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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2600117262 |
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最近更新日期: Date of Last Refreshed on: |
2026-01-21 16:33:45 |
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注册时间: Date of Registration: |
2026-01-21 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
扑米酮治疗肌萎缩侧索硬化症成人受试者的疗效和安全性研究——一项随机、双盲、安慰剂对照的临床试验 |
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Public title: |
Study on the Efficacy and Safety of Primidone in Adult with Amyotrophic Lateral Sclerosis — A Randomized, Double-blind, Placebo-controlled Clinical Trial |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
扑米酮治疗肌萎缩侧索硬化症成人受试者的疗效和安全性研究——一项随机、双盲、安慰剂对照的临床试验 |
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Scientific title: |
Study on the Efficacy and Safety of Primidone in Adult with Amyotrophic Lateral Sclerosis — A Randomized, Double-blind, Placebo-controlled Clinical Trial |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
李敏 |
研究负责人: |
魏钧 |
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Applicant: |
Min Li |
Study leader: |
Jun Wei |
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申请注册联系人电话: Applicant telephone: |
+86 158 7253 0467 |
研究负责人电话:
Study leader's |
+86 150 9092 2368 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
minli2018@ctgu.edu.cn |
研究负责人电子邮件: Study leader's E-mail: |
junwei@ctgu.edu.cn |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
宜昌市中心人民医院 |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
湖北省宜昌市湖堤街4号443000 |
研究负责人通讯地址: |
湖北省宜昌市湖堤街4号443000 |
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Applicant address: |
No. 4 Hudi Street, Yichang 443000, Hubei, China |
Study leader's address: |
No. 4 Hudi Street, Yichang 443000, Hubei, China |
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申请注册联系人邮政编码: Applicant postcode: |
443000 |
研究负责人邮政编码: Study leader's postcode: |
443000 |
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申请人所在单位: |
宜昌市中心人民医院 |
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Applicant's institution: |
Yichang Central People's Hospital |
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研究负责人所在单位: |
宜昌市中心人民医院 |
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Affiliation of the Leader: |
Yichang Central People's Hospital |
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是否获伦理委员会批准: |
是 |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
2025-355-01 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
宜昌市中心人民医院医学伦理委员会 |
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Name of the ethic committee: |
Medical Ethics Committee of Yichang Central People's Hospital |
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伦理委员会批准日期: Date of approved by ethic committee: |
2025-10-31 00:00:00 | ||
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伦理委员会联系人: |
王珊珊 |
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Contact Name of the ethic committee: |
Shanshan Wang |
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伦理委员会联系地址: |
湖北省宜昌市夷陵大道 183 号宜昌市中心人民医院行政楼4楼 |
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Contact Address of the ethic committee: |
4F, Administration Building, Yichang Central People's Hospital, 183 Yiling Avenue, Yichang, Hubei Province, China |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 717 648 1150 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
zxyyec@163.com |
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研究实施负责(组长)单位: |
宜昌市中心人民医院 |
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Primary sponsor: |
Yichang Central People's Hospital |
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研究实施负责(组长)单位地址: |
湖北省宜昌市西陵区解放路2号 |
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Primary sponsor's address: |
Yichang Central People's Hospital, 183 Yiling Avenue, Yichang, Hubei Province, China |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
自筹 |
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Source(s) of funding: |
Self-raised |
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研究疾病: |
肌萎缩侧索硬化症 |
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Target disease: |
Amyotrophic lateral sclerosis |
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研究疾病代码: |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
其它 | ||||||||||||||||||||||
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Study phase: |
N/A |
