Clinical Study Report
[pic]
Clinical Study Report
[Study Title]
[Study number]
[Dd month yyyy]
CONFIDENTIAL
Signature pages for clinical study report
I have read this report and confirm that to the best of my knowledge it accurately describes the conduct and results of the study.
Signed: Date: ____/____/______
Print name:
Affiliation:
Address:
Signed: Date: ____/____/______
Print name:
Affiliation:
Address:
Signed: Date: ____/____/______
Print name:
Affiliation:
Address:
Signed: Date: ____/____/______
Print name:
Affiliation:
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Signed: Date: ____/____/______
Print name:
Affiliation:
Address:
TITLE PAGE
Study title:
Name of Test Drug:
Indication studied:
Study description:
Sponsors:
Protocol:
Clinical Phase:
Study dates:
Investigators:
Medical Officer:
Sponsor signatory:
GCP Statement: This study was performed in compliance with ICH Good Clinical Practise (GCP) including the archiving of essential documents
Date of report:
SYNOPSIS
|NAME OF SPONSOR |INDIVIDUAL STUDY TABLE REFERRING TO |(FOR NATIONAL AUTHORITY |
| |MODULE 5 OF THE CTD |USE ONLY) |
|NAME OF FINISHED PRODUCT N/A | | |
| |Volume: | |
|NAME OF ACTIVE INGREDIENT(S) | | |
| |Page: | |
|Title of Study | |
|Investigator(s) | |
|Study centre(s) | |
|Publication |N/A |
|Study period |From: |Phase of development | Phase |
| |To: | | |
|Objectives |Primary Objective |
| | |
| |Secondary Objective |
|Methodology | |
|Number of patients |Planned: |
| | |
| |Analysed: |
|Diagnosis and main | |
|criteria for inclusion | |
|Test product, dose and | |
|mode of administration | |
|Duration of treatment | |
|Criteria for evaluation |Primary: |
| |Secondary: |
|Statistical methods | |
|NAME OF COMPANY |INDIVIDUAL STUDY TABLE REFERRING TO |(FOR NATIONAL AUTHORITY |
| |MODULE 5 OF THE CTD |USE ONLY) |
|NAME OF FINISHED PRODUCT N/A | | |
| |Volume: | |
|NAME OF ACTIVE INGREDIENT(S) | | |
| |Page: | |
| |
|SUMMARY CONCLUSIONS |
| |
|EFFICACY RESULTS |
| |
| |
| |
|SAFETY RESULTS |
| |
| |
| |
| |
|CONCLUSION |
| |
| |
| |
|DATE OF THE REPORT: |
TABLE OF CONTENTS
1 TITLE PAGE 3
2 SYNOPSIS 4
3 TABLE OF CONTENTS 6
4 LIST OF ABBREVIATIONS & DEFINITION OF TERMS 8
5 ETHICS AND REGULATORY APPROVAL 9
5.1 INDEPENDENT ETHICS COMMITTEE APPROVAL 9
5.2 ETHICAL CONDUCT OF THE STUDY 9
5.3 PATIENT INFORMATION AND CONSENT 9
5.4 REGULATORY APPROVAL 10
6 INVESTIGATORS AND STUDY ADMINISTRATIVE STRUCTURE 10
7 INTRODUCTION 11
7.1 [THERAPEUTIC AREA] 11
7.2 RATIONALE FOR THE STUDY 11
8 STUDY OBJECTIVES 12
9 INVESTIGATIONAL PLAN 12
9.1 OVERALL STUDY DESIGN AND PLAN 12
9.1.1 STUDY TIMING 12
9.1.2 STUDY LOCATION 12
9.2 DISCUSSION OF STUDY DESIGN 12
9.3 SELECTION OF STUDY POPULATION 12
9.3.1 INCLUSION CRITERIA 12
9.3.2 EXCLUSION CRITERIA 12
9.3.3 WITHDRAWAL OF PATIENTS FROM THERAPY OR ASSESSMENT 12
9.4 TREATMENTS 13
9.4.1 TREATMENTS ADMINISTERED 13
9.4.2 DESCRIPTION OF INVESTIGATIONAL PRODUCTS 13
9.4.2.1 [Prime] 13
9.4.2.2 [Boost] 13
