Subