Institute of Clinical Research (India)
D-41, Defence Colony
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Editor SK Gupta Dean and Director General Institute of Clinical Research (India) New Delhi, India
Formerly Professor and Head Department of Pharmacology All India Institute of Medical Sciences New Delhi, India
Jitendar P Vij
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Basic Principles of Clinical Research and Methodology
© 2007, Institute of Clinical Research (India), New Delhi, India
All rights reserved. Produced in India. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, or otherwise, without the prior written permission of the ICRI and the publisher.
Institute of Clinical Research India, D-41, IIIrd Floor, Defence Colony, New Delhi-110024. www.icriindia.com
First Edition: 2007
9788184480863
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd., Noida
4CONTRIBUTORS
- Vijai Kumar md
- President and
- Chief Medical Officer
- Excel Life Sciences, Inc
- 2 Spreading Oak Court
- Durham, NC, USA
- Clinical Research—Past, Present and Future
- SK Mishra md
- Vice President - Clinical
- Research and Medical Services
- Dabur Research Foundation
- 22, Site IV, Sahibabad
- Ghaziabad - 201010
- Drug Development and Discovery
- MUR Naidu md
- Professor and Head
- P Usha Rani md
- Associate Professor
- Department of Clinical
- Pharmacology and
- Therapeutics
- Nizam's Institute of Medical
- Sciences, Panjagutta
- Hyderabad - 500082
- Designing Clinical Trials
- Urmila Thatte md
- Professor and Head
- Dept. of Clinical
- Pharmacology
- TN Medical College and BYL
- Nair Hospital Mumbai - 400008
- Ethical Issues in Clinical Research
- Sonal Vora md
- Director
- Sunita Nair md
- Aventis Pharma Limited
- Aventis House,
- 54/A, Sir Mathuradas Vasanji
- Road, Andheri (E), Mumbai
- ICH -GCP Guidelines
- Surinder Kher md
- Chief Executive Officer
- Jubilant Clinsys Ltd.
- D-12, Sector - 59, Noida - 201301
- Informed Consent Process: Protecting Subjects Rights
- Sauren Das md
- Director Operations, India
- ExcelTrials India Pvt Ltd
- 252, 2nd Main, 5th Cross, RMV
- 2nd Stage, HIG Dollars Colony
- Bangalore - 560 094
- Role of CRC and CRA in Clinical Trials
- Anish Desai md
- Vice President-Medical Services
- Manish Garg md
- Shree Yashraj Apts,
- Flat No. 1000, 10th floor
- Plot No. 29 K.A. Subramaniam
- Road, Off Bhau Daji Road,
- King's Circle, Mumbai 400019
- Protocol Designing
- Zinobia Madan ph.d
- Associate Vice President
- Anil Kukreja md
- Medical Advisor Wockhardt Ltd
- Wockhardt Towers
- Bandra Kurla complex, Bandra
- (East), Mumbai - 400051
- Sponsor's and Investigator's Responsibilities
- Suhasini Sharma md
- Ex-Chief Operating Officer
- Rashna Cama md
- Principal Investigator
- ICRI Research P Ltd
- 127, Chintamani Plaza 1
- Chakala, Andheri Kurla Road
- Andheri Mumbai - 400099
- Patient Recruitment and Retention in Clinical Trials
- Aran Bhatt md
- President
- Clinlnvent Research (P) Ltd.
- A-302, Everest Chambers
- Next to Star TV Office
- Marol Naka
- Andheri-Kurla Road
- Andheri (E)
- Mumbai - 400059
- Project Management in Clinical Trials
- Moin Don md
- Senior Manager -
- Pharmacovigilance
- Dr. Reddy's laboratories Ltd.
- 7-1-27/1, Srinivasa Complex
- Ameerpet
- Hyderabad - 500016
- Pharmacovigilance in Clinical Research
- Chetan Tamhankar md
- Chief Operating Officer
- Anand Bidarkar md
- Senior Manager
- SIRO Clinpharm Pvt Ltd
- DIL Premises
- Swami Vivekanand Road
- Nr Tatvagyan Veedyapeeth
- Ghodbunder Road
- Thane (W) 400 607
- Role of Contract Research Organizations in Clinical Research Management
- Mohanish Anand ph.d
- Senior Manager
- Alliances and Outsourced
- Operations
- Pfizer Limited
- Pfizer Centre Patel Estate
- S.V. Road
- Jogeshwari (W)
- Mumbai - 400102
- Suresh Bowalekar ph.d
- Executive Director
- PharmaNet Clinical Services
- Pvt. Ltd.
