Design, Review of Clinical Trial Protocol and Role of Bio- statisticians Design Review of Clinical Trial Protocol and Role of Bio- statisticians

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The workshop on Design, Review of Clinical Trial Protocol and Role of Biostatisticians was organized by Quality Assurance Division of CDSCO at Hotel Metropolitan, Bangla Sahib Road, New Delhi on 22 nd -24 th January, 2014 to impart the knowledge on review of Clinical Trial Protocol to Officers of Central Drugs Standard Control Organization. The workshop on Design Review of Clinical Trial Protocol and Role of Biostatisticians was organized for three days, the first two days 22 nd -23 rd January, 2014 was planned for the Drugs Inspectors who review clinical trial protocols, alongwith ADC(I) and DDC(I) of the concerned divisions. The third day i.e. 24 th January, 2014 was planned for the Drugs Inspectors who review vaccine clinical trial protocols, alongwith ADC (I) and DDC (I) of the concerned divisions. Experts from Central Drugs Research Institute (CDRI), Luck now, All India Institute of Medical Science (AIIMS) and Maulana Azad Medical College (MAMC) gave the presentations to all the participants. The objective of this workshop was to strengthen the Regulatory System on Clinical Trials. Regulatory oversight of Clinical Trial and Marketing Authorization and Licensing are two functional indicators. To fulfill the indicators it is required to increase the capacity and knowledge of the reviewers of CDSCO in Clinical Trial Protocol, Ethical oversight and role of Bio-statisticians in Clinical Studies including its evaluation.

Agenda for the workshop 22 January, 2014 TIME TITLE OF ACTIVITY SPEAKER/ PARTICIPANTS 09:00 am 09.30 am 09:30 am 09:45 am Registration Inaugural Session (Welcome address, Introduction of participants) Pre-assessment 9:45am - 10:00am 10:00am - 10:30 am Role of Biostatistician in review of Clinical Trial protocol and report CDSCO Mrs. M. Kalaivani, Scientist-III,AIIMS, New Delhi 10:30am - 10:45am Tea Break 10:45am - 11:15am Case Study Mrs. M. Kalaivani, Scientist-III,AIIMS, New Delhi and all participants 11:15am - 11:30pm Group Discussion -do- 11:30pm - 12:15pm Design & Review of Clinical trial protocol (including method of randomization)and Clinical trial report Dr. Vivek Bhosale, Scientist, CDRI, Lucknow 12:15pm - 12:45pm Case Study Dr. Vivek Bhosale, Scientist,CDRI,

TIME TITLE OF ACTIVITY SPEAKER/ PARTICIPANTS 12:45pm - 1:00pm Group Discussion -do- 1:00pm - 1:45pm Lunch Break 1:45pm - 2:30pm Drug Design & Development, Pre-formulation Studies up to Scale-up. Dr. Anil Kumar Saxena, Chief Scientist & Former Head, CDRI, Luck now 2:30pm - 3:00pm Case Study -do- 3:00pm - 3:15pm Group Discussion -do- 3:15pm - 3:30pm Tea Break 3:30pm - 4:15pm Pre-clinical safety evaluation (Safety, pharmacology & toxicology studies) as per regulatory requirements Dr. Anil Kumar Saxena, Chief Scientist & Former Head, CDRI, Luck now 4:15pm - 4:45pm Case Study -do- 4:45pm - 5:00pm Group Discussion -do- 5:00pm - 5:15pm Post-assessment CDSCO

12:15pm - 12:45pm Case Study Dr. Anil Kumar Saxena, Ex. Chief Scientist & Former Head, CDRI, Luck now and all the participants 12:45pm 1:00pm Group Discussion -do- AGENDA FOR THE WORKSHOP 23 JANUARY, 2014 TIME TITLE OF ACTIVITY SPEAKER/ PARTICIPANTS 09:00 am 09.30 am Registration 09:30 am 09:45 am Pre-assessment CDSCO 9:45am - 10:30am Drug Design & Development, Preformulation Studies up to Scale-up" Luck now Dr. Anil Kumar Saxena, Ex. Chief Scientist & Former Head, CDRI, 10:30am - 10:45 am Tea Break 10:45am - 11:15am Case Study Dr. Anil Kumar Saxena, Ex. Chief Scientist & Former Head, CDRI, Luck now and all the participants 11:15am - 11:30pm Group Discussion -do- 11:30pm - 12:15pm Pre-clinical safety evaluation (Safety, pharmacology & toxicology studies) as per regulatory requirements. Dr. Anil Kumar Saxena, Ex. Chief Scientist & Former Head, CDRI, Luck now

