Design and regulation of clinical trials; from the laboratory to the pharmacy
development of new drugs and medical devices takes many years and a lot of
scientific research. After identifying a new molecule, which is likely to be
beneficial in human disease, it must undergo rigorous trials to ensure its
efficacy and safety. Regulatory bodies ensure that clinical trials are carried
out in a uniformly acceptable manner, and that the results are reliable. Their
main aim is to protect the individual from harm. The aim of this review article
is to describe the process of drug development and clinical trials as well as
the role(s) of the regulatory agencies involved. A MEDLINE search was conducted
using relevant keywords to access published information on clinical trials.
Other sources of information include relevant websites and publications of
regulatory agencies and major textbooks. The development of a new drug or
device starts from identification of the molecule in the laboratory, where it
is postulated to have useful characteristics. Following rigorous animal tests,
the drug is then entered into clinical trials using human subjects. Clinical
trials are conducted in four phases. Regulatory agencies are involved at every
stage to ensure compliance with guidelines. There are various designs of
clinical trials that may be used and the appropriate design has to be chosen to
produce reliable results. The appropriate statistics must also be chosen and
the submission to regulatory bodies for approval must be done in a systematic
and scientific manner. The International Conference on Harmonisation was
convened in 1990 and has drafted good clinical practice (GCP) guidelines for
clinical trials. Submission of the application for a new drug involves proper
regulatory writing procedures and protocols.
Keywords: clinical trial, regulatory agencies, ICH
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