Investigational New Drug (IND) Orientation Responsibilities of IND Sponsor-Investigators MICHR IND/IDE Assistance Program (MIAP) Responsibilities of IND Sponsor-Investigators Definitions • Sponsor is an individual, company, academic institution, or other organization that takes responsibility for and initiates a clinical investigation. The sponsor is not the “funding organization” by FDA definitions. • Investigator is an individual under whose immediate direction a drug is administered or dispensed • Sponsor-Investigator is an individual who both initiates and conducts an investigation. The requirements/responsibilities under this part include both those applicable to an investigator and a sponsor. Responsibilities of IND Sponsor-Investigators APPLICABLE REGULATIONS The Federal Food, Drug, and Cosmetic Act (FD&C Act) gives the FDA authority to regulate drugs and biologics Code of Federal Regulations (CFR) 21 CFR Part 312: Investigational New Drugs Contains procedures and requirements governing the use of investigational new drugs Applies to all clinical investigations of products that are subject to section 505 of the FD&C Act Website for INDs: IND Regulations Responsibilities of IND Sponsor-Investigators Regulations 21 CFR §11 Electronic Records; Electronic Signatures 21 CFR §50 FDA (21 CFR) Protection of Human Subjects 21 CFR §54 Financial Disclosure by Clinical Investigators 21 CFR §56 Institutional Review Boards 21 CFR §58 Good Laboratory Practices 21 CFR §211, § 810 Good Manufacturing Practices 21 CFR §1271 Good Tissue Practices Responsibilities of IND Sponsor-Investigators Regulations Investigational Application 21 CFR §312 21 CFR §812 21 CFR §809 IND Drugs and Biologics IDE Devices IVD In Vitro Diagnostics Marketing Application 21 CFR §601 21 CFR §314 21 CFR §814 BLA Biologics NDA Drugs PMA Devices Responsibilities of IND Sponsor-Investigators Good Clinical Practice (GCP) www.fda.gov/oc/gcp/ GCP is a standard for the design, conduct, performance, monitoring, auditing, recording, analysis, and reporting of clinical trials. Not Law, but FDA has adopted GCP. (follow them…) Responsibilities of IND Sponsor-Investigators FDA RESPONSIBILITIES OF IND INVESTIGATORS Conduct study in compliance with GCP, protocol, & applicable IND/IDE regulations Ensure informed consent of each subject is obtained (and retained) Personally conduct or supervise the investigation Protect the rights, safety, and welfare of participants Ensure adequate medical care for the study participants Obtain necessary approvals from IRB Maintain and retain drug/device disposition and patient case history records Provide written reports to the IRB, as required Ensure changes are not implemented without prospective IRB/FDA approval Promptly report serious adverse events to the sponsor, IRB, and FDA Furnish Progress reports and Safety reports Ensure all study team members are informed about their obligations noted above Responsibilities of IND Sponsor-Investigators FDA RESPONSIBILITIES OF IND SPONSOR-INVESTIGATORS IN ADDITION TO THE INVESTIGATOR RESPONSIBILITIES, SPONSOR-INVESTIGATORS ARE REQUIRED TO: Select qualified investigators at other institutions for multi-site trials Provide information to other investigators and study staff to ensure that the study is performed properly Ensure proper monitoring of the study Ensure the study is performed in accordance with the general investigational plan and protocol Submit necessary amendments/supplements to FDA Ensure that FDA and all participating investigators are promptly informed of significant new adverse effects or risks Maintain adequate records Maintain proper control of the study drug/device Responsibilities of IND Sponsor-Investigators FDA Form 1571 (CFR 21 §312.23(a)(1)(i-ix)) • Contractual agreement between sponsor and FDA • Contains name of person responsible for conduct and progress of the study (Item 15) • Contains name of person responsible for the review and evaluation of information relevant to the safety of the drug (Item 16) • Sponsor or sponsor’s authorized representative agrees to conduct investigation in accordance with all applicable regulatory requirements (Item 17) FDA Form 1571 FDA Form 1571 Responsibilities of IND Sponsor-Investigators IND Maintenance (IND Amendments) IND Amendment (Documents submitted to an active IND) The 4 major types are… • • • • Protocol Amendments (21 CFR §312.30) Information Amendments (21 CFR § 312.31) IND Safety Reports (21 CFR § 312.32) IND Annual Reports (21 CFR § 312.33) Responsibilities of IND Sponsor-Investigators FDA Submissions - Responsibilities To FDA Submission Timing Amendment - New protocol After IRB approval Amendment - Changed protocol At time of change, usually after IRB approval Amendment - New investigator Within 30 days of being added Amendment - Information At time of occurrence IND safety report (unexpected AE that is serious and associated with the use of the drug or lab tests that suggest significant risk) Within 15 calendar days of receiving notification Contact MIAP when you receive notification IND safety report (unexpected fatal or life threatening experience associated with the use of the drug) Within 7 calendar days of receiving notification Contact MIAP when you receive notification Annual report Within 60 days of anniversary of IND Withdrawal of IND At time of withdrawal Discontinuation of investigation Within 5 working days of discontinuance Financial disclosure report At time of change Responsibilities of IND Sponsor-Investigators Amendments - New Protocol • New study that is not covered by a protocol already contained in the IND • Must submit the new protocol to the FDA • The new protocol can begin after both conditions have been met: – The protocol has been approved by the IRB – The sponsor has submitted the protocol to the FDA for its review • There is no need to wait for the 30 day review period at the FDA unless we have specifically asked the FDA for advice on the protocol content • Contact MIAP early to discuss regulatory strategy Responsibilities of IND Sponsor-Investigators Amendments - Changes in a Protocol • A sponsor shall submit a protocol amendment describing any change in a Phase I protocol that significantly affects the safety of subjects or any change in a Phase 2 or 3 protocol that significantly affects the safety of subjects, the scope of the investigation, or the scientific quality of the study • Examples: – Any increase in drug dosage or duration of exposure of any individual subjects – Any significant increase in the number of subjects under study – Any significant change in the design of a protocol (the addition or dropping of a control group) – The addition of a new test, or procedure, that is intended to improve monitoring for, or reduce the risk of, a side effect or adverse event; or the dropping of a test intended to monitor safety Responsibilities of IND Sponsor-Investigators Amendments – Changes in a protocol (continued) • A protocol change may be implemented provided the following two conditions are met: – The change has been approved by the IRB with responsibility for review and approval of the study – The sponsor has submitted the change to FDA for its review • No need to wait 30 days unless we have specifically asked for feedback • Contact MIAP early in process to discuss regulatory strategy – IRB Minor Amendment: URGENT REQUEST • PLEASE contact MIAP immediately when starting this process Responsibilities of IND Sponsor-Investigators Amendments – Changes in Protocol (continued) • Documents required to submit to the FDA – Summary of Changes Document for protocol – Tracked changed version of protocol – Clean version of protocol – Tracked changed version of informed consent document – Clean version of informed consent document Responsibilities of IND Sponsor-Investigators Amendments – New Investigator • A sponsor shall submit a protocol amendment when a new investigator is added to carry out a previously submitted protocol • The sponsor shall notify FDA of the new investigator within 30 days of the investigator being added • Try to group new investigators/and or sites together • Also includes new lab, new clinic • Can submit together with a change in protocol or new protocol submission • Required paperwork – Form 1572 – Investigator CV – signed and dated on first page FDA Form 1572 FDA Form 1572 Responsibilities of IND Sponsor-Investigators Amendments – Information • • • • New toxicology, chemistry, or other technical information New Investigator’s Brochure Submit at the time of change, but, to the extent feasible, not more than every 30 days Can submit with protocol amendment or new investigator amendment Responsibilities of IND Sponsor-Investigators IND Safety Report • • • • • Unexpected fatal or life threatening suspected adverse reactions – Must submit to the FDA