9.4.3 METHOD OF ASSIGNING PATIENTS TO TREATMENT GROUPS 13
9.4.4 SELECTION OF DOSES IN THE STUDY 13
9.4.5 SELECTION AND TIMING OF DOSE FOR INDIVIDUAL PATIENTS 13
9.4.6 PRIOR AND CONCOMITANT THERAPY 13
9.4.7 TREATMENT COMPLIANCE 13
9.5 EFFICACY AND SAFETY VARIABLES 13
9.5.1 EFFICACY AND SAFETY MEASUREMENTS ASSESSED 13
9.5.2 APPROPRIATENESS OF MEASUREMENTS 16
9.5.3 IMMUNOGENICITY VARIABLES 16
9.6 DATA QUALITY ASSURANCE 16
9.7 STATISTICAL METHODS PLANNED IN THE PROTOCOL & DETERMINATION OF SAMPLE SIZE 16
9.7.1 STATISTICAL AND ANALYTICAL PLANS 16
9.7.2 DETERMINATION OF SAMPLE SIZE 16
9.8 CHANGES IN THE CONDUCT OF THE STUDY OR PLANNED ANALYSES 16
9.8.1 PROTOCOL AMENDMENTS 16
10 STUDY POPULATION 16
10.1 DISPOSITION OF PATIENTS 16
10.2 PROTOCOL DEVIATIONS 18
11 RESULTS 19
11.1 DATA SETS ANALYSED 19
11.2 DEMOGRAPHIC AND OTHER BASELINE CHARACTERISTICS 19
11.3 MEASUREMENTS OF TREATMENT COMPLIANCE 19
11.4 STUDY DURATION 19
11.5 IMMUNOGENECITY RESULTS AND TABULATIONS OF PATIENT DATA 20
11.5.1 ANALYSIS OF IMMUNOGENECITY 20
11.5.2 STATISTICAL/ANALYTICAL ISSUES 20
11.5.2.1 HANDLING OF DROPOUTS OR MISSING DATA 20
11.5.3 TABULATION OF INDIVIDUAL RESPONSE DATA 20
11.5.4 VACCINE DOSE AND RELATIONSHIP TO RESPONSE 20
11.5.5 BY-PATIENT DISPLAYS 20
11.5.6 IMMUNOGENECITY CONCLUSIONS 20
12 SAFETY EVALUATION 21
12.1 EXTENT OF EXPOSURE 21
12.2 ADVERSE EVENTS (AE’s) 21
12.2.1 BRIEF SUMMARY OF ADVERSE EVENTS 21
12.2.2 TREATMENT EMERGENT ADVERSE EVENTS 21
12.2.3 TREATMENT RELATED ADVERSE EVENTS 21
12.2.4 IMMUNISATION TOLERANCE 21
12.3 SERIOUS ADVERSE EVENTS AND OTHER SIGNIFICANT ADVERSE EVENTS 22
12.4 DEATHS 22
12.5 CLINICAL LABORATORY EVALUATION 22
12.5.1 EVALUATION OF EACH LABORATORY PARAMETER 22
12.6 VITAL SIGNS, PHYSICAL FINDINGS AND OTHER OBSERVATIONS RELATED TO SAFETY 22
12.7 CONCOMITTANT MEDICATION USE 22
12.8 SAFETY CONCLUSIONS 22
13 DISCUSSION AND OVERALL CONCLUSIONS 22
14 TABLES, FIGURES AND GRAPHS 23
15 REFERENCES 24
16 APPENDICES 25
LIST OF ABBREVIATIONS & DEFINITION OF TERMS
ETHICS AND REGULATORY APPROVAL
1 INDEPENDENT ETHICS COMMITTEE APPROVAL
The study protocol and all its amendments, and the patient information sheet(s) were reviewed and approved by the appropriate independent ethics committees as detailed in table one below.
Table I: Ethics committees
|Centre name and number | | |
|Investigator | | |
|Ethics committee | | |
|Chairman | | |
|Date of approval of the final protocol | | |
|Date of approval of amendment 1 | | |
|Date of approval of amendment 2 | | |
|Date of approval of amendment 3 | | |
2 ETHICAL CONDUCT OF THE STUDY
The study was performed in accordance with the current version of the declaration of Helsinki (52nd WMA General Assembly, Edinburgh, Scotland, October 2000). The trial was conducted in agreement with the International Conference on Harmonisation (ICH) guidelines on Good Clinical Practise (GCP)
3 PATIENT INFORMATION AND CONSENT
All patients provided written informed consent to participate in the study prior to being screened.
