ClinicalTrials.gov is a registry of clinical trials. It is run by the United States National Library of Medicine (NLM) at the National Institutes of Health, and is the largest clinical trials database, currently holding registrations from over 93,000 trials from more than 170 countries in the world.
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As a result of pressure from HIV-infected men in the gay community, who demanded better access to clinical trials, the U.S. Congress passed the Health Omnibus Programs Extension Act of 1988 (HOPE or Public Law 100-607) which mandated the development of a database of AIDS Clinical Trials Information System (ACTIS). This effort served as an example of what might be done to improve public access to clinical trials, and motivated other disease-related interest groups to push for something similar for all diseases.
The Food and Drug Administration Modernization Act of 1997 (FDAMA or Public Act 105-115) amended the Food, Drug and Cosmetic Act and the Public Health Service Act to require that the NIH create and operate a public information resource, which came to be called ClinicalTrials.gov, tracking drug efficacy studies resulting from approved Investigational New Drug (IND) applications (FDA Regulations 21 CFR Parts 312 and 812). With the primary purpose of improving access of the public to clinical trials where individuals with serious diseases and conditions might find experimental treatments, this law required information about:
The National Library of Medicine in the National Institutes of Health made ClinicalTrials.gov available to the public via the Internet on February 29, 2000[1]. In this initial release, ClinicalTrials.gov primarily included information about NIH-sponsored trials, omitting the majority of clinical trials being performed by private industry. On March 29, 2000 the FDA issued a Draft Guidance called Information Program on Clinical Trials for Serious or Life-Threatening Diseases: Establishment of a Data Bank and put into In) with the hope that this would increase use by industry. After a second draft guidance was released in June 2001, a final guidance was issued on March 18, 2002 titled Guidance for Industry Information Program on Clinical Trials for Serious or Life-Threatening Diseases and Conditions. The Best Pharmaceuticals for Children Act of 2004 (BPCA or Public Law 107-109 amended the Public Health Service Act to require that additional information be included in ClinicalTrials.gov.
As the result of toxicity tracking concerns raised following retraction of several drugs from the prescription market, ClinicalTrials.gov was further reinforced by the Food and Drug Administration Amendments Act of 2007 (FDAAA or U.S. Public Law 110-85) which mandated the expansion of ClinicalTrials.gov for better tracking of the basic results of clinical trials, requiring[2]:
The National Institutes of Health (NIH) of the U.S. Department of Health and Human Services (HHS) held a public meeting on Monday, April 20, 2009, on Expansion of the Clinical Trial Registry and Results Data Bank in accordance with section 801 of the Food and Drug Administration Amendments Act of 2007 (FDAAA) [Public Law 110-85]. The meeting was held in the Masur Auditorium on the NIH campus, and videotaped for public access.[3] NIH is now considering comments submitted from the public on what should be included in this expansion of the database.[4] One of goals of the expansion is to have more clearly defined and consistent standards for the reporting of clinical trials. This mandate will allow public access of the clinical trial data in this registry data bank, and that the information formats are easily used and compared by the public.[5]