| Page Range | 48441-48445 | |
| FR Document | 2018-20764 |
[Federal Register Volume 83, Number 186 (Tuesday, September 25, 2018)] [Notices] [Pages 48441-48445] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2018-20764] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0559] Agency Information Collection Activities; Proposed Collection; Comment Request; Public Health Service Guideline on Infectious Disease Issues in Xenotransplantation AGENCY: Food and Drug Administration, HHS. ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: The Food and Drug Administration (FDA or Agency) is announcing an opportunity for public comment on the proposed collection of certain information by the Agency. Under the Paperwork Reduction Act of 1995 (PRA), Federal Agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension of an existing collection of information, and to allow 60 days for public comment in response to this notice. This notice solicits comments on the collection of information contained in the Public Health Service (PHS) guideline entitled ``PHS Guideline on Infectious Disease Issues in Xenotransplantation'' dated January 19, 2001. DATES: Submit either electronic or written comments on the collection of information by November 26, 2018. ADDRESSES: You may submit comments as follows. Please note that late, untimely filed comments will not be considered. Electronic comments must be submitted on or before November 26, 2018. The https://www.regulations.gov electronic filing system will accept comments until midnight Eastern Time at the end of November 26, 2018. Comments received by mail/hand delivery/courier (for written/paper submissions) will be considered timely if they are postmarked or the delivery service acceptance receipt is on or before that date. Electronic Submissions Submit electronic comments in the following way:Federal eRulemaking Portal: https://www.regulations.gov. Follow the instructions for submitting comments. Comments submitted electronically, including attachments, to https://www.regulations.gov will be posted to the docket unchanged. Because your comment will be made public, you are solely responsible for ensuring that your comment does not include any confidential information that you or a third party may not wish to be posted, such as medical information, your or anyone else's Social Security number, or confidential business information, such as a manufacturing process. Please note that if you include your name, contact information, or other information that identifies you in the body of your comments, that information will be posted on https://www.regulations.gov. If you want to submit a comment with confidential information that you do not wish to be made available to the public, submit the comment as a written/paper submission and in the manner detailed (see ``Written/Paper Submissions'' and ``Instructions''). Written/Paper Submissions Submit written/paper submissions as follows: Mail/Hand delivery/Courier (for written/paper submissions): Dockets Management Staff (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. For written/paper comments submitted to the Dockets Management Staff, FDA will post your comment, as well as any attachments, except for information submitted, marked and identified, as confidential, if submitted as detailed in ``Instructions.'' Instructions: All submissions received must include the Docket No. FDA-2012-N-0559 for ``PHS Guideline on Infectious Disease Issues in Xenotransplantation.'' Received comments, those filed in a timely manner (see ADDRESSES), will be placed in the docket and, except for those submitted as ``Confidential Submissions,'' publicly viewable at https://www.regulations.gov or at the Dockets Management Staff between 9 a.m. and 4 p.m., Monday through Friday. Confidential Submissions--To submit a comment with confidential information that you do not wish to be made publicly available, submit your comments only as a written/paper submission. You should submit two copies total. One copy will include the information you claim to be confidential with a heading or cover note that states ``THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.'' The Agency will review this copy, including the claimed confidential information, in its consideration of comments. The second copy, which will have the claimed confidential information redacted/blacked out, will be available for public viewing and posted on https://www.regulations.gov. Submit both copies to the Dockets Management Staff. If you do not wish your name and contact information to be made publicly available, you can provide this information on the cover sheet and not in the body of your comments and you must identify this information as ``confidential.'' Any information marked as ``confidential'' will not be disclosed except in accordance with 21 CFR 10.20 and other applicable disclosure law. For more information about FDA's posting of comments to public dockets, see 80 FR 56469, September 18, 2015, or access the information at: https://www.thefederalregister.org/fdsys/pkg/FR-2015-09-18/pdf/2015-23389.pdf. Docket: For access to the docket to read background documents or the electronic and written/paper comments received, go to https://www.regulations.gov and insert the docket number, found in brackets in the heading of this document, into the ``Search'' box and follow the prompts and/or go to the Dockets Management Staff, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. [[Page 48442]] FOR FURTHER INFORMATION CONTACT: Ila S. Mizrachi, Office of Operations, Food and Drug Administration, Three White Flint North, 10A-12M, 11601 Landsdown St., North Bethesda, MD 20852, 301-796-7726, [email protected]. SUPPLEMENTARY INFORMATION: Under the PRA (44 U.S.C. 3501-3520), Federal Agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. ``Collection of information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and includes Agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party. Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires Federal Agencies to provide a 60-day notice in the Federal Register concerning each proposed collection of information, including each proposed extension of an existing collection of information, before submitting the collection to OMB for approval. To comply with this requirement, FDA is publishing notice of the proposed collection of information set forth in this document. With respect to the following collection of information, FDA invites comments on these topics: (1) Whether the proposed collection of information is necessary for the proper performance of FDA's functions, including whether the information will have practical utility; (2) the accuracy of FDA's estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques, when appropriate, and other forms of information technology. PHS Guideline on Infectious Disease Issues in Xenotransplantation OMB Control Number 0910-0456--Extension The statutory authority to collect this information is provided under sections 351 and 361 of the PHS Act (42 U.S.C. 262 and 264) and the provisions of the Federal Food, Drug, and Cosmetic Act that apply to drugs (21 U.S.C. 321 et seq.). The PHS guideline recommends procedures to diminish the risk of transmission of infectious agents to the xenotransplantation product recipient and to the general public. The PHS guideline is intended to address public health issues raised by xenotransplantation, through identification of general principles of prevention and control of infectious diseases associated with xenotransplantation that may pose a hazard to the public health. The collection of information described in this guideline is intended to provide general guidance on the following topics: (1) The development of xenotransplantation clinical protocols; (2) the preparation of submissions to FDA; and (3) the conduct of xenotransplantation clinical trials. Also, the collection of information will help ensure that the sponsor maintains important information in a cross-referenced system that links the relevant records of the xenotransplantation product recipient, xenotransplantation product, source animal(s), animal procurement center, and significant nosocomial exposures. The PHS guideline describes an occupational health service program for the protection of health care workers involved in xenotransplantation procedures, caring for xenotransplantation product recipients, and performing associated laboratory testing. The PHS guideline is intended to protect the public health and to help ensure the safety of using xenotransplantation products in humans by preventing the introduction, transmission, and spread of infectious diseases associated with xenotransplantation. The PHS guideline also recommends that certain specimens and records be maintained for 50 years beyond the date of the xenotransplantation. These include: (1) Records linking each xenotransplantation product recipient with relevant health records of the source animal, herd or colony, and the specific organ, tissue, or cell type included in or used in the manufacture of the product (3.2.7.1); (2) aliquots of serum samples from randomly selected animal and specific disease investigations (3.4.3.1); (3) source animal biological specimens designated for PHS use (3.7.1); animal health records (3.7.2), including necropsy results (3.6.4); and (4) recipients' biological specimens (4.1.2). The retention period is intended to assist health care practitioners and officials in surveillance and in tracking the source of an infection, disease, or illness that might emerge in the recipient, the source animal, or the animal herd or colony after a xenotransplantation. The recommendation for maintaining records for 50 years is based on clinical experience with several human viruses that have presented problems in human to human transplantation and are therefore thought to share certain characteristics with viruses that may pose potential risks in xenotransplantation. These characteristics include long latency periods and the ability to establish persistent infections. Several also share the possibility of transmission among individuals through intimate contact with human body fluids. Human immunodeficiency virus (HIV) and Human T-lymphotropic virus are human retroviruses. Retroviruses contain ribonucleic acid that is reverse-transcribed into deoxyribonucleic acid (DNA) using an enzyme provided by the virus and the human cell machinery. That viral DNA can then be integrated into the human cellular DNA. Both viruses establish persistent infections and have long latency periods before the onset of disease, 10 years and 40 to 60 years, respectively. The human hepatitis viruses are not retroviruses, but several share with HIV the characteristic that they can be transmitted through body fluids, can establish persistent infections, and have long latency periods, e.g., approximately 30 years for Hepatitis C. In addition, the PHS guideline recommends that a record system be developed that allows easy, accurate, and