- Marwah Centre 7th Floor
- Krishanlal Marwah Marg
- Andheri (E),
- Mumbai - 400072
- Biostatistics in Clinical Trials
- Satish Bhatia ph.d
- Chief Executive-CRO
- Fortis Clinical Research Limited
- Sunflag Hospital and Research
- Centre Sector 16A,
- Faridabad- 121002
- Bioequivalence Studies in Drug Development
- Kiran Marthak md
- Director
- Veeda Clinical Research (P)
- Ltd., Shivalik Plaza - A
- Near IIM
- Ambawadi
- Ahmedabad - 380015
- Finance and Budgeting in Clinical Trials
- ICRI Faculties
- Institute of Clinical Research
- (India)
- 242, 13th Cross
- CMH Road, Indranagar
- 2nd Stage, Bangalore-560038
- Clinical Data Management
- CK Katiyar ph.d
- Director - Herbal Drug Research
- Ranbaxy Research Laboratories
- R and D - II, Plot No. 20
- Sector-18
- Udyog Vihar Industrial Area
- Gurgoan - 122001
- P Yadav
- Research Scientist
- Ranbaxy Research
- Laboratories
- R and D - II, Plot No. 20
- Sector-18
- Udyog Vihar Industrial Area
- Gurgoan - 122001
- Clinical Trials for Herbal Drugs and Traditional Medicines
- ICRI Faculties
- Institute of Clinical Research
- (India), A 201 Okhla Ph I
- New Delhi - 110020
- Investigational New Drug Applications
- ICRI Faculties
- Institute of Clinical Research
- (India)
- C-9, Central Road No. 22
- MIDC Industrial Area
- Andheri (East)
- Mumbai - 400093
- Case Report Form
- ICRI Faculties
- Institute of Clinical Research
- (India)
- A 201 Okhla Ph I,
- New Delhi - 110020
- Clinical Trial Logs
- ICRI Faculty
- Institute of Clinical Research
- (India) A 201 Okhla Ph I
- New Delhi - 110020
- Standard Operating Procedures
- ICRI Faculty
- Institute of Clinical Research
- (India)
- A 201 Okhla Ph I
- New Delhi - 110020
- Audits and Inspections in Clinical Trials
- ICRI Faculty
- Institute of Clinical
- Research (India)
- 242, 13th Cross
- CMH Road
- Indranagar
- 2nd Stage
- Bangalore - 560038
- Fraud and Misconduct in Clinical Research
- Natasha Das mbbs
- Consultant Team Lead
- and Domain Expert iLogy
- 4203, Anriya Dwellington
- Dollars Colony
- Bangalore
- An Introduction to Medical Writing
- Rajani Mathur ph.d
- Delhi Institute of
- Pharmaceutical Sciences and
- Research (Delhi University)
- Pushp Vihar
- New Delhi-110017
- Communication Skills
- SK Gupta ph.d
- Dean and Director General
- Institute of Clinical Research
- (India)
- A-201 Okhla Phase-1
- Industrial Area
- New Delhi-110020
India is increasingly being recognized as a quality player and a preferred partner for global clinical trials. India has several prized attributes for clinical trial development making it the “Hub for Global Clinical Research”. It is certain that as Clinical Research is growing in India, the demand for Clinical Research professionals is increasing. According to McKinsey Report, the global clinical trial outsourcing to India in the pharmaceutical industry is estimated to reach around Rs. 5,000 crores by the year 2010, and there will be requirement of approximately 50,000 Clinical Research Professionals.
Clinical Research requires specific cognitive and communication skills to handle complex issue. Such know-how resides with specialists, such as clinical research associate, clinical team leader, project manager, clinical supply manager, quality assurance manager, medical and regulatory affairs manager, data manager and head of clinical operations. Training of these professionals in GCP standards would go a long way to strengthen the CR industry. Specialized training requirements may include, training on clinical trial processes, development of standard operating procedures and GCP and applicable regulatory guidelines.
India has already demonstrated its capabilities to undertake contract research for compound discovery and development. There is a phenomenal increase in screening capacity of pharma companies and the Process Development and Synthesis. India's expertise in chemical synthesis can be utilized for development of cost-effective processes for new drugs and intermediates. At this stage the operational deficiencies should be defined and appropriate Regulations/Guidelines developed.