The patient information sheet detailed the procedures involved in the study (aims, methodology. potential risks, anticipated benefits) and the investigator explained these to each patient. The patient signed the consent form to indicate that the information had been explained and understood. The patient was then allowed time to consider the information presented before signing and dating the informed consent form to indicate that they fully understood the information, and willingly volunteered to participate in the study. The patient was given a copy of the informed consent form for their information. The original copy of the informed consent was kept in a confidential file in the Investigators centre records. A sample of the patient information sheet and consent form can be found at appendix [insert]
4 REGULATORY APPROVAL
The study was performed in compliance with the requirements of the [regulatory authorities]. The study gained full regulatory approval from the on [date], SPONSOR was issued with the following EudraCT number [ ]. A copy can be found in appendix [insert]
The study gained full approval from [EC] on [insert] a copy can be found in appendix [insert]
INVESTIGATORS AND STUDY ADMINISTRATIVE STRUCTURE
Table II shows the principal study personnel involved in the study.
Table II: Principal study personnel
|Title |Name and affiliation |
|Principal Investigator | |
|Principal investigator | |
|Sponsor | |
|Sponsor | |
|Project Managers | |
|Project Leaders | |
|Clinical Research | |
|Associate(s) | |
|Medical Adviser | |
|Laboratory investigator | |
|Data Management | |
INTRODUCTION
1 [THERAPEUTIC AREA]
2 RATIONALE FOR THE STUDY
STUDY OBJECTIVES
Primary Objective
Secondary Objective
INVESTIGATIONAL PLAN
1 OVERALL STUDY DESIGN AND PLAN
1 STUDY TIMING
Figure I Schematic chart of Protocol
2 STUDY LOCATION
This study was conducted at the following locations:
2 DISCUSSION OF STUDY DESIGN
3 SELECTION OF STUDY POPULATION
1 INCLUSION CRITERIA
2 EXCLUSION CRITERIA
3 WITHDRAWAL OF PATIENTS FROM THERAPY OR ASSESSMENT
Patients were free to withdraw from the study at any time without giving a reason. Patients were advised that if they requested to withdraw from the study, at any time during the trial, then this would have no negative consequences.
The investigator could also withdraw patients from the trial if they deemed it appropriate for safety or ethical reasons or if it was considered to be to be detrimental to the well-being of the patient. Patients who withdrew or were withdrawn underwent a final evaluation at [visit]. Patients who did not complete the study through to [visit], unless removed due to toxicity, could have been replaced
Full documentation was made of any withdrawals that occurred during the study in the CRF. The Investigator documented the date and time of the withdrawal and results of any assessments made at this time. If the patient withdrew because of an adverse event (AE) or a serious adverse event (SAE) then details were forwarded to the Ethics committee as required. The investigator also forwarded details to SPONSOR. SPONSOR forwarded details to the regulatory authorities as appropriate.
4 TREATMENTS
1 TREATMENTS ADMINISTERED
2 DESCRIPTION OF INVESTIGATIONAL PRODUCTS
3 METHOD OF ASSIGNING PATIENTS TO TREATMENT GROUPS
4 SELECTION OF DOSES IN THE STUDY
5 SELECTION AND TIMING OF DOSE FOR INDIVIDUAL PATIENTS
6 PRIOR AND CONCOMITANT THERAPY
7 TREATMENT COMPLIANCE
All study treatment was administered by the study investigator or designated member of staff. To ensure drug accountability the investigator or designated deputy maintained accurate records of the dates and amounts of drug received, to whom it was dispensed and accounts of any supplies which were accidentally or deliberately destroyed; these details were recorded on a drug accountability form. All unused clinical supplies and the drug accountability forms were returned to SPONSOR at the end of the study.
5 EFFICACY AND SAFETY VARIABLES
1 EFFICACY AND SAFETY MEASUREMENTS ASSESSED
Performance status
CT Scan (Disease status)
ECG
Clinical Assessment of Injection Site
Clinical Examination
Vital Signs
Safety
Laboratory Tests
Haematology
Serum chemistry
Urinalysis
HBV, HCV, HIV and pregnancy
Cellular immunology
Table III shows the schedule of examinations and procedures.
Table III [Schedule of examinations and procedures]
| | |Study day |
| | | | |
|Enrolled | | | |
|Received at least one injection | | | |
|Received all [x] injections and attended | | | |
|[vist] | | | |
|Completed [visit] | | | |
|Withdrawn: | | | |
|Lost to follow up | | | |
|Adverse event | | | |
|Death | | | |
|Other | | | |
| | | | |
| | | | |
| | | | |
Source Data: Listing xx:
6 PROTOCOL DEVIATIONS
Table V gives details of study protocol deviations.