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研究设计: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
(一)主要目的:明确扑米酮治疗 ALS 受试者的有效性,即扑米酮对 ALS 受试者 ALSFRS-R 评分改善作用及进展速度延缓作用。 (二)次要目的:确定扑米酮治疗 ALS 受试者的安全性和耐受性。 (三)探索性目的:评估扑米酮在开放标签扩展期中的长期疗效和安全性。通过汉密顿抑郁量表(Hamilton Depression Scale,HAMD)、抑郁自评量表(Self-rating depression scale,SDS)评估 ALS 患者精神心理状体,探索扑米酮对 ALS 患者精神心理状态的影响。评估扑米酮对 ALS 患者体液生物样本(包括血液、尿液)蛋白组学和代谢组学等组学的影响(已建立稳定检测方案)。评估扑米酮对 ALS 患者外周血有核细胞(PBMC)程序性坏死激活分子标志物的影响(与中国科学院生物与化学交叉研究中心相关研究课题组已建立稳定检测技术且与本课题组形成了稳定合作机制)。评估扑米酮对 ALS 患者肠道菌群的影响(建立稳定检测方案)。分析外周血中程序性坏死标志物、细胞因子及其他 ALS 疾病病程相关的生物标志物(已在我院实验室建立稳定检测体系);扑米酮血药浓度;受试者疾病特征(疾病严重程度、疾病进展速度、起病部位、性别、体重指数、营养及呼吸支持情况等);探索对 ALS 的诊断、治疗、预后具有应用潜力的生物标志物。 |
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Objectives of Study: |
(I) Primary Objective: To clarify the efficacy of primidone in treating ALS subjects, specifically its effect on improving ALSFRS-R scores and slowing the rate of progression in ALS subjects. (II) Secondary Objective: To determine the safety and tolerability of primidone in treating ALS subjects. (III) Exploratory Objectives: To evaluate the long-term efficacy and safety of primidone during the open-label extension period. To assess the impact of primidone on the mental and psychological state of ALS patients using the Hamilton Depression Scale (HAMD) and the Self-rating Depression Scale (SDS). To explore the effects of primidone on proteomics, metabolomics, and other omics profiles in body fluid samples (including blood and urine) from ALS patients (stable detection protocols have been established). To evaluate the influence of primidone on molecular markers of programmed necrosis activation in peripheral blood mononuclear cells (PBMCs) of ALS patients (stable detection techniques have been established in collaboration with relevant research groups at the Chinese Academy of Sciences’ Bio-X and Chemical Research Center, and a stable cooperation mechanism has been formed with our research group). To assess the impact of primidone on the gut microbiota of ALS patients (stable detection protocols have been established). To analyze biomarkers related to programmed necrosis markers, cytokines, and other ALS disease progression in peripheral blood (stable detection systems have been established in our hospital’s laboratory); primidone plasma concentration; disease characteristics of subjects (disease severity, rate of progression, site of onset, gender, body mass index, nutritional and respiratory support status, etc.); and to explore potential biomarkers with diagnostic, therapeutic, and prognostic applications for ALS. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1.入选标准 (1)受试者在签署知情同意书时年龄必须介于 18-80 岁(含)之间。 (2)受试者根据 El Escorial 世界神经病学联合会标准修订版 16被诊断为可能、临床上很可能的 ALS、临床上很可能的实验室支持的ALS 或临床上明确的 ALS。 (3)受试者的 ALS 病程(从首次症状发作至筛选访视)≤2 年。 (4)筛选访视前受试者的 ALSFRS-R 研究前斜率 ≥ 0.5 分/月(ΔALSFRS-R =(48-筛选访视时的 ALSFRS-R 评分)/筛选访视与疾病发作之间的持续时间[月])。 (5)用力肺活量(FVC)为必须 ≥50%预测值。 (6)在筛选访视时受试者必须能够吞咽研究药片。 (7)受试者当前没有正在接受利鲁唑治疗,或在筛选访视前已接受稳定剂量的利鲁唑治疗至少 4 周。预计接受利鲁唑治疗的受试者在整个研究期间保持相同的剂量。 (8)受试者必须当前没有接受依达拉奉治疗,或正在接受获批的依达拉奉标准方案治疗。正在接受依达拉奉治疗的受试者在筛选访视前必须已完成至少 2 个周期的治疗,并预计在整个研究期间继续使用依达拉奉治疗。 (9)体重不低于 45 kg 且体重指数(BMI)不低于 18.0 kg/m2的受试者。 (10)受试者签署知情同意书并能遵守本方案中列出的要求和限制。 |
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Inclusion criteria |
(1) Subjects must be between 18 and 80 years of age (inclusive) at the time of signing the informed consent form. (2) Subjects are diagnosed with possible, clinically probable, clinically probable laboratory-supported, or clinically definite ALS according to the revised El Escorial World Federation of Neurology criteria. (3) The subject's ALS disease duration (from the onset of the first symptom to the screening visit) is ≤2 years. (4) The pre-study ALSFRS-R slope of the subject prior to the screening visit must be ≥0.5 points/month (ΔALSFRS-R = (48 - ALSFRS-R score at the screening visit) / duration in months between the screening visit and disease onset). (5) Forced Vital Capacity (FVC) must be ≥50% of the predicted value. (6) At the screening visit, the subject must be capable of swallowing the study tablets. (7) The subject is not currently receiving riluzole treatment, or has been on a stable dose of riluzole for at least 4 weeks prior to the screening visit. Subjects on riluzole treatment are expected to maintain the same dose throughout the study period. (8) The subject must not be currently receiving edaravone treatment, or must be undergoing treatment with an approved standard regimen of edaravone. Subjects receiving edaravone treatment must have completed at least 2 cycles prior to the screening visit and are expected to continue edaravone treatment throughout the study period. (9) Subjects with a body weight not less than 45 kg and a Body Mass Index (BMI) not less than 18.0 kg/m2. (10) The subject has signed the informed consent form and is able to comply with the requirements and restrictions listed in this protocol. |