within 7 calendar days of receiving the notification – Complete MedWatch 3500 A – Follow-up reports must be submitted as soon as possible Unexpected serious suspected adverse reactions – Must submit to the FDA within 15 calendar days of receiving the notification – Complete MedWatch 3500A Follow-up reports should be submitted within 15 days of receiving the first notification (not required if 7 day report is complete) If FDA requests any additional data or information, the sponsor must submit it to the FDA as soon as possible, but no later than 15 calendar days after receiving the request Contact MIAP if the IRB (at any site) disagrees with the Sponsor-Investigator assessment of attribution and causality Safety Reporting Via MedWatch How to report Patient/ Subject Product info (drug, biologic, device, etc.) Description of Event or Problem Relevant tests/labs Reporter Responsibilities of IND Sponsor-Investigators Annual Report • • • • • Due to the FDA within 60 calendar days of the IND Anniversary Date (date IND was deemed “safe to proceed”) MIAP will contact study coordinator and PI approximately 60 days before the report is due to obtain required information – Patient demographics – Study information (number of patients enrolled, number of sites, etc.) – Adverse events – Any other new information MIAP will complete the annual report template and send to study coordinator and PI to review MIAP will send final annual report to the FDA Upload FDA annual report into eResearch application (ORIO) Responsibilities of IND Sponsor-Investigators Monitoring the Trial • Clinical Trial Monitoring is required for clinical trials conducted under an IND • Clinical Trial Monitor examines quality of trial conduct: – Perform on-site (if indicated, also off-site) evaluations of trial-related activities – Identify deviations in protocol conduct – Review documents for Adverse Events – Drug accountability – see also handout of IDS monitoring • Extent and frequency of monitoring as appropriate: – Length, complexity, subject enrollment and other aspects of the trial Responsibilities of IND Sponsor-Investigators Monitoring the Trial: DSMB • Additional measure of human subject protection • Evaluates accumulating data from a clinical trial • Generally, established by the sponsor – Select members, should be independent – Charter generally written by sponsor, may have consultation by members • Recommendations regarding the conduct and design of the trial (safety and efficacy) • Does not visit sites or substitute for clinical trial monitors • Send DSMB reports to the IRB for review Responsibilities of IND Sponsor-Investigators Responsibilities of IND Sponsor-Investigators The FDA Calls – now what? • Make immediate internal notifications – IRB – Regulatory Affairs – MIAP • Review UMHS Policy 01-01-020 “External/Third Party Reviews • IRBMED ORIO Reporting – “As soon as possible after notification of the audit and prior to a site visit by an external oversight entity (e.g. sponsor, FDA). For FDA audits, you should also call the IRBMED Office Responsibilities of IND Sponsor-Investigators Most Common Violations Noted by the FDA • Failure to follow the protocol example: Required testing is incomplete • Recordkeeping errors • Informed consent problems/issues Responsibilities of IND Sponsor-Investigators Most Significant Violations noted by the FDA • • • • Enrollment of ineligible subjects Violation of protocol affecting safety Extensive data corrections and questionable changes Inadequate oversight of study personnel – Inappropriate delegation of authority – Poor oversight of sites • No Informed consent • Failure to communicate with IRB Responsibilities of IND Sponsor-Investigators Responsibilities of IND Sponsor-Investigators If you are doing something in eResearch then it may need to be reported to the FDA! Contact MIAP. • • • • • Protocol deviations – dosing errors, safety reasons Lapse in IRB Approval Urgent Amendment request Addition of new site Adverse event Responsibilities of IND Sponsor-Investigators Add MIAP lead as a study team member in eResearch • Add as administrative staff • Question 1.6 NO to edit right • Question 1.7 YES to include this person on all correspondence Responsibilities of IND Sponsor-Investigators MIAP Established to Provide Comprehensive: Regulatory Expertise… Regulatory Support… Regulatory Education Services… To Faculty Investigators and their Team