University of Helsinki and Helsinki University Hospital, Department of Children and Adolescents, Helsinki, Finland
Portfolio Delivery Operations, Janssen Research & Development, High Wycombe, Buckinghamshire, UK.
Arch Dis Child. 2022 Jun;107(6):582-590. doi: 10.1136/archdischild-2021-322798. Epub 2021 Dec 1.
Clinical trial sponsors spend considerable resources preparing informed consent (IC) and assent documentation for multinational paediatric clinical trial applications in Europe due to the limited and dispersed patient populations, the variation of national legal and ethical requirements, and the lack of detailed guidance. The aim of this study was to design new easy-to-use guide publicly available on European Medicines Agency's, Enpr-EMA website for all stakeholders.
Current EU legal, ethical and regulatory guidance for paediatric clinical trials were collated, analysed and divided into 30 subject elements in two tables. The European Network of Young Person's Advisory Group reviewed the data and provided specific comments. A three-level recommendation using 'traffic light' symbols was designed for four age groups of children, according to relevance and the requirements.
A single guide document includes two tables: (1) general information and (2) trial-specific information. In the age group of 6-9 years old, 92% of the trial-specific subject elements can be or should be included in the IC discussion. Even in the youngest possible age group (2-5 years old children), the number of elements considered was, on average, 52%.
The EU Clinical Trial Regulation (2014) does not contain specific requirements exclusively for paediatric clinical trials. This work is the first to extensively collate all the current legal, regulatory and ethical documentation on the IC process, together with input from adolescents. This guide may increase the ethical standards in paediatric clinical trials.
由于儿童患者人群有限且分散、各国法律和伦理要求存在差异,以及缺乏详细的指导,临床试验发起者在为欧洲多中心儿科临床试验申请准备知情同意书(IC)和同意书文件时需要投入大量资源。本研究旨在为所有利益相关者设计一份新的、易于使用的指南,并将其发布在欧洲药品管理局(EMA)的 Enpr-EMA 网站上。
收集、分析并将当前适用于儿科临床试验的欧盟法律、伦理和监管指南分为两表 30 个主题元素。欧洲青少年咨询小组对数据进行了审查并提供了具体意见。根据相关性和要求,为四个年龄段的儿童设计了使用“红绿灯”符号的三级推荐。
一份单独的指南文件包括两个表格:(1)一般信息和(2)试验具体信息。在 6-9 岁年龄组中,92%的试验具体主题元素可以或应该包含在 IC 讨论中。即使在最小的年龄组(2-5 岁儿童),考虑的元素数量平均也有 52%。
欧盟临床试验法规(2014 年)并未包含专门针对儿科临床试验的具体要求。这项工作首次广泛整理了 IC 流程的所有现行法律、监管和伦理文件,并结合了青少年的意见。该指南可能会提高儿科临床试验的伦理标准。