Before every Phase I trial, as well as assessing risk and justifying that assessment, there must be a strategy for ensuring that any risk is minimised throughout the trial. Should potential investigators be concerned about the level of risk of the IMP, the sponsor must give them access to people with responsibility for the relevant pre-clinical work. Also, the sponsor’s physician should liaise with the investigator. If investigators still have concerns about pre-clinical data, they should consult an independent adviser. Assessment and management of risks should be documented (e.g., through a risk management plan). The strategy for managing risk should consider all aspects of the trial. The majority of Phase I clinical trials use healthy subjects. This approach has the advantage of speed of recruitment and ease of scheduling cohorts of subjects throughout the study. It also removes potential confounding factors such as concomitant medication and disease pathology when reviewing adverse event and PK data. Healthy subjects may generally tolerate and facilities match the level of risk of the IMP. Investigators must not take on trials of an IMP for which they do not have adequate experience or training. The PI and unit staff responsible for the care of subjects in FIH clinical trials should always be appropriately qualified and experienced. The PI for a FIH trial has to meet specific training and experience requirements. The sponsor should ensure that the investigator knows enough about the agent, its target, mechanism of action and potential adverse events to be in a position to manage the informed consent process with the subject, and to make informed clinical judgments during the study. The investigator must also understand the intricacies of executing FIH trials, including the potential need to adjust doses during the study as human data become available. The investigator must assess the risk of harm, by reviewing the protocol, investigator’s brochure, IMP dossier, CTA application and, any relevant medical and scientific literature. In addition, the investigator must weigh the foreseeable risks and inconveniences against the expected benefits for the individual subject, and for future subjects with the target disease. Finally, the investigator must explain and justify any risks in the information leaflet for trial subjects and in the EC application. The sponsor should conduct a site evaluation to consider the site’s capabilities to meet the specific demands of a particular protocol such as appropriate medical governance, drug-specific biomarker methodologies or sample acquisition/ analysis, the ability to recruit study participants FIH clinical trials of IMPs with identified factors of risk should be conducted in research units with sufficient expertise and know-how. However, this does not negate the importance of a site-evaluation by sponsor staff. Site assessment by the sponsor staff should include, but not be limited to:
In FIH clinical trials where there is a predictable risk of certain types of severe adverse reaction, the sponsor should specifically address risk mitigation in the protocol, which should include considerations for treatment of such reactions. The sponsor and research site should ensure that any specific antidotes will be readily available, where they exist, as well as a clear plan of supportive treatment, including the pre-arranged contingency availability of intensive care facilities or specialty consultation. The research site should assess the study-specific requirements for clinical cover and ensure that an appropriate level of staffing, with medical doctors during and after dosing, will be present. For the FIH trials of IMPs other than those factors of risk, the sponsor should consider similar factors as previously discussed, on a case-by-case basis. As a minimum, the sponsor must assess facilities, training and experience of personnel, and the evidence that unit medical staff are appropriately qualified and trained in handling emergency situations. Finally, it is critical that subjects taking part in FIH clinical trials have not been recently exposed to other investigational products.
Convex CRC is a clinical research center with a built-in phase I unit in which we have the capabilities and expertise to conduct clinical trials in early phases. Convex center for early drug development is focused on the conduct of single-center clinical trials (Phase 1 Studies) on healthy volunteers and patient populations:
Early phase clinical trial | Dedicated clinical research institution specialized in the conduct of early phase clinical trials focused on healthy volunteers and specific patient population clinical studies. |
State of the art equipment | The research institution is equipped with all necessary equipment for the proper conduct of FIM, BE/BA, PK/PD studies. |
Research quality service | We do make conscious decisions to commit to research requirements needed to build a sustainable research site. We constantly invest in quality systems to deliver quality data for the ultimate outcome of safe and effective new medical therapies. We commit daily to providing optimal care for study patients, following the regulations and self-regulating with the intent of quality improvement. |
Clinical subject data base | Constantly increasing our study subject database consisting of large number of healthy volunteers and specific patient population. We are proud to make our study participants stay involved through-out the entire course of a studies as well as relaxed & happy. |
Related clinical research services | Convex provides end-to-end services for our biotech/pharma/or generic companies. Starting from clinical study design to the development of final study report. All services under one company including safety lab and PK analysis, biostatistical and data management, medical writing, project management, clinical monitoring, regulatory and consultation, IP packaging. Convex research organization successfully manage all steps of the way through the final results by an already proven and effective approch for every sponsor. |