mentz R, Hernandez A, Berdan L, et al. Good clinical practice guidance and pragmatic clinical trials: balancing the best of both worlds. Circulation 2016; 133: 872–880.
- 5. Co‐ordinated response to the consultation by the International Council for Harmonisation (ICH) on its proposed E6 (R2) “Integrated Addendum” to the ICH E6 Guideline for “Good Clinical Practice”. Updated open letter to EMA & ICH from 5 research organisations and an international consortium of 119 health researchers in 22 countries. 26 Feb 2016. https://moretrials.net/?download_id=029bb92127a231e9c1d925b8cf5c6d6a (viewed June 2020).
- 6. International Council for Harmonisation. ICH reflection on “GCP renovation”: modernization of ICH E8 and subsequent renovation of ICH E6. January 2017. https://admin.ich.org/sites/default/files/2019-04/ICH_Reflection_paper_GCP_Renovation_Jan_2017_Final.pdf (viewed May 2020).
- 7. International Council for Harmonisation. Final concept paper ICH E6(R3): guideline for good clinical practice. 17 Nov 2019. https://database.ich.org/sites/default/files/E6-R3_FinalConceptPaper_2019_1117.pdf (viewed May 2020).
- 8. Grimes DA, Hubacher D, Nanda K, et al. The Good Clinical Practice guideline: a bronze standard for clinical research. Lancet 2005; 366: 172–174.
- 9. National Statement on Ethical Conduct in Human Research 2007 (Updated 2018). The National Health and Medical Research Council, the Australian Research Council and Universities Australia. Commonwealth of Australia, Canberra. https://www.nhmrc.gov.au/about-us/publications/national-statement-ethical-conduct-human-research-2007-updated-2018 (viewed Dec 2020).
- 10. Sharp MS. Consent documents for oncology trials: does anybody read these things? Am J Clin Oncol 2004; 27: 570–575.
- 11. Hallinan ZP, Forrest A, Uhlenbrauck G, et al. Barriers to change in the informed consent process: a systematic literature review. IRB 2016; 38: 1–10.
- 12. Krishnamurti T, Argo N. A patient‐centered approach to informed consent: results from a survey and randomized trial. Med Decis Making 2016; 36: 726–740.
- 13. Reith C, Landray M, Devereaux PJ, et al. Randomized clinical trials: removing unnecessary obstacles. N Engl J Med 2013; 369: 1061–1065.
- 14. Regulation (EU) No 536/2014 of the European Parliament and of the Council of 16 April 2014 on clinical trials on medicinal products for human use, and repealing Directive 2001/20/EC. https://ec.europa.eu/health/sites/health/files/files/eudralex/vol-1/reg_2014_536/reg_2014_536_en.pdf (viewed Dec 2020).
- 15. National Health and Medical Research Council. Safety monitoring and reporting in clinical trials involving therapeutic goods. Canberra: National Health and Medical Research Council. Canberra: NHMRC, 2016. https://www.nhmrc.gov.au/about-us/publications/safety-monitoring-and-reporting-clinical-trials-involving-therapeutic-goods (viewed Dec 2020).
- 16. Collins R. Sensible guidelines for clinical trials: are current European regulations ‘a gift to America’? Interview by Barry Shurlock. Eur Heart J 2013; 35: 1767–1768.
- 17. Sheetz N, Wilson B, Benedict J, et al. Evaluating source data verification as a quality control measure in clinical trials. Ther Innov Regul Sci 2014; 48: 671–680.
- 18. Meeker‐O’Connell A, Glessner C, Behm M, et al. Enhancing clinical evidence by proactively building quality into clinical trials. Clin Trials 2016; 13: 439–444.
- 19. Food and Drug Administration. Information sheet guidance for sponsors, clinical investigators, and IRBs. Frequently asked questions – statement of investigator (Form FDA 1572). https://www.fda.gov/media/78830/download (viewed Dec 2020).
- 20. Health Research Authority; Medicines and Healthcare Products Regulatory Agency. Joint Statement on the Application of Good Clinical Practice to Training for Researchers (HRA, MHRA, Devolved Administrations for Northern Ireland, Scotland and Wales). Updated Feb 2020. https://www.hra.nhs.uk/planning-and-improving-research/policies-standards-legislation/good-clinical-practice/joint-statement-application-good-clinical-practice-training-researchers-hra-mhra-devolved-administrations-northern-ireland-scotland-and-wales/ (viewed Dec 2020).
No relevant disclosures.