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排除标准: |
(1)有惊厥发作或癫痫病史的受试者(不包括儿童期的发热性惊厥发作史)。 (2)存在显著认知受损、精神疾病、其他神经退行性疾病(例如帕金森病或 AD)、物质滥用(包括滥用药物、酒精、烟草和咖啡因)。 (3)受试者在筛选访视前 4 周内有严重感染(例如感染性肺炎、败血症);在筛选前 4 周内有需要住院或静脉注射抗生素、抗病毒药或抗真菌药治疗的感染;或根据研究者的判断认为不可接受的慢性细菌感染(例如结核病)的病史。 (4)受试者在筛选访视前 2 个月内有活动性带状疱疹感染。 (5)在筛选访视前 6 个月内有自杀未遂的记录,或研究者判断有自杀企图的风险的受试者。 (6)受试者有不稳定型或重度心脏、肺、肿瘤、肝或肾脏疾病史,或除 ALS 外妨碍其安全参加本研究的其他重大医学疾病史。 (7)受试者处于妊娠期或哺乳期。 (8)已知对扑米酮有过敏史的受试者。 (9)受试者在筛选访视前 14 天内接种过活疫苗。 (10)受试者同时参加任何其他干预性临床研究或在筛选访视前4 周或研究用药的 5 个半衰期内(以时间较长者为准)接受过另一种研究用药物治疗。 (11)受试者在过去的任何时间接受过干细胞或基因疗法治疗 ALS。 (12)人类免疫缺陷病毒(HIV)抗体检测阳性的受试者。 (13) 筛选访视时实验室检查异常的受试者,包括:丙氨酸氨基转移酶(ALT)或天门冬氨酸氨基转移酶(AST)> 3.0×正常值上限(ULN);胆红素 > 1.5×ULN;血清白蛋白 < 3.5 g/dL;肾小球滤过率估计值 < 60 mL/min/1.73 m2。研究者认为具有临床意义的其他异常实验室检查值。 (14)受试者在筛选访视时或研究药物首次给药前 3 个月内存在乙型肝炎表面抗原(HBsAg)或抗乙型肝炎核心抗体(抗 HBcAb)检测结果呈阳性。 (15)受试者在筛选访视时或开始研究药物给药前 3 个月内丙型肝炎抗体检测结果呈阳性。 (16)受试者在筛选访视前 1 个月内服用研究药物(扑米酮),或扑米酮中间代谢产物苯巴比妥血药浓度检测阳性。 (17)不能遵守研究方案服用扑米酮者。 |
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Exclusion criteria: |
(1) Subjects with a history of convulsive seizures or epilepsy (excluding a history of febrile seizures in childhood). (2) Subjects with significant cognitive impairment, psychiatric disorders, other neurodegenerative diseases (e.g., Parkinson's disease or Alzheimer's disease), or substance abuse (including drugs, alcohol, tobacco, and caffeine). (3) Subjects with severe infection (e.g., infectious pneumonia, sepsis) within 4 weeks prior to the screening visit; infection requiring hospitalization or intravenous antibiotic, antiviral, or antifungal treatment within 4 weeks prior to screening; or a history of chronic bacterial infection (e.g., tuberculosis) deemed unacceptable by the investigator's judgment. (4) Subjects with active herpes zoster infection within 2 months prior to the screening visit. (5) Subjects with a documented suicide attempt within 6 months prior to the screening visit, or those judged by the investigator to be at risk of suicide attempt. (6) Subjects with a history of unstable or severe cardiac, pulmonary, oncological, hepatic, or renal disease, or any other significant medical condition besides ALS that would preclude their safe participation in this study. (7) Subjects who are pregnant or breastfeeding. (8) Subjects with a known history of allergy to primidone. (9) Subjects who have received live vaccines within 14 days prior to the screening visit. (10) Subjects concurrently participating in any other interventional clinical trial or having received another investigational drug within 4 weeks prior to the screening visit or within 5 half-lives of the study drug (whichever is longer). (11) Subjects who have received stem cell or gene therapy for ALS at any time in the past. (12) Subjects who test positive for Human Immunodeficiency Virus (HIV) antibodies. (13) Subjects with abnormal laboratory findings at the screening visit, including: Alanine Aminotransferase (ALT) or Aspartate Aminotransferase (AST) > 3.0 x Upper Limit of Normal (ULN); Bilirubin > 1.5 x ULN; Serum Albumin < 3.5 g/dL; Estimated Glomerular Filtration Rate (eGFR) < 60 mL/min/1.73 m2; or other abnormal laboratory values considered clinically significant by the investigator. (14) Subjects with a positive test result for Hepatitis B surface antigen (HBsAg) or anti-Hepatitis B core antibody (anti-HBcAb) at the screening visit or within 3 months prior to the first dose of the study drug. (15) Subjects with a positive test result for Hepatitis C antibodies at the screening visit or within 3 months prior to the initiation of the study drug. (16) Subjects who have taken the investigational drug (primidone) within 1 month prior to the screening visit, or test positive for blood concentrations of phenobarbital, an intermediate metabolite of primidone. (17) Subjects who are unable to comply with the study protocol for taking primidone. |
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研究实施时间: Study execute time: |
从 From 2026-01-20 00:00:00至 To 2028-12-01 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2026-01-30 00:00:00 至 To 2026-06-30 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
