ICH E6(R3) 1.2
Any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product.
An adverse event encompasses any unfavorable and unintended sign, symptom, or disease temporally associated with the use of an investigational product or study procedure, whether or not considered related to the treatment. This deliberately broad definition ensures comprehensive safety monitoring by capturing all medical occurrences during a trial, allowing patterns and potential safety signals to emerge that might not be apparent if only suspected drug-related events were recorded. The definition explicitly states that causality need not be established; the temporal association alone is sufficient to trigger documentation requirements.
Adverse events range in severity from minor inconveniences, such as mild headaches or temporary nausea, to life-threatening conditions requiring immediate medical intervention. Severity is typically graded using standardized scales such as mild, moderate, or severe, or using the Common Terminology Criteria for Adverse Events which provides detailed grading criteria for specific event types. Clinical trials establish systematic processes for identifying, documenting, and evaluating adverse events throughout the study, with clear procedures for reporting events to the sponsor and, where required, to regulatory authorities.
The distinction between adverse events and adverse drug reactions is clinically and regulatorily significant. While an adverse event is any untoward occurrence regardless of suspected cause, an adverse drug reaction implies a reasonable possibility of causal relationship with the investigational product. This distinction influences reporting requirements and timelines, with suspected adverse drug reactions often triggering more stringent notification requirements, particularly when they are both serious and unexpected. Site personnel must be trained to recognize and appropriately document all adverse events while also providing causality assessments for serious events.
Comprehensive adverse event collection and analysis represents a cornerstone of clinical trial safety evaluation. Investigators must diligently identify and record all adverse events occurring during the study period, even those that seem unrelated to treatment. These data enable safety reviewers and regulatory authorities to identify patterns that might indicate previously unrecognized risks. The aggregate adverse event profile from clinical trials ultimately informs the product's safety labeling and guides prescribers and patients in making treatment decisions.
Clinical trial monitoring
"During the monthly safety review, the Data Safety Monitoring Board noted an increased frequency of headache adverse events in the treatment group compared to placebo, prompting additional analysis to determine whether this represented a drug-related effect."
Site documentation
"The clinical research coordinator documented the participant's report of mild nausea as an adverse event in the case report form, recording the onset date, duration, severity grade, outcome, and any actions taken, regardless of suspected relationship to the study drug."
Ongoing monitoring
"Throughout the participant's time on study, all new symptoms, worsening of existing conditions, and abnormal laboratory values meeting protocol-defined criteria were captured as adverse events to ensure comprehensive safety monitoring."
A response to a medicinal product that is noxious and unintended, where a causal relationship between the product and the adverse event is at least a reasonable possibility.
The strictest warning required by the FDA to appear on prescription drug labeling, alerting prescribers and patients to serious risks that may lead to death or severe injury.
The systematic evaluation of the likelihood that an adverse event was caused by the investigational product or another factor, using established criteria to determine the relationship between exposure and outcome.
A standardized one-page format developed by the Council for International Organizations of Medical Sciences for reporting suspected adverse drug reactions from clinical trials to regulatory authorities.
A specific situation or condition in which a drug, procedure, or treatment should not be used because it may be harmful to the patient.
ICH E6(R3) 1.2
Any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product.
An adverse event encompasses any unfavorable and unintended sign, symptom, or disease temporally associated with the use of an investigational product or study procedure, whether or not considered related to the treatment. This deliberately broad definition ensures comprehensive safety monitoring by capturing all medical occurrences during a trial, allowing patterns and potential safety signals to emerge that might not be apparent if only suspected drug-related events were recorded. The definition explicitly states that causality need not be established; the temporal association alone is sufficient to trigger documentation requirements.
Adverse events range in severity from minor inconveniences, such as mild headaches or temporary nausea, to life-threatening conditions requiring immediate medical intervention. Severity is typically graded using standardized scales such as mild, moderate, or severe, or using the Common Terminology Criteria for Adverse Events which provides detailed grading criteria for specific event types. Clinical trials establish systematic processes for identifying, documenting, and evaluating adverse events throughout the study, with clear procedures for reporting events to the sponsor and, where required, to regulatory authorities.
The distinction between adverse events and adverse drug reactions is clinically and regulatorily significant. While an adverse event is any untoward occurrence regardless of suspected cause, an adverse drug reaction implies a reasonable possibility of causal relationship with the investigational product. This distinction influences reporting requirements and timelines, with suspected adverse drug reactions often triggering more stringent notification requirements, particularly when they are both serious and unexpected. Site personnel must be trained to recognize and appropriately document all adverse events while also providing causality assessments for serious events.
Comprehensive adverse event collection and analysis represents a cornerstone of clinical trial safety evaluation. Investigators must diligently identify and record all adverse events occurring during the study period, even those that seem unrelated to treatment. These data enable safety reviewers and regulatory authorities to identify patterns that might indicate previously unrecognized risks. The aggregate adverse event profile from clinical trials ultimately informs the product's safety labeling and guides prescribers and patients in making treatment decisions.
Clinical trial monitoring
"During the monthly safety review, the Data Safety Monitoring Board noted an increased frequency of headache adverse events in the treatment group compared to placebo, prompting additional analysis to determine whether this represented a drug-related effect."
Site documentation
"The clinical research coordinator documented the participant's report of mild nausea as an adverse event in the case report form, recording the onset date, duration, severity grade, outcome, and any actions taken, regardless of suspected relationship to the study drug."
Ongoing monitoring
"Throughout the participant's time on study, all new symptoms, worsening of existing conditions, and abnormal laboratory values meeting protocol-defined criteria were captured as adverse events to ensure comprehensive safety monitoring."
A response to a medicinal product that is noxious and unintended, where a causal relationship between the product and the adverse event is at least a reasonable possibility.
The strictest warning required by the FDA to appear on prescription drug labeling, alerting prescribers and patients to serious risks that may lead to death or severe injury.
The systematic evaluation of the likelihood that an adverse event was caused by the investigational product or another factor, using established criteria to determine the relationship between exposure and outcome.
A standardized one-page format developed by the Council for International Organizations of Medical Sciences for reporting suspected adverse drug reactions from clinical trials to regulatory authorities.
A specific situation or condition in which a drug, procedure, or treatment should not be used because it may be harmful to the patient.