AGENDA FOR THE WORKSHOP TIME TITLE OF ACTIVITY SPEAKER/ PARTICIPANTS 1:00pm - 1:45pm 1:45pm - 2:30pm Lunch Break Design & Review of Clinical trial protocol (including method of randomization) and Clinical trial report". Dr. Vivek Bhosale, Scientist, CDRI,Lucknow 2:30pm - 3:00pm Case study Dr. Vivek Bhosale, Scientist, CDRI,Lucknow and all participants 3:00pm - 3:15pm Group Discussion -do- 3:15pm - 3:30pm 3:30pm - 4:15pm Tea Break Role of Biostatistician in review of Clinical Trial protocol and report Mrs. M. Kalaivani, Scientist- III,AIIMS, New Delhi 4:15pm - 4:45pm Case study Mrs. M. Kalaivani, Scientist- III,AIIMS, New Delhi and all participants 4:45pm - 5:00pm Group Discussion -do- 5:00 pm - 5:15pm Post-assessment CDSCO

AGENDA FOR THE WORKSHOP 24 JANUARY, 2014 TIME TITLE OF ACTIVITY SPEAKER/ PARTICIPANTS 10:00am - 10:30 am 10:30am - 10:45am 10:45am -11:45am 11:45am - 1:00pm Present Regulatory Regime in Clinical Trials Tea Break Present Regulatory Regime in Clinical Trials Regulatory requirements in clinical Trials- specific to Biological Products CDSCO CDSCO CDSCO 1:00pm - 1:45pm Lunch Break 1:45pm - 2:30pm Review of clinical trial protocol and Dr. Sangeeta Yadav, Professor, MAMC report of vaccines- salient features 2:30pm -3:00pm Case study Dr. Sangeeta Yadav, Professor, MAMC and all participants 3:00pm - 3:15pm Group Discussion -do-

AGENDA FOR THE WORKSHOP TIME TITLE OF ACTIVITY SPEAKER/ PARTICIPANTS 1:45pm - 2:30pm Review of clinical trial protocol and report of vaccines- salient features Dr. Sangeeta Yadav, Professor, MAMC 2:30pm -3:00pm Case study Dr. Sangeeta Yadav, Professor, MAMC and all participants 3:00pm - 3:15pm Group Discussion -do- 3:15pm - 3:30pm 3:30pm - 4:45pm Tea Break Case study on role of Biostatistician in review of Clinical Trial protocol and report of vaccine 4:45pm - 5:00pm Group Discussion -do- Mrs. M. Kalaivani, Scientist- III,AIIMS, New Delhi and all participants

List of Participants on 22 January, 2014 Sr. No. Name of the Participant Office Address Designation 1. 2. Dr. A. K. Saxena CDRI, Lucknow Dr. Vivek Bhosale CDRI, Lucknow Scientist Ex. Chief Scientist & Former Head 3. Dr. M. Kalaivani AIIMS, New Delhi Scientist-III 4. 5. Dr. A. Ramkishan Mr. S.P. Shani CDSCO (HQ) Deputy Drugs Controller(I) Deputy Drugs Controller(I) 6. Mr. S.P. Shani Deputy Drugs Controller (I) 7. Smt. Annam Visala Deputy Drugs Controller (I) 8. 9. Dr. Inderjeet Singh Hura Mrs. Rubina Bose Assistant Drugs Controller (India) Assistant Drugs Controller (I)

