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Zemsi A, Nekame LJG, Mohammed N, Batchilly ES, Dabira E, Sillah SO, Sey G, Williams DH, Dondeh BL, Cerami C, Clarke E, D'Alessandro U. Practical Guidelines for Standardised Resolution of Important Protocol Deviations in Clinical Trials Conducted in Sub-Saharan Africa. Ther Innov Regul Sci 2024; 58:395-403. [PMID: 38285370 PMCID: PMC11043146 DOI: 10.1007/s43441-023-00604-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/01/2023] [Indexed: 01/30/2024]
Abstract
A clinical trial is any research on human subjects that involves an investigational medicinal product or device. Investigational medicinal products include unlicensed drugs or drugs used outside the product license (e.g. for a new indication) (ICH-GCP). As per the internationally accepted ICH-GCP guidelines, clinical trials should be conducted strictly per the approved protocol. However, during the lifecycle of a trial, protocol deviations may occur. Under ICH efficacy guidelines, protocol deviations are divided into non-important (minor) or important (major), and the latter can jeopardise the participant's rights, safety or the quality of data generated by the study. Existing guidelines on protocol deviation management do not detail or standardise actions to be taken for participants, investigational products, data or samples as part of a holistic management of important protocol deviations. Herein, we propose guidelines to address the current literature gap and promote the standardisation of actions to address important protocol deviations in clinical trials. The advised actions should complement the existing local institutional review board and national regulatory authority requirements.
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Affiliation(s)
- Armel Zemsi
- MRCG at LSHTM, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia.
| | | | - Nuredin Mohammed
- MRCG at LSHTM, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia
| | | | - Edgard Dabira
- MRCG at LSHTM, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia
| | - Sheikh Omar Sillah
- MRCG at LSHTM, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia
| | - Gibbi Sey
- MRCG at LSHTM, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia
| | - Daisy H Williams
- MRCG at LSHTM, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia
| | - Bai-Lamin Dondeh
- MRCG at LSHTM, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia
| | - Carla Cerami
- MRCG at LSHTM, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia
| | - Ed Clarke
- MRCG at LSHTM, Atlantic Boulevard, Fajara, P.O. Box 273, Banjul, The Gambia
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