[The national legislation accompanying the approval procedure for clinical trials of medicinal products for human use under Regulation (EU) No. 536/2014]. / Die nationale Begleitgesetzgebung zum Genehmigungsverfahren klinischer Prüfungen mit Humanarzneimitteln im Rahmen der Verordnung (EU) Nr. 536/2014.

The Regulation (EU) No 536/2014 (Clinical Trials Regulation [CTR]) on clinical trials on medicinal products for human use is a challenge not only for sponsors but also for national authorities and ethics committees. Thus, fundamental structural changes were necessary for the establishment of the novel authorisation procedure. The necessary accompanying law was created in 2016 with the Fourth Law on the Amendment of the Medicinal Products Act (4th AMGÄndG) and in 2017 with the Clinical Trial Assessment Procedure Ordinance (KPBV).The 4th AMGÄndG provided for legal amendments to the Medicinal Products Act (AMG) that came into force in advance of the date of application of the CTR. Essentially, this concerns the introduction of a registration obligation for ethics committees at the Federal Institute for Drugs and Medical Devices (BfArM). In addition, the 4th AMGÄndG contains regulations that came into force at the beginning of 2022, in parallel with the date of application of the CTR. The Regulation on the application of Good Clinical Practice in the conduct of clinical trials of medicinal products for human use (GCP-Regulation, GCP-V) was repealed. The 6th section of the AMG on the protection of humans in clinical trials has been rewritten to supplement the requirements of the CTR and to fit the procedural flow into the national legal system. In particular, this concerns the regulations on the cooperation between higher federal authorities and ethics committees, such as responsibilities, deadlines, procedures and fees. Regulations were also made for the national procedure of release authorisation for clinical trials with medicinal products containing or consisting of genetically modified organisms (GMOs) as well as special protective regulations for special groups of participants.

[Principles of the EU Clinical Trials Regulation No 536/2014 : What will change?] / Grundzüge der EU-Verordnung 536/2014 : Was wird sich ändern?

The new Regulation (EU) No. 536/2014 for clinical trials of medicinal products for human use will replace the still valid European Directive 2001/20/EC in the future. The new regulation aims to further harmonise authorisation and reporting procedures for clinical trials and introduces of a joint European assessment for multinational clinical trials in the EU. Despite the joint assessment administered by a reporting member state, each member state continues to authorise clinical trial applications nationally. In the future, applications and any communication will be submitted paperlessly via a new electronic EU portal, which is still being developed. The regulation provides detailed information on the implementation of multinational clinical trials. In particular, the complex processing procedures and shorter time limits are to be stressed in comparison to the previously valid regulations. This is a major challenge for all stakeholders, but on the other hand it should contribute to the future role of the EU in the development of innovative medicines.

[Changes in the German Medicinal Product Act imposed by the EU regulation on clinical trials]. / Änderungen des Arzneimittelgesetzes durch die EU-Verordnung zu klinischen Prüfungen.

The entry into force of Regulation (EU) No. 536/2014 of the European Parliament, the Council of 16 April 2014 for clinical trials on medicinal products for human use, and repealing Directive 2001/20/EC necessitated amendments to the national legislation on medicinal products. These changes mainly concern the sixth chapter of the German Medicinal Products Act (Arzneimittelgesetz, AMG) and the elimination of the GCP (good clinical practice) ordinance for clinical trials that will be covered by the regulation in the future. Sections 41a, 41b and 41c, which came into force in December 2016, regulate the registration procedure, the procedural rules and the business distribution plan according to which the responsibilities of the registered ethics committees for the authorisation procedures will be determined and cooperation with the federal higher authorities will be handled. All other amendments in the sixth chapter will not enter into force until the date of application of the regulation - presumably in the fourth quarter of 2018. In the future, Section 40a will regulate the general prerequisites - in particular the basic procedures for cooperation between the federal higher authority and the ethics committees - in addition to the provisions of the regulation. Section 40b governs special prerequisites for clinical trials and contains, in particular provisions for the informed consent in clinical trials with minors and incapacitated adults. Further changes concern, among other things, the transfer of previous regulations of the GCP ordinance into the AMG and adjustments regarding reporting obligations in the context of clinical trials in the AMG.

[Safety monitoring of cell-based medicinal products (CBMPs)]. / Überwachung der Sicherheit von Zelltherapeutika (CBMPs).

Cell-based medicinal products (CBMPs), a category of advanced-therapy medicinal products (ATMPs), are authorised for the European market by the European Commission by means of the centralized marketing authorisation. By conforming to the German Medicinal Products Act (Sec. 4b AMG), national authorisation can be granted by the Paul-Ehrlich-Institut in Germany exclusively for ATMPs not based on a routine manufacturing procedure. In both procedures, quality, efficacy, and safety are evaluated and the risk-benefit balance is assessed. For the centralised procedure, mainly controlled clinical trial data must be submitted, whereas the requirements for national procedures could be modified corresponding to the stage of development of the ATMP. After marketing authorization, the marketing authorization/license holder is obligated to report all serious adverse reactions to the competent authority and to provide periodic safety update reports. If necessary, post-authorization safety studies could be imposed. On the basis of these regulatory measures, the safety of advanced therapies can be monitored and improved.