WHO Expert Committee on Selection and Use of Essential Medicines - WHO Technical Report Series, No. 850, Annex 3 (Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products) - Sixth Report: 7. MONITORING OF SAFETY: 7.1 Handling and recording adverse events

WHO Expert Committee on Selection and Use of Essential Medicines - WHO Technical Report Series, No. 850, Annex 3 (Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products) - Sixth Report
(1995; 36 pages) [French] [Spanish]

Table of Contents

	INTRODUCTION
	GLOSSARY
	1. PROVISIONS AND PREREQUISITES FOR A CLINICAL TRIAL
		1.1 Justification for the trial
		1.2 Ethical principles
		1.3 Supporting data for the investigational product
		1.4 Investigator and site(s) of investigation
		1.5 Regulatory requirements
	2. THE PROTOCOL
	3. PROTECTION OF TRIAL SUBJECTS
		3.1 Declaration of Helsinki
		3.2 Ethics committee
		3.3 Informed consent
		3.4 Confidentiality
	4. RESPONSIBILITIES OF THE INVESTIGATOR
		4.1 Medical care of trial subjects
		4.2 Qualifications
		4.3 Selection of trial subjects
		4.4 Compliance with the protocol
		4.5 Information for subjects and informed consent
		4.6 The investigational product
		4.7 Site of the trial, facilities and staff
		4.8 Notification of the trial or submission to the drug regulatory authority
		4.9 Review by an ethics committee
		4.10 Serious adverse events/reactions
		4.11 Financing
		4.12 Monitoring, auditing and inspection
		4.13 Record-keeping and handling of data
		4.14 Handling of and accountability for pharmaceutical products for trial
		4.15 Termination of trial
		4.16 Final report
		4.17 Trials in which the investigator is the sponsor
	5. RESPONSIBILITIES OF THE SPONSOR
		5.1 Selection of the investigator(s)
		5.2 Delegation of responsibilities
		5.3 Compliance with the protocol and procedures
		5.4 Product information
		5.5 Safety information
		5.6 Investigational product
		5.7 Trial management and handling of data
		5.8 Standard operating procedures
		5.9 Compensation for subjects and investigators
		5.10 Monitoring
		5.11 Quality assurance
		5.12 Study reports
		5.13 Handling of adverse events
		5.14 Termination of trial
	6. RESPONSIBILITIES OF THE MONITOR
		6.1 Qualifications
		6.2 Assessment of the trial site
		6.3 Staff education and compliance
		6.4 Data management
		6.5 Case-report forms
		6.6 Investigational product
		6.7 Communication
		6.8 Notification of the trial or submission to the drug regulatory authority
		6.9 Reports
	7. MONITORING OF SAFETY
		7.1 Handling and recording adverse events
		7.2 Reporting adverse events
	8. RECORD KEEPING AND HANDLING OF DATA
		8.1 Responsibilities of the investigator
		8.2 Responsibilities of the sponsor and the monitor
		8.3 Archiving of data
	9. STATISTICS AND CALCULATIONS
		9.1 Experimental design
		9.2 Randomization and blinding
		9.3 Statistical analysis
	10. HANDLING OF AND ACCOUNTABILITY FOR PHARMACEUTICAL PRODUCTS
		10.1 Supply and storage
		10.2 Investigational labelling and packaging
		10.3 Responsibilities of the investigator
		10.4 Responsibilities of the sponsor and monitor¹
	11. ROLE OF THE DRUG REGULATORY AUTHORITY
		11.1 General responsibilities
		11.2 On-site inspections
	12. QUALITY ASSURANCE FOR THE CONDUCT OF A CLINICAL TRIAL
	13. CONSIDERATIONS FOR MULTICENTRE TRIALS
	REFERENCES
	APPENDIX 1: World Medical Association’s Declaration of Helsinki¹
	APPENDIX 2: Model list of items to be contained in a clinical trial protocol

7.1 Handling and recording adverse events

In accordance with Sections 4.1 and 4.3 of these guidelines, the investigator must ensure the safety of the trial subjects. This includes providing the best possible care for subjects experiencing any trial-related adverse events and conducting a thorough investigation to determine causality.

The occurrence of adverse events must be monitored carefully and recorded in detail during the course of the clinical trial.

The trial protocol should clearly state the method(s) by which adverse events will be monitored. Provisions should be included to ensure prompt dose reduction or withdrawal of therapy for patients experiencing unacceptable toxic effects. The protocol should describe how information relating to adverse events is to be handled and analysed by the investigator and sponsor, and their responsibilities to report to each other and to the drug regulatory authority. The sponsor should provide special forms for reporting trial-related adverse events.

Consideration should be given to establishing a special committee to monitor adverse events (see also Section 13).