Involved In FDA Regulated Clinical Research At The University of Michigan Responsibilities of IND Sponsor-Investigators MIAP SERVICES OVERVIEW • Agent/Device development strategy consultation • IND/IDE consultation including determination of need for IND or IDE • Pre-IND FDA meeting requests and support • Protocol development • IND/IDE application preparation and submission • Clinical hold response preparation/submission • Communication with the FDA, IRB and other regulatory bodies • IND/IDE “maintenance” support –Safety report submissions –Protocol amendments to the FDA –Annual reports to the FDA • Clinical Trial Monitoring –Investigators meetings –Site initiation visits –Interim site monitoring visits –Study close out activities Responsibilities of IND Sponsor-Investigators MIAP Activities FY 2012 • • • • • • Supported 31 active INDs (representing 34 active clinical study protocols) and 2 IDEs Submitted 21 new IND applications and 2 new IDE applications to the FDA Submitted 5 single-patient (expanded access) INDs and 2 emergency use IDEs to the FDA Submitted over 110 IND/IDE life-cycle maintenance submissions to the FDA Submitted 10 IND exemption requests to the FDA Submitted 3 pre IND/IDE meeting packages to the FDA Responsibilities of IND Sponsor-Investigators MIAP is here to help with INDs and IDEs MIAP contacts: Kevin Weatherwax, BS, CCRC, CCRA Manager, MICHR IND/IDE Assistance Program (MIAP) Michigan Institute for Clinical and Health Research (MICHR) University of Michigan Health System NCRC Bldg # 400 2800 Plymouth Road Ann Arbor, MI 48109-2800 Phone: 734-998-6275 Pager: 734-936-6266, #9912 Fax: 734-998-7318 Website: www.MICHR.umich.edu kweath@med.umich.edu Responsibilities of IND Sponsor-Investigators MIAP contacts (cont’d): MICHR/MIAP CLINICAL RESEARCH PROJECT MANAGERS: Mona Moore, MS, RAC Phone: 734-998-7818 monamoor@med.umich.edu Bill Reisdorph, MS, CQA, RAC Phone: 734-998-8427 reisdorp@med.umich.edu Jeanne Wright, RN, BSN, MT, CCRP, RAC Phone: 734-998-7598 jeanburn@med.umich.edu E. Mitchell Seymour, PhD, RAC Phone: 734-998-6421 seymoure@med.umich.edu MIAP TEAM Shared group e-mail for documents: MICHRMIAP@med.umich.edu Responsibilities of IND Sponsor-Investigators Office of Human Research Compliance Review (OHRCR) Director Ron Maio, D.O., M.S., Professor, Department of Emergency Medicine ronmaio@umich.edu 734 647-0489 Research Compliance Associates Terry VandenBosch, PhD, RN, CIP, CCRP terryvb@umich.edu 734 647-0457 Ted Hamilton, MS tedah@umich.edu 734 647-1622 Responsibilities of IND Sponsor-Investigators UMMS Regulatory Affairs Ray Hutchinson, MD, MS, Associate Dean 734 615-1702 rhutchin@umich.edu Pat Ward, MPA, Director 734-647-1954 patward@umich.edu Responsibilities of IND Sponsor-Investigators Office of the General Counsel Kara Morgenstern, JD, MPH, Assistant General Counsel Phone: 734-763-6240 kmorgens@umich.edu Institutional Review Board - IRBMED Judith Birk, JD, IRBMED Director Phone: 734-647-7615 Fax: 734-763-1234 jbirk@umich.edu Responsibilities of IND Sponsor-Investigators Investigational Drug Service (IDS) Helen Tamer, Pharm.D. Clinical Pharmacist Phone: 734-936-7469 Fax: 734-647-9302 hrtamer@umich.edu Amy Skyles, Pharm. D. Clinical Pharmacist Phone: 734-936-8210 Fax: 734-936-7027 ajskyles@med.umich.edu Drug shipment address: University of Michigan Hospital Department of Pharmacy Services-IDS UH B2D400 1500 E. Medical Center Drive Ann Arbor, MI 48109-0008 Attention: Investigational Drug Service Responsibilities of IND Sponsor-Investigators Labeling of Investigational Agents 21 CFR §312.6 • Immediate packaging of product – “Caution: New Drug – Limited by Federal (or United States) law to investigational use” • The labels and labeling shall not – Bear false and misleading statements – Represent that the drug is safe and effective for purposes being investigated 734.998.7474 www.michr.umich.edu Fund Pilot Grants Grant Writing Educate Pre-doctoral, post-doctoral, faculty, & staff programs Connect Outreach, Partnerships, Recruitment, Mental Health, Child Health Support 360° support for your research study Consultation MCRU Project Management Data Management Biostatistics Regulatory Support Biorepository Informatics Tools Ethics Reaching Us “Visit” www.michr.umich.edu “Read” Breakthrough “Like” Facebook “Follow” Twitter “Watch” YouTube “Call” 734.998.7474 “Email” um_michr@umich.edu Responsibilities of IND Sponsor-Investigators Q&A