Table V Protocol deviations
|Deviation |Site: |Site: |
|Entry criteria |0 |0 |
|Withdrawal criteria |0 |0 |
|Incorrect dosing regimen |0 |0 |
|Concomitant treatment/medication |0 |0 |
|Other |0 |0 |
Full details of the protocol deviations can be found in appendix 16.2.2
RESULTS
1 DATA SETS ANALYSED
2 DEMOGRAPHIC AND OTHER BASELINE CHARACTERISTICS
Table XX Demographics of the Study Patients
| | | | | |
| | |Group A | |Group B |
| | |(N=) | |(N=) |
|Gender |Male | | | |
| |Female | | | |
|Age (years) |n | | | |
| |Mean | | | |
| |Min | | | |
| |Max | | | |
|Height (m) |n | | | |
| |Mean | | | |
| |Min | | | |
| |Max | | | |
|Weight (kg) |n | | | |
| |Mean | | | |
| |Min | | | |
| |Max | | | |
|BMI (kg/m2) |n | | | |
| |Mean | | | |
| |Min | | | |
| |Max | | | |
| | | | | |
See appendix XX for by-patient tabular listings of demographic details.
3 MEASUREMENTS OF TREATMENT COMPLIANCE
4 STUDY DURATION
5 IMMUNOGENECITY RESULTS AND TABULATIONS OF PATIENT DATA
1 ANALYSIS OF IMMUNOGENECITY
2 STATISTICAL/ANALYTICAL ISSUES
1 HANDLING OF DROPOUTS OR MISSING DATA
How if any dropouts were handled- why they dropped out, how long they were in the study for. Analysis of a pattern for patient drop out rates, determining factor, common variant. Missing data, incomplete CRF’s, how this is handled, and why this took place.
3 TABULATION OF INDIVIDUAL RESPONSE DATA
4 VACCINE DOSE AND RELATIONSHIP TO RESPONSE
5 BY-PATIENT DISPLAYS
6 IMMUNOGENECITY CONCLUSIONS
SAFETY EVALUATION
1 EXTENT OF EXPOSURE
2 ADVERSE EVENTS (AE’s)
1 BRIEF SUMMARY OF ADVERSE EVENTS
2 TREATMENT EMERGENT ADVERSE EVENTS
3 TREATMENT RELATED ADVERSE EVENTS
4 IMMUNISATION TOLERANCE
3 SERIOUS ADVERSE EVENTS AND OTHER SIGNIFICANT ADVERSE EVENTS
4 DEATHS
5 CLINICAL LABORATORY EVALUATION
1 EVALUATION OF EACH LABORATORY PARAMETER
6 VITAL SIGNS, PHYSICAL FINDINGS AND OTHER OBSERVATIONS RELATED TO SAFETY
7 CONCOMITTANT MEDICATION USE
8 SAFETY CONCLUSIONS
DISCUSSION AND OVERALL CONCLUSIONS
TABLES, FIGURES AND GRAPHS
REFERENCES
APPENDICES
16.1 STUDY INFORMATION
16.1.1 Protocol and Protocol Amendments
16.1.2 Case Report Form
16.1.3 Ethics Committees and Subject Information
16.1.4 Regulatory Approval
16.1.5 Investigators and Study Personnel
16.1.6 Sponsor and Investigator Signatures
16.1.7 Randomisation Code
16.1.8 Study Drugs
16.1.9 Audit Certificate
16.1.10 Statistical Analysis Plan
16.1.11 Laboratory quality assurance
16.1.12 Publications based on the study
16.1.13 Publications referenced in the report
16.2 PATIENT DATA LISTINGS
3. CASE REPORT FORMS
1. CRFs for deaths, other serious adverse events and withdrawals for AE
2. Other CRFs submitted
-----------------------
PATIENTS SCREENED
N=
PATIENTS RANDOMISED
N=
SCREENING FAILURES
N=
GROUP A
N=
GROUP B
N=
COMPLETED N=
WITHDRAWN N=
WITHDRAWN
N=
COMPLETED
N=
LOST TO FOLLOW UP (0)
ADVERSE EVENT (0)
DEATH (0 )
OTHER ( )
RECEIVED [Prime]
RECEIVED [Prime]
RECEIVED [Boost] RECEIVED [Boost]
ATTENDED [visit]
COMPLETED [Visit]
RECEIVED [Prime]
RECEIVED [Prime]
RECEIVED [Boost] RECEIVED [Boost]
ATTENDED [visit]
COMPLETED [Visit]
-----------------------
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