The mission of the Clinical Trials Registry-India (CTRI) is to ensure that all clinical trials conducted in India are prospectively registered, i.e. before the enrolment of the first participant. Additionally, post-marketing surveillance studies, BA/BE studies as well as clinical studies as part of PG thesis are also expected to be registered in the CTRI. The vision of the CTRI is to ensure that every clinical trial conducted in the region is prospectively registered with full disclosure of the trial data set items. While this register is meant primarily for trials conducted in India, the CTRI will also accept registration of trials conducted in other countries in the region, which do not have a Primary Registry of its own, provided ethics approval (in English) is available and the study has not begun enrolling. The Clinical Trials Registry- India (CTRI), hosted at the ICMR's National Institute of Medical Statistics (http://icmr-nims.nic.in), is a free and online public record system for registration of clinical trials being conducted in India that was launched on 20th July 2007 (www.ctri.nic.in). Initiated as a voluntary measure, since 15th June 2009, trial registration in the CTRI has been made mandatory by the Drugs Controller General (India) (DCGI) (www.cdsco.nic.in). Moreover, Editors of Biomedical Journals of 11 major journals of India declared that only registered trials would be considered for publication1, 2.
Today, any researcher who plans to conduct a trial involving human participants, of any intervention such as drugs, surgical procedures, preventive measures, lifestyle modifications, devices, educational or behavioral treatment, rehabilitation strategies as well as trials being conducted in the purview of the Department of AYUSH (http://indianmedicine.nic.in/) is expected to register the trial in the CTRI before enrollment of the first participant. Trial registration involves public declaration and identification of trial investigators, sponsors, interventions, patient population etc before the enrollment of the first patient. Submission of Ethics approval and DCGI approval (if applicable) is essential for trial registration in the CTRI. Multi-country trials, where India is a participating country, which have been registered in an international registry, are also expected to be registered in the CTRI. In the CTRI, details of Indian investigators, trial sites, Indian target sample size and date of enrollment are captured. After a trial is registered, trialists are expected to regularly update the trial status or other aspects as the case may be. After a trial is registered, all updates and changes will be recorded and available for public display.
Siro Clinical Research Institute
Post Graduate Diploma in Clinical Research
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2. OVERVIEW
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01
• CLINICAL
RESEARCH
02
• CLINICAL
TRIAL
03
• CLINICAL
TRIALS
REGISTRY-
INDIA (CTRI)
3. CLINICAL
RESEARCH
Clinical research is a branch of healthcare science
that determines the safety and effectiveness of
medications, devices, diagnostic products and
treatment regimens intended for human use. These may
be used for prevention, treatment, diagnosis or for
relieving symptoms of a disease.
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4. CLINICAL
TRIAL
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Any investigation in human subjects intended to
discover or verify the clinical, pharmacological and/or
other pharmacodynamic effects of an investigational
product(s), and/or to identify any adverse reactions to
an investigational product(s), and/or to study
absorption, distribution, metabolism and excretion of
an investigational product(s) with the object of
ascertaining its safety and/or efficacy is known as
Clinical Trial.
5. PHASES IN CLINICAL TRIALS
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PRECLINICAL
• Animal
Studies
PHASE I
• Human
Pharmacology
PHASE II
• Therapeutic
Exploratory
PHASE III
• Therapeutic
Confirmatory
FDA
APPROVAL
PHASE IV
• Post-
marketing
Studies
6. CLINICAL
TRIALS
REGISTRY-
INDIA (CTRI)
The Clinical Trial Registry of India (CTRI) – is an online
system developed by National Institute of Medical
Statistics, under Indian Council for Medical Research
(ICMR), New Delhi.
The Clinical Trials Registry – India (CTRI), is a free,
searchable online platform for registration of clinical
trials being conducted in India and as well as countries
which do not have a Primary Registry of their own.
The registered trials are freely searchable not only
through CTRI but also from the International Clinical
Trials Registry Platform (ICTRP).