Education in Clinical Research Methodology requires the most up-to-date information to achieve the Global Standards. The book on “Basic Principles of Clinical Research and Methodology” contributed by the eminent professionals from Academia and Industry will fulfill the long felt need for such a publication in the country. I congratulate Institute of Clinical Research (India) and Professor S.K. Gupta for bringing out this excellent publication.
N.K. Ganguly
Director General
7PREFACE
In the last decade, there has been a paradigm shift in drug discovery from the days of lab chemistry, isolation of actives and synthesis to clinical research. Clinical trials represent a bridge from early stage drug development to commercialization. It takes over billion dollars to bring a drug from the lab to the market after a time-span - 9 years on average. Traditionally, high quality clinical research has been branded as a “Western capability” as they possessed excellent infrastructure, standardized research processes, mature Government regulations and healthcare systems and intellectual property protection.
India is fast gearing and rising up to the challenge and catering to the needs of the clinical research industry. It is being recognized as “tomorrow's market”. The fast growing private healthcare sector, lower costs for conduct of trials, rapidly increasing awareness of Good Clinical Practice, vast majority of educated, English conversant population, ethno-socio-cultural diversity, Government commitment and above all wide spectrum of disease-conditions, lure top names in the pharmaceutical world to zero-in on India for their pursuits in clinical research. Global consultancy McKinsey and Co estimates that by 2010, global pharma majors would spend around $1-1.5 billion just for drug trials in the country. Many big global pharma names like Novo Nordisk, Aventis, Novartis, GlaxoSmithKline, Eli Lilly and Pfizer have begun clinical drug trials across various Indian cities. Today, about 80 government and private hospitals in India are engaged in global and local clinical trials. The multinationals in the CRO segment include ICON Clinical Research, Omnicare Clinical Research, Pharmanet global, Pharm-Olam, ClinTec International and Quintiles Spectral have already set their eyes on India.
However, there are some burning issues regarding clinical research that need to be addressed such as amendment of regulations, availability of trained and experienced medical staff, ethical considerations, patient education, pharmacovigilance, intellectual property rights etc. Though a gradual change evident, the area is still in its infancy. WHO and ICMR sponsored survey on the issue had shown that there are no standard, consistent, planned teaching programme on the subject. An academic curriculum needs to develop that can mould and inculcate the essentials of the need and methodology of clinical research right at the undergraduate level. This will equip the students of today to become rational, effective and safe clinical researchers of tomorrow and help to launch India as global leader in the field.
Institute of Clinical Research India has made outstanding contributions in education and training programmes by providing structured course to the postgraduate students. Thus, Clinical Research professionals by providing postgraduate education this fulfilling the need of the country. ICRI is the pioneering institute in India which provides Masters in clinical research and postgraduate courses in clinical research, clinical data management and quality assurance.
This book addresses the broad array of essential topics in clinical research and provides a valuable overview of this rapidly evolving field, not only for professionals from academia but also those in the pharmaceutical industry. All efforts have been made to merge the inputs from the stalwarts in the area, and comprehensively provide information in this area, which appears as a maze, hitherto.
S K Gupta
8ACKNOWLEDGEMENTS
I first congratulate all the contributors for being a part of this launch venture and secondly, thank them for their outstanding contributions. Despite their busy schedule and pressing commitments, the authors have put their best effort to give shape to this textbook. The practicalities and nuances that they have gained as experience by way of being in the field for decades, have been succinctly described here. My earnest thanks to them once again, for an excellent job done.
Dr. Laxman Prasad, Advisor and Head, Department of Science and Technology and Dr. G. J. Samathanam, Advisor, Department of Science and Technology (DPRP) Programme of the Government of India, has been constant source of inspiration and help for providing financial support for this publication, which has been the part of proceedings of the national conference.
I would like to place on record the constant encouragement and support provided by Mr. Shiv Raman Dugal, Chairman of the ICRI in completing this task.
I wish to acknowledge the exemplary technical assistance rendered by Dr. Sushma Srivastava for bringing the book in its present form. The Jaypee Brothers Medical Publishers have been associated with me for long and have once again given justice to the contents. Lastly, I pay special thanks to my collegues and students at ICRI and DIPSAR for their valuable help in editorial assistance, without which this task would have been meaningless.