Sr. No. Name of the Participant Office Address Designation 10. Ms. Swati Srivastava Assistant Drugs Controller (I) 11. Mr. Vinay Kumar Gupta Drugs Inspector 12. Mr. Milind Patil CDSCO, Ahmedabad Drugs Inspector 13. Mr. Vinod Kumar Drugs Inspector 14. Mr. Sourabh Mittal Drugs Inspector 15. Dr. Vijay Kumar Karwasra Drugs Inspector 16. Ms. A. Ambuselvi Drugs Inspector 17. Mr. Bidhyashekhar Drugs Inspector 18. Mr. Arvind Singh Panwar Drugs Inspector 19. Ms. Sunitha Seerapu Drugs Inspector 20. 21. 22. Mr. Pratyush Kumar Drugs Inspector Mr. Parthiban J. Drugs Inspector Mr. Deepak Kumar Sehrawat Drugs Inspector

Sr. No. Name of the Participant Office Address Designation 23. 24. 25. Mr. Amol Eknath Kandekar Drugs Inspector Mr. Popat Dattaraya Thorat Drugs Inspector Ms. Shyamaladevi D. Drugs Inspector 26. Mr. Manish Horo Drugs Inspector 27. 28. Mr. Avinash Kumar Yadav Drugs Inspector Ms. Nisha Kaushik Drugs Inspector 29. Mr. V. Sooraj Drugs Inspector 30. Mr. Sandeep Kumar Drugs Inspector 31. Mr. Abhinav Kapoor Drugs Inspector 32. Mr. Bikramaditya Chowdhury Drugs Inspector 33. Mr. Balakumar Mahalingam Drugs Inspector

Sr. No. Name of the Participant Office Address Designation 34. Dr. Bikash Roy Drugs Inspector 35. Mr. John G. Drugs Inspector 36. Mr. C. Arunachalam Drugs Inspector 37. Mr. Manish Nikhra CDSCO, EZ Drugs Inspector 38. Mr. Dinesh Kumar CDSCO, NZ Drugs Inspector 39. Ms. Prerna Saurabh Technical Data Associate 40. Ms. Vandana Wallabh Technical Data Associate 41. Ms. Swarupa Wankhade Technical Data Associate 42. Ms. Shraddha Mishra Technical Data Associate 43. Ms. Barkha Dubey Technical Data Associate 44. Mr. Mohd. Fayyaz Rashid Technical Data Associate 45. Ms. Pooja Arora Technical Data Associate 46. Mr. A. J. Singh Technical Data Associate

List of Participants on 23 January, 2014. Sr. No. Name of the Participant Office Address Designation 1. 2. Dr. A. K. Saxena CDRI, Lucknow Dr. Vivek Bhosale CDRI, Lucknow Scientist Chief Scientist & Former Head 3. Dr. M. Kalaivani AIIMS, New Delhi Scientist-III 4. Dr. A. Ramkishan CDSCO (HQ) 5. Mr. S.P. Shani Deputy Drugs Controller(I) Deputy Drugs Controller (I) 6. Dr. Inderjeet Singh Hura Assistant Drugs Controller (India) 7. Mr. Somnath Basu Assistant Drugs Controller (I) 8. Mrs. Rubina Bose Assistant Drugs Controller (I) 9. Ms. Swati Srivastava Assistant Drugs Controller (I)

Sr. No. Name of the Participant Office Address Designation 10. 11. Mr. Yogesh Shelar Drugs Inspector Mr. Rajesh Kumar Verma Drugs Inspector 12. Mr. Vinod Kumar Drugs Inspector 13. Mr. Ankur Bansal Drugs Inspector 14. Mr. Rahul Panwar Drugs Inspector 15. Mr. Fahim Khan Drugs Inspector 16. Mr. Hemant Madhukar Patil Drugs Inspector 17. Ms. Sudarmathi S. Drugs Inspector 18. Mr. Manoj Choudhary Jatav Drugs Inspector 19. Mr. Rakesh Negi Drugs Inspector 20. Mr. Amol Eknath Kandekar Drugs Inspector 21. Mr. Sachin Yadaorao Bhagwate Drugs Inspector 22. Mr. Sri Babu Drugs Inspector