At present the Government of India has made
registration of Clinical trials in this CTRI registry as
mandatory and is notified by Drug Controller General
of India (DCGI).
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7. INTRODUCTION
The Clinical Trials Registry – India (CTRI) is a free, online platform (www.ctri.nic.in) for registering
clinical trials being conducted in India and countries which do not have a Primary Registry of their
own.
From its inconspicuous and humble beginnings on July 20, 2007, with just 11 trials registered in the
first 6 months, after a decade, the CTRI now has >12,000 trials registered.
Currently, the CTRI registers all types of clinical studies including interventional trials (73%),
observational (24%), bioavailability/bioequivalence, and post marketing surveillance studies (3%).
All registered trials are freely searchable and viewable by the public from the CTRI homepage using
appropriate and relevant keywords.
In 2005, the International Committee of Medical Journal Editors took the lead in listing minimum
requirements for protocol-related data to be published in publicly available registries before trial
initiation, without which manuscripts would not be considered for publication.
Apart from transparency, setting up of the CTRI is expected to help remove publication bias by
bringing in all the trial results, positive or negative, in the public domain and also prevent duplicate
research
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8. HISTORY
The CTRI, an online trial registry portal, was launched on July 20, 2007. The CTRI is hosted and
managed by ICMR-National Institute of Medical Statistics, New Delhi.
In February 2008, editors of 11 Indian biomedical journals came out in support of clinical trial
registration. They published a joint statement stating their support for trial registration with a
pledge not to accept any unregistered clinical trial for publication in their journal from 2010
onward.
In December 2008,the World Health Organization (WHO) recognized CTRI as a Primary
Registry and since then, every month, data from the CTRI is transferred to the International
Clinical Trials Registry Platform, which is a one-stop portal for all registered clinical trials being
conducted all over in the world.
The CTRI continued to actively promote and advocate prospective trial registration and made
specific efforts to rope in major stakeholders. These efforts paid off and in 2009, the Central
Drugs Standard Control Organization (CDSCO) gave a major boost to the mission of CTRI by
making it mandatory for all regulatory trials to be prospectively registered in the CTRI.
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9. HISTORY
The CTRI software was upgraded and the revised software application with its
previously registered data intact was implemented on March 15, 2011. The new
application helped CTRI become an entirely paperless portal as electronic copies of
ethics and regulatory approvals could be uploaded into the system. Further, the revised
software included more drop-down options, better search as well as audit trail facilities.
The CTRI organized a series of workshops, including that for ethics committee
members, to garner their support for trial registration. This further enhanced trial
registration in CTRI, as several ethics committees made trial registration mandatory. In
addition, as a direct result of CTRI advocacy efforts, AYUSH (Ayurveda, Yoga, Unani,
Siddha, and Homeopathy) studies were also brought under the umbrella of
registration.
In 2015, an e-tutorial of the CTRI was launched. This tutorial guides the interested
stakeholder through the entire process of trial registration and search facilities offered
by the CTRI.
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10. OBJECTIVE, MISSION & VISION OF CTRI
Objective of CTRI:
The main objective of this CTRI is to ensure transparency, accountability and
accessibility of all the clinical trials that are being conducted in India.
Mission of CTRI:
The mission of CTRI is to encourage all clinical trials conducted in India to be
prospectively registered. i.e. before the enrollment of first participant.
Vision of CTRI:
The vision of CTRI is to ensure every clinical trial conducted in the region is
prospectively registered with full disclosure of the trial data set times. Though this register is
primarily meant for trials conducted in India, the CTRI will also accept registration of trials
conducted in other countries in the region, which do not have a primary registry of its own.
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11. Why is Trial Registration Important?
Prevent selective reporting and publication of positive results
Prevent unnecessary duplication of research efforts
Empower patients and the public about planned or ongoing trials and if
necessary enroll in them.
Give ethics committees and researchers access to studies being conducted and
compare them to research that is under their consideration or is being planned.