rapid linkage of information among the specimen archive, the recipient's medical records, and the records of the source animal for 50 years. The development of such a record system is a one-time burden. Such a system is intended to cross- reference and locate relevant records of recipients, products, source animals, animal procurement centers, and significant nosocomial exposures. Respondents to this collection of information are the sponsors of clinical studies of investigational xenotransplantation products under investigational new drug applications (INDs) and xenotransplantation product procurement centers, referred to as source animal facilities. There are an estimated three respondents who are sponsors of INDs that include protocols for xenotransplantation in humans and five clinical centers doing xenotransplantation procedures. Other respondents for this collection of information are an estimated four source animal facilities which provide source xenotransplantation product material to sponsors for use in human xenotransplantation procedures. These four source animal facilities keep medical records of the herds/colonies as well as the medical records of the individual source animal(s). The burden estimates are based on FDA's records of [[Page 48443]] xenotransplantation-related INDs and estimates of time required to complete the various reporting, recordkeeping, and third-party disclosure tasks described in the PHS guideline. FDA is requesting an extension of OMB approval for the following reporting, recordkeeping, and third-party disclosure recommendations in the PHS guideline: Table 1--Reporting Recommendations ------------------------------------------------------------------------ PHS guideline section Description ------------------------------------------------------------------------ 3.2.7.2.................. Notify sponsor or FDA of new archive site when the source animal facility or sponsor ceases operations. ------------------------------------------------------------------------ Table 2--Recordkeeping Recommendations ------------------------------------------------------------------------ PHS guideline section Description ------------------------------------------------------------------------ 3.2.7.................... Establish records linking each xenotransplantation product recipient with relevant records. 4.3...................... Sponsor to maintain cross-referenced system that links all relevant records (recipient, product, source animal, animal procurement center, and nosocomial exposures). 3.4.2.................... Document results of monitoring program used to detect introduction of infectious agents which may not be apparent clinically. 3.4.3.2.................. Document full necropsy investigations including evaluation for infectious etiologies. 3.5.1.................... Justify shortening a source animal's quarantine period of 3 weeks prior to xenotransplantation product procurement. 3.5.2.................... Document absence of infectious agent in xenotransplantation product if its presence elsewhere in source animal does not preclude using it. 3.5.4.................... Add summary of individual source animal record to permanent medical record of the xenotransplantation product recipient. 3.6.4.................... Document complete necropsy results on source animals (50-year record retention). 3.7...................... Link xenotransplantation product recipients to individual source animal records and archived biologic specimens. 4.2.3.2.................. Record baseline sera of xenotransplantation health care workers and specific nosocomial exposure. 4.2.3.3 and 4.3.2........ Keep a log of health care workers' significant nosocomial exposure(s). 4.3.1.................... Document each xenotransplant procedure. 5.2...................... Document location and nature of archived specimens in health care records of xenotransplantation product recipient and source animal. ------------------------------------------------------------------------ Table 3--Disclosure Recommendations ------------------------------------------------------------------------ PHS guideline section Description ------------------------------------------------------------------------ 3.2.7.2.................. Notify sponsor or FDA of new archive site when the source animal facility or sponsor ceases operations. 3.4...................... Standard operating procedures (SOPs) of source animal facility should be available to review bodies. 3.5.1.................... Include increased infectious risk in informed consent if source animal quarantine period of 3 weeks is shortened. 3.5.4.................... Sponsor to make linked records described in section 3.2.7 available for review. 3.5.5.................... Source animal facility to notify clinical center when infectious agent is identified in source animal or herd after xenotransplantation product procurement. ------------------------------------------------------------------------ FDA estimates the burden for this collection of information as follows: Table 4--Estimated Annual Reporting Burden \1\ ---------------------------------------------------------------------------------------------------------------- Number of PHS guideline section Number of responses per Total annual Average burden Total hours respondents respondent responses per response ---------------------------------------------------------------------------------------------------------------- 3.2.7.2 \2\..................... 1 1 1 0.50 0.5 (30 minutes) ---------------------------------------------------------------------------------------------------------------- \1\ There are no capital costs or operating and maintenance costs associated with this collection of information. \2\ FDA is using 1 animal facility or sponsor for estimation purposes. Table 5--Estimated Annual Recordkeeping Burden \1\ ---------------------------------------------------------------------------------------------------------------- Number of Average burden PHS guideline section Number of records per Total annual per Total hours recordkeepers recordkeeper records recordkeeping ---------------------------------------------------------------------------------------------------------------- 3.2.7 \2\....................... 1 1 1 16 16 4.3 \3\......................... 3 1 3 0.75 2.25 (45 minutes) 3.4.2 \4\....................... 3 10.67 32 0.25 8 (15 minutes) [[Page 48444]] 3.4.3.2 \5\..................... 3 2.67 8 0.25 2 (15 minutes) 3.5.1 \6\....................... 3 0.33 1 0.50 0.5 (30 minutes) 3.5.2 \6\....................... 3 0.33 1 0.25 0.25 (15 minutes) 3.5.4........................... 3 1 3 0.17 0.51 (10 minutes) 3.6.4 \7\....................... 3 2.67 8 0.25 2 (15 minutes) 3.7 \7\......................... 4 2 8 0.08 0.64 (5 minutes) 4.2.3.2 \8\..................... 5 25 125 0.17 21.25 (10 minutes) 4.2.3.2 \6\..................... 5 0.20 1 0.17 0.17 (10 minutes) 4.2.3.3 and 4.3.2 \6\........... 5 0.20 1 0.17 0.17 (10 minutes) 4.3.1........................... 3 1 3 0.25 0.75 (15 minutes) 5.2 \9\......................... 3 4 12 0.08 0.96 (5 minutes) ------------------------------------------------------------------------------- Total....................... .............. .............. .............. .............. 55.45 ---------------------------------------------------------------------------------------------------------------- \1\ There are no capital costs or operating and maintenance costs associated with this collection of information. \2\ A one-time burden for new respondents to set up a recordkeeping system linking all relevant records. FDA is using 1 new sponsor for estimation purposes. \3\ FDA estimates there is minimal recordkeeping burden associated with maintaining the record system. \4\ Monitoring for sentinel animals (subset representative of herd) plus all source animals. There are approximately 6 sentinel animals per herd x 1 herd per facility x 4 facilities = 24 sentinel animals. There are approximately 8 source animals per year (see footnote 7 of this table); 24 + 8 = 32 monitoring records to document. \5\ Necropsy for animal deaths of unknown cause estimated to be approximately 2 per herd per year x 1 herd per facility x 4 facilities = 8. \6\ Has not occurred in the past 3 years and is expected to continue to be a rare occurrence. \7\ On average 2 source animals are used for preparing xenotransplantation product material for one recipient. The average number of source animals is 2 source animals per recipient x 4 recipients annually = 8 source animals per year. (See footnote 5 of table 6 of this document.) \8\ FDA estimates there are 5 clinical centers doing xenotransplantation procedures x approximately 25 health care workers involved per center = 125 health care workers. \9\ Eight source animal records + 4 recipient records = 12 total records. Table 6--Estimated Annual Third-Party Disclosure Burden \1\ ---------------------------------------------------------------------------------------------------------------- Number of Average PHS guideline section Number of disclosures Total annual burden per Total hours respondents per respondent disclosures disclosure ---------------------------------------------------------------------------------------------------------------- 3.2.7.2 \2\..................... 1 1 1 0.50 0.5 (30 minutes) 3.4 \3\......................... 4 0.25 1 0.08 0.08 (5 minutes) 3.5.1 \4\....................... 4 0.25 1 0.25 0.25 (15 minutes) 3.5.4 \5\....................... 4 1 4 0.50 2 (30 minutes) 3.5.5 \4\....................... 4 0.25 1 0.25 0.25 (15 minutes) ------------------------------------------------------------------------------- Total....................... .............. .............. .............. .............. 3.08 ---------------------------------------------------------------------------------------------------------------- \1\ There are no capital costs or operating and maintenance costs associated with this collection of information. \2\ FDA is using 1 animal facility or sponsor for estimation purposes. \3\ FDA's records indicate that an average of 1 INDs are expected to be submitted per year. \4\ To our knowledge, has not occurred in the past 3 years and is expected to continue to be a rare occurrence. \5\ Based on an estimate of 12 patients treated over a 3 year period, the average number of xenotransplantation product recipients per year is estimated to be 4. Because of the potential risk for cross-species transmission of pathogenic persistent virus, the guideline recommends that health records be retained for 50 years. Since these records are medical records, the retention of such records for up to 50 years is not information subject to the PRA (5 CFR 1320.3(h)(5)). Also, because of the limited number of clinical studies with small patient populations, the [[Page 48445]] number of records is expected to be insignificant at this time. Information collections in this guideline not included in tables 1 through 6 can be found under