Sr. No. Name of the Participant Office Address Designation 23. 24. 25. Mr. Bibekananda Behera Drugs Inspector Mr. Dinesh Kumar Drugs Inspector Mr. Sunil Kumar Malviya Drugs Inspector 26. Mr. Dileep Kumar Drugs Inspector 27. Mr. Basant Kumar Yadav Drugs Inspector 28. 29. 30. Mr. Saurabh Jain Drugs Inspector Mr. Haribabu J. Drugs Inspector Mr. Jay Jyoti Roy Drugs Inspector 31. Mr. Akash Rama Kondalkar Drugs Inspector 32. Mr. S.R. Manikandan Drugs Inspector 33. Mr. J. Suresh kumar Drugs Inspector

Sr. No. Name of the Participant Office Address Designation 34. Ms. C.Thiruvidha Drugs Inspector 35. Mr. Mohan R. Drugs Inspector 36. Drugs Inspector Mr. Dhananjay Sable 37. Saurabh Garg Drugs Inspector 38. Ms. Prerna Saurabh Technical Data Associate 39. Ms. Pragya Sharma Technical Data Associate 40. Haris Chandran. S Technical Data Associate

List of Participants on 24 January, 2014 Sr. No. Name of the Participant Office Address Designation 1 Dr. Sangeeta Yadav, MAMC, New Delhi Professor 2 Dr. M. Kalaivani AIIMS, New Delhi Scientist II 3 Mr. S.P. Shani Deputy Drugs Controller (I) 4 Ms. Rubina Bose Assistant Drugs Controller (I) 5 Ms. Swati Srivastava Assistant Drugs Controller (I) 6 Mr. I.S. Hura Assistant Drugs Controller (I) 7 Mr. Jayant Gangakhedkar Assistant Drugs Controller (I) 8 Mr. Saurabh Garg Drugs Inspector 9 Mr. Sourabh Mittal Drugs Inspector 10 Mr. Devendra Nath Drugs Inspector 11 Mr. Rakesh Negi Drugs Inspector 12 Mr. Amol Eknath Kandekar Drugs Inspector 13 Mr. Ankur Bansal Drugs Inspector 14 Mr. Fahim Khan Drugs Inspector 15 Mr. Rahul Panwar Drugs Inspector

Sr. No. Name of the Participant Office Address Designation 16 Mr. Rajesh Verma Drugs Inspector 17 Mr. Vinod Kumar Drugs Inspector 18 Mr. Pushpraj Kumar Singh Drugs Inspector 19 Ms. A Anbuselvi Drugs Inspector 20 Mr.BidyaSekhar Mishra Drugs Inspector 21 Mr.Hemant Madhukar Patil Drugs Inspector 22 Mr. Arvind Singh Panwar Drugs Inspector 23 Dr. Vijai Singh Karwasara Drugs Inspector 24 Mr.Surender Kumar Kaswan Drugs Inspector 25 Mr.Sandeep Kumar Drugs Inspector 26 Mr. Jay Jyoti Roy Drugs Inspector 27 Sh. A. K. Rai Drugs Inspector 28 Mr. Sanjay Kr. Agrawal Drugs Inspector 29 Mr. Sushant Sarkar Drugs Inspector 30 Mr. John Gerard Drugs Inspector

Sr. No. Name of the Participant Office Address Designation 31 Mr. Manish Singhal Drugs Inspector 32 Mr. Vinay Kumar Drugs Inspector 33 Mr. Dharmvir Singh Drugs Inspector 34 Ms. SunithaSeerapu Drugs Inspector 35 Mr. Manoj Choudhary Jatav Drugs Inspector 36 Ms. S. Sudarmathi Drugs Inspector 37 Rahul Singh Drugs Inspector 38 Mukesh Kumar Drugs Inspector 39 Ms. Prerna Saurabh Technical Data Associate 40 Ms. Vandana Technical Data Associate 41 Ms. Swarupa A. Wankhade Technical Data Associate 42 Ms. Pragya Sharma Technical Data Associate

