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WHO Training Workshop on Pharmaceutical Quality, Good Manufacturing Practice & Bioequivalence Quality of BE Studies Kiev, October 3-7, 2005 Dr. H. Potthast (h.potthast@bfarm.de). Regulations. ICH-GCP guideline (CPMP/ICH/135/95) Guide to GMP incl. Annex 13 WHO documents
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WHO Training Workshop on Pharmaceutical Quality, Good Manufacturing Practice & Bioequivalence Quality of BE Studies Kiev, October 3-7, 2005 Dr. H. Potthast (h.potthast@bfarm.de)
Regulations • ICH-GCP guideline (CPMP/ICH/135/95) • Guide to GMP incl. Annex 13 • WHO documents • EU “Note for Guidance on the Investigation of Bioavailability and Bioequivalence” CPMP/EWP/QWP/1401/98, related guidances and others
Legal Basis • acc. to e.g. Directive 2001/20/EC: “The verification of compliance with the standards of good clinical practice and the need to subject data, information and documents to inspection in order to confirm that they have been properly generated, recorded and reported are essential in order to justify the involvement of human subjects in clinical trials.” finding/definition of inspection triggers
Assessment Process • General Requirements BE studies as a substitute for clinical and preclinical data Quality of the BE study is of decisive importance for approval of the product
Inspection Triggers • Environmental triggers - examples random selection acc. to annual inspection program information from other regulatory authorities • type of product (e.g. particular narrow therap. range) • lack of previous inspections for product/applicant/location • …… • general indication for inspection
Inspection Triggers • Early phase triggers - examples history of (serious) problems for sponsor, CRO, sites, labs • involvement of clinical site/CRO/labs in many studies • business related issues (e.g. bankruptcy, mergers) • lack of audit certificates • ….. • Still general indication without direct implication of trial data
Inspection Triggers • Evaluation phase triggers - examples protocol gives incomplete/illogical information • numerous protocol violations • unsatisfactory explanation for protocol violations • data too clean/too messy • number of missing values/drop outs/nds…. • Findings due to knowledge from literature and other studies; type of generic product already known
Inspection Triggers • Evaluation phase triggers – contd. conflicting (PK-)results as compared to known data • insufficient documentation (clinic, analytics, statistics) • missing documentation • implausibility/inconsistency of clinical or analytical data (e.g. long half-life – short wash-out – no carry-over?!) • doubtful statistics or change in the analysis….
Inspection Triggers • Information exchange • evaluation of triggers positive (negative – non serious/’formal’) negative – serious request/list of questions EMEA inspection data base since 2004
Inspections • Evaluation/Inspection based on source data/raw data e.g. • print outs of chromatograms signed CRFs analytic protocols • time schedules • list of providers …….
Inspections Data verification & QA issues • GCP compliance statement available? • audit/monitoring reports available? • protocol valid, i.e. signed (incl. amendments)? • was the protocol followed? • genuine study subjects/volunteers? • archiving of source/raw data? • violations of the protocol justified?
Inspections Data verification & QA issues ctd. • excluded subjects - traceable? • consistent trial results? • final responsibility of investigators (signing)? • source of investigative products? • batch information available? • handling of investigative products?
Inspections Data verification & QA issues ctd. • validation of bioanalytical method? • timing • validation characteristics • adherence to GLP • SOPs available…… • calibrated equipment? • computer systems???? • archiving of bioanalytical raw data
Inspections Data verification & QA issues ctd. • statistical plan adhered to? • transfer of analytical data to statistics • main pharmacokinetic characteristics • method of determination • nd values considered? • statistical outcome and conclusions consistent? • archiving of statistical raw data
Inspections Regulatory & ethical issues • independent ethics committee? • ethical approval based on appropriate documentation? • protocol • amendments • investigators brochure; SPC • subjects information informed consent • approval of competent authority in time? • subjects from vulnerable populations? • signing of subjects available?
Inspections Regulatory & ethical issues ctd. • insurance of subjects adequate? • adequately instructed personnel? • investigators • technicians • suppliers….. • safety evaluation assured throughout the trial? • retention samples sufficient? • storage of retention samples?
Inspections FINDINGS • … • …. • … • … • …
Inspections A Matter of TRUST!