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12. Signatories to Joint Statement
Indian Council of Medical Research (ICMR)
Research Council of Norway
UK Medical Research Council
Medicines' Sans Frontier's
Epicenters
CEPI (Coalition for Epidemic Preparedness Innovations)
PATH (Program for Appropriate Technology in Health)
Institute Pasteur
Bill and Melinda Gates Foundation
Welcome Trust
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13. TYPES OF TRIAL REGISTRATION
1 •Prospective Registration
2 •Retrospective Registration
3 •Yet to be submitted Trials
4 •Updating Registered Trials
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14. IMPACT OF CTRI
Information base for stakeholders
A learning tool
Impact on ethics of research
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15. Financial support and sponsorship
The CTRI has been set up with financial support from :-
1. The Department of Science and Technology (DST)
2. The Government of India (GOI)
3. The Indian Council of Medical Research (ICMR)
4. The Ministry of Health and Family Welfare (MOHFW)
5. World Health Organization (WHO) New Delhi, India
NOTE - No funding has been received for the preparation of this manuscript.
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16. How to Register a Trial?
Trial registration in the CTRI is an online process and free of cost. The trial registration dataset
of the CTRI is given in the below picture.
Process of trial registration is discussed in detail in the E- tutorial on the home page of CTRI.
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17. REGISTRATION PROCESS (1/2)
Public declaration and Identification of Trial Investigators
Sponsor details
Intervention details
Study details like Method and conduct of Study, Population, Study Place,
Health condition/problem studied, Study type
Trial sites
IEC/DCGI approval
Outcome of the study
Recruitment status of the trial
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18. REGISTRATION PROCESS (2/2)
Brief summary
Estimated duration of the trial
Recruitment status of the trial
After registration of a trial, the trial lists and changes are updated
regularly and are recorded. The details are available for public display. Being a
Primary Register of the International Clinical Trials Registry Platform (ICTRP)
(http://www.who.int/ictrp/search/en/), registered trials are freely searchable
both from the WHO’s search portal, the ICTRP as well as from the CTRI
(www.ctri.nic.in)
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19. Registration Data Set of the CTRI (1/4)
1. Registration Number
2. Trial Registration Date
3. Public Title of Study*
4. Scientific Title of Study Acronym, if any*
5. Secondary IDs, (UTN, Protocol No etc.)*
6. Principal Investigator’s Name and Address
7. Contact Person (Scientific Query)*
8. Contact Person (Public Query)*
9. Source/s of Material or Monetary Support*
10. Primary Sponsor*
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20. Registration Data Set of the CTRI (2/4)
11. Secondary Sponsor*
12. Countries of Recruitment*
13. Site/s of study*
14. Name of Ethics Committee and approval status*
15. Regulatory Clearance obtained from DCGI*
16. Health Condition/Problem studied*
17. Study Type*
18. Intervention and Comparator agent*
19. Key inclusion/Exclusion Criteria*
20. Method of generating randomization sequence
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21. Registration Data Set of the CTRI (3/4)
21. Method of allocation concealment
22. Blinding and masking
23. Primary Outcome/s*
24. Secondary Outcome/s*
25. Target sample size*
26. Phase of Trial*
27. Date of first enrollment*
28. Estimated duration of trial
29. Status of Trial*
30. Publication
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22. Registration Data Set of the CTRI (4/4)
31. Brief Summary*
32. Date of actual study completion
33. Final enrolment number achieved.
NOTE -
Underlined items are assigned by the CTRI software upon trial registration.
Items marked with an (*)are mandatory items i.e. without these items the trial will not be
submitted
Items in Black are WHO Data Set items.
Items in Green are additional requirements in the CTRI.
Items in Red are New Data Set Items for Completed /Terminated trial.
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23. How to use CTRI Website?
• www.ctri.nic.in
• ICTRP search portal (who.int)
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24. What is Trial Verification?
An email is sent from CTRI to all contact persons mentioned
in the trial registration form (except to the trial registrant). Once all
the trial contact persons respond, trial verification process is
considered complete.
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