After registration of all the participants and facilitators, Mrs. Rubina Bose, Assistant Drugs Controller (India), CDSCO welcomed all the experts and the participants and also explained the procedure of the workshop. Dr. A. Ramkishan, Deputy Drugs Controller (India) has chaired the session and emphasized on significance of development of good Protocols in Clinical Research and also briefed about the review procedures during the workshop. Preassessment and post assessment was also part of agenda for evolution of knowledge of the participants on the subject. The experts from Central Drugs Research Institute (CDRI) Mr. A.K. Saxena, Chief Scientist & Former Head, CDRI, Lucknow, delivered presentations on Drug Design & Development, Pre-formulation Studies up to Scale-up" and Pre-clinical safety evaluation (Safety, pharmacology & toxicology studies) as per regulatory requirements. Also Dr. Vivek Bhosale, Scientist, CDRI, Lucknow discussed the Design & Review of Clinical trial protocol (including method of randomization) and Clinical trial report. The case study and group discussion of individual topic imparted practical knowledge to all the participants. Dr. M. Kalaivani, Scientist-III, and Biostatistician, AIIMS, New Delhi gave presentation on Role of Biostatistician in review of Clinical Trial protocol and report along with case studies to all the participants. Dr. Sangeeta Yadav, Professor, MAMC, delivered presentation on Review of clinical trial protocol and report of vaccines- salient features to all the participants.

Dr. A. Ramkishan, Deputy Drugs Controller (India) has chaired the session and emphasized on significance of development of good Protocols in Clinical Research and also briefed about the review procedures during the workshop.

PRE - ASSESSMENT OF THE PARTICIPANTS

Dr. A.K. Saxena, Chief Scientist from CDRI Lucknow and Dr. Vivek Bhosale, Scientist discussed on various aspects of Drug Design & Development, Pre-formulation Studies up to Scale-up, Pre-clinical safety evaluation of drug and Design & Review of Clinical trial protocol respectively.

Case studies were given to all the participants during the presentation by the faculties to make learning interactive and interesting and easy to understand the concept of the presentations.

Post- assessment of the participants on 24 th January, 2014

THE THIRD DAY I.E. 24 TH JANUARY, 2014 WAS PLANNED FOR THE DRUGS INSPECTORS WHO REVIEW VACCINE CLINICAL TRIAL PROTOCOLS INCLUDING ADC (I) AND DDC (I) OF THE CONCERNED DIVISIONS. MR. S. P. SHANI, DEPUTY DRUGS CONTROLLER (INDIA) GAVE PRESENTATION ON VACCINE LICENSING AND PRE MARKET AUTHORIZATION.

DR. SANGEETA YADAV, PROFESSOR, MAULANA AZAD MEDICAL COLLEGE, NEW DELHI, DISCUSSED REVIEW OF CLINICAL TRIAL PROTOCOL AND REPORT OF VACCINES AND ALSO SHARED HER EXPERIENCE AS AN INVESTIGATOR OF CLINICAL TRIAL WITH THE CDSCO INSPECTION TEAM.

DR. M. KALAIVANI, SCIENTIST III, BIOSTATISTICIAN FROM AIIMS, NEW DELHI DISCUSSED CASE STUDY ON BIOSTATISTICS INVOLVED IN DESIGN OF CLINICAL TRIAL PROTOCOL AND REPORT OF VACCINE, ESTIMATION OF SAMPLE SIZE IN THE CLINICAL TRIAL AND ROLE OF BIOSTATISTICIAN FOR THE CALCULATION OF SAMPLE SIZE, STUDY DESIGN AND STATISTICAL ANALYSIS OF CLINICAL STUDY.

GROUP DISCUSSION ON VACCINE CLINICAL TRIAL PROTOCOL

Participants for workshop

OUTCOME OF WORKSHOP: THE PRESENTATION, GROUP DISCUSSION AND CASE STUDIES DURING THE WORKSHOP COVERED ALL THE IMPORTANT FUNCTIONAL AREA INCLUDING SYSTEMATIC REVIEW OF CLINICAL TRIAL PROTOCOL OF BIOLOGICAL AND MEDICINAL PRODUCTS AND GAVE ALL THE PARTICIPANTS ADEQUATE KNOWLEDGE AND CAPACITY FOR EVALUATION OF DOCUMENTS. THIS WOULD BE USEFUL FOR THEM TO IMPLEMENT THE KNOWLEDGE WITH CAPACITY OF PROPER REVIEW AND ANALYSIS LEADING TO UNIFORM REGULATORY DECISIONS.