Post on 01-Aug-2020
International Clinical Trials Registry Platform (ICTRP)
A tool to enhance transparency &accountability of clinical research
Tikki PangResearch Policy & Cooperation
World Health OrganizationGeneva, Switzerland
International Herald Tribune, May 31, 2007
NatureMarch 16, 2006
PLoS Medicine 2008, 5 (11), e217
All new NDA's in 2001 & 2002• Only ¾ of original trials were published• Those with positive outcomes were nearly 5x
as likely to be published as those that were negative
• 41 primary outcomes never published• 17 outcomes published without having first
been discussed in regulatory filings -15/17 made the drugs look better
• Discrepancies between published conclusions from those reported to FDA in ways that favored the new drugs
Nature, May 31, 2008
58th WHA Resolution (2005)“to establish a platform linking a network of international clinical trials registers in order to ensure a single point of accessand the unambiguous identification of trials”
Policy• All trials• Before recruitment of first trial participant
Why register trials?• Addresses publication bias• Contribute to systematic reviews• Increase participation of patients, doctors and
researchers• A scientific, ethical and moral responsibility• Facilitate collaboration between researchers
and coordination between funders - increase effectiveness of the overall research process
• Knowing the denominator • Empowers countries
Manto Tshabalala MsimangMinister of Health, South Africa,World Health Assembly, May 16, 2005
"Clinical trials remain a major concern for us. South Africa is overwhelmed and our people are exposed to too many trials. Regulation, coordination and better access to information on which trials are going on are essential to protect the people"
www.who.int/ictrp
A Network of Registries
AIM: provide a forum for registries to exchange information and work together to establish best practice for clinical trial registration
Platform
Central Database
WHO Trial Registration Data Set
Data providers
ICTRPSearch Portal
Data ModelData Model
Partner registries
95,000 records
ICTRP data providers 2007 - 2009
USA
UKNetherlands
Germany
Iran
India
Sri Lanka
China
Japan
AustraliaPACTR
Potential data providers for the future
Advanced Search
Search results
Universal Trial Number (UTN)Launched in June 2009
Aims to facilitate the unambiguous identification of clinical trials
NOT a
registration number
Permanently attached to the trial
Used whenever information about the trial is communicated
Part of the trial's identity
Documented in the trial protocol
Submitted every time the trial is registered
Should be…
UTN request page
"Bridging"• The problem
–Many multinational trials are recorded in more than one database
• The ideal–One record per trial
• The solution: "bridging"– Group together records about the
same trial
Bridging - ScreenshotsPortal shows that it has found a group of records aboutthe same trial by displaying a plus (+) sign in its search results
Bridging - Screenshots• Clicking on the (+) sign shows the other records (from different
data providers) referring to the same trial • Record with the earliest date of registration is always shown
first
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ArabicSpanishRussianFrenchChineseEnglish
Top 20 Searches (October 2009)
1. Cancer2. Xience3. Multiple Sclerosis4. Breast cancer5. Stimuvax6. Combretastatin7. Kidney cancer8. oxi45039. BLP2510. Liver cancer
11. Diabetes12. p5313. asthma14. India15. Heart failure 16. Stockholm17. Ovarian cancer18. tuberculosis19. Brazil20. United States
1000 new pre-market drug trials every month600 trials registered in the past 2 years
Compliance?
Recent legislationin Brazil andArgentina
April 6, 2009
Future challenges• Involvement of more journals in requesting
registration• Mandating registration in more countries• Triaging registration with ethics review and
regulatory approval in countries• Build capacity-not just to conduct trials but to
manage, register, disseminate• Reporting of trial results• Register of systematic reviews & meta analyses
Ultimate Goal• Improving the transparency and
accountability of the clinical research process– Improving protection of patients rights &
safety– Strengthening the overall efficiency of the
research process– Better decision making– Rebuilding public trust in science
Visit the ICTRP Search Portalhttp://www.who.int/trialsearch/
and send us your comments and suggestions!Thank you