existing regulations and approved under the OMB control numbers as follows: (1) ``Current Good Manufacturing Practice for Finished Pharmaceuticals,'' 21 CFR 211.1 through 211.208, approved under OMB control number 0910-0139; (2) ``Investigational New Drug Application,'' 21 CFR 312.1 through 312.160, approved under OMB control number 0910-0014; and (3) information included in a biologics license application, 21 CFR 601.2, approved under OMB control number 0910-0338. (Although it is possible that a xenotransplantation product may not be regulated as a biological product (e.g., it may be regulated as a medical device), FDA believes, based on its knowledge and experience with xenotransplantation, that any xenotransplantation product subject to FDA regulation within the next 3 years will most likely be regulated as a biological product.). However, FDA recognized that some of the information collections go beyond approved collections; assessments for these burdens are included in tables 1 through 6. In table 7, FDA identifies those collection of information activities that are already encompassed by existing regulations or are consistent with voluntary standards which reflect industry's usual and customary business practice. Table 7--Collection of Information Required by Current Regulations and Standards ------------------------------------------------------------------------ Description of 21 CFR section PHS guideline section collection of (unless otherwise information activity stated) ------------------------------------------------------------------------ 2.2.1.................... Document off-site 312.52. collaborations. 2.5...................... Sponsor ensures 312.62(c). counseling patient + family + contacts. 3.1.1 and 3.1.6.......... Document well- 312.23(a)(7)(a) and characterized health 211.84. history and lineage of source animals. 3.1.8.................... Registration with and 42 CFR 71.53. import permit from the Centers for Disease Control and Prevention. 3.2.2.................... Document collaboration 312.52. with accredited microbiology labs. 3.2.3.................... Procedures to ensure the 9 CFR parts 1, 2, humane care of animals. and 3 and PHS Policy \1\. 3.2.4.................... Procedures consistent AAALAC for accreditation by International the Association for Rules of Assessment and Accreditation \2\ Accreditation of and NRC Guide \3\. Laboratory Animal Care International (AAALAC International) and consistent with the National Research Council's (NRC) Guide. 3.2.5, 3.4, and 3.4.1.... Herd health maintenance 211.100 and and surveillance to be 211.122. documented, available, and in accordance with documented procedures; record standard veterinary care. 3.2.6.................... Animal facility SOPs.... PHS Policy \1\. 3.3.3.................... Validate assay methods.. 211.160(a). 3.6.1.................... Procurement and 211.100 and processing of 211.122. xenografts using documented aseptic conditions. 3.6.2.................... Develop, implement, and 211.84(d) and enforce SOP's for 211.122(c). procurement and screening processes. 3.6.4.................... Communicate to FDA 312.32(c). animal necropsy findings pertinent to health of recipient. 3.7.1.................... PHS specimens to be 312.23(a)(6). linked to health records; provide to FDA justification for types of tissues, cells, and plasma, and quantities of plasma and leukocytes collected. 4.1.1.................... Surveillance of 312.23(a)(6)(iii)(f xenotransplant ) and (g), and recipient; sponsor 312.62(b) and (c). ensures documentation of surveillance program life-long (justify >2 yrs.); investigator case histories (2 yrs. after investigation is discontinued). 4.1.2.................... Sponsor to justify 211.122. amount and type of reserve samples. 4.1.2.2.................. System for prompt 312.57(a). retrieval of PHS specimens and linkage to medical records (recipient and source animal). 4.1.2.3.................. Notify FDA of a clinical 312.32. episode potentially representing a xenogeneic infection. 4.2.2.1.................. Document collaborations 312.52. (transfer of obligation). 4.2.3.1.................. Develop educational 312.50. materials (sponsor provides investigators with information needed to conduct investigation properly). 4.3...................... Sponsor to keep records 312.57 and of receipt, shipment, 312.62(b). and disposition of investigative drug; investigator to keep records of case histories. ------------------------------------------------------------------------ \1\ The ``Public Health Service Policy on Humane Care and Use of Laboratory Animals'' (https://www.grants.nih.gov/grants/olaw/references/phspol.htm). \2\ AAALAC International Rules of Accreditation (https://www.aaalac.org/accreditation/rules.cfm). \3\ The NRC's ``Guide for the Care and Use of Laboratory Animals.'' Based on a review of the information collection since our last request for OMB approval, we have made no adjustments to our burden estimate. Dated: September 19, 2018. Leslie Kux, Associate Commissioner for Policy. [FR Doc. 2018-20764 Filed 9-24-18; 8:45 am] BILLING CODE 4164-01-P
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice. | |
| Dates | Submit either electronic or written comments on the collection of information by November 26, 2018. | |
| Contact | Ila S. Mizrachi, Office of Operations, Food and Drug Administration, Three White Flint North, 10A-12M, 11601 Landsdown St., North Bethesda, MD 20852, 301-796-7726, [email protected] | |
| FR Citation | 83 FR 48441 |