研究者在 A 部分将 288 名患者分别通过 ALS 发病部位(延髓和其他部位)、利鲁唑的使用情况(是与否)和依达拉奉的使用情况(是与否)进行分层区组随机的方法按 2:1 随机分入扑米酮组和安慰剂组。 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
The investigators will randomly assign the 288 patients in Part A into the primidone group and the placebo group in a 2:1 ratio using stratified block randomization. The stratification factors include ALS site of onset (bulbar vs. other sites), riluzole use (yes vs. no), and edaravone use (yes vs. no). |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
公开/Public |
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盲法: |
受试者及研究者 |
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Blinding: |
Subjects and investigators |
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试验完成后的统计结果(上传文件): |
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Calculated Results after
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是否共享原始数据: IPD sharing |
是Yes |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
原始数据在试验完成后6个月内于中国临床试验注册中心公开。 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
The raw data will be made public on the Chinese Clinical Trial Registry within 6 months after the completion of the trial. |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
一、数据采集:由专人收集填写,并及时上报EDC系统。 二、源数据及其文件的管理:试验数据须具有可溯源性(Traceability)的性能。 1、CRF中数据应当与源文件一致,如有不一致应作出解释。 2、对CRF中数据进行的任何更改或更正都应该注明日期、签署姓名并解释原因(如需要并应使原来的记录依然可见。 3、临床试验数据的稽查轨迹(Audit Trail),从第一次的数据录入以及每一次的更改、删除或增加,都必须保留在临床试验数据库系统中。稽查轨迹应包括更改的日期、时间、更改人、更改原因、更改前数据值、更改后数据值。此稽查轨迹为系统保护,不允许任何人为的修改和编辑。稽查轨迹记录应存档并可查询。 4、临床试验数据管理系统必须有完善的系统权限管理。纸质化或电子化的数据管理均需要制定SOPs进行权限控制(Access Control)与管理。对数据管理系统中不同人员或角色授予不同的权限,只有经过授权的人员才允许操作(记录、修改等),并应采取适当的方法来监控和防止未获得授权的人的操作。 三、数据核查制度: 1、核查内容:数据核对制度:随机化核查,违背方案核查,时间窗核查,逻辑核查,范围核查,一致性核查。 2、数据管理人员应对方案中规定的主要和次要有效性指标、关键的安全性指标进行充分的核查以确保这些数据的正确性和完整性。 3、每个临床研究人员有责任采用不同的工具从不同的角度参与数据库的疑问清理工作。 4、对于事先定义的逻辑简单且能明确判断的错误,在得到研究者同意后数据管理员可对数据按照事先的规定进行修订,并记录在稽查轨迹里。 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
I. Data Collection: Collected and filled in by a dedicated person and reported to the EDC system in a timely manner. II. Management of Source Data and Its Documents: Trial data must have the performance of traceability. 1. The data in the CRF should be consistent with the source documents. If there are inconsistencies, explanations should be provided. 2. Any changes or corrections made to the data in the CRF should be dated, signed with the name, and the reasons should be explained (if necessary, the original record should still be visible). 3. The audit trail of clinical trial data, from the first data entry and every change, deletion, or addition, must be retained in the clinical trial database system. The audit trail should include the date and time of the change, the person making the change, the reason for the change, the data value before the change, and the data value after the change. This audit trail is protected by the system, and no manual modification or editing is allowed. The audit trail records should be archived and retrievable. 4. The clinical trial data management system must have a perfect system permission management. Whether it is paper - based or electronic data management, SOPs need to be formulated for access control and management. Different permissions should be granted to different personnel or roles in the data management system. Only authorized personnel are allowed to operate (record, modify, etc.), and appropriate methods should be adopted to monitor and prevent the operations of unauthorized persons. III. Data Verification System: 1. Verification Content: Data verification system: Randomization verification, protocol violation verification, time - window verification, logical verification, range verification, consistency verification. 2. Data managers should conduct full verification of the primary and secondary efficacy indicators and key safety indicators specified in the protocol to ensure the correctness and integrity of these data. 3. Each clinical researcher is responsible for participating in the query - cleaning work of the database from different perspectives using different tools. 4. For pre - defined errors with simple logic and clear judgment, after obtaining the consent of the researcher, the data administrator can revise the data according to the pre - set regulations and record it in the audit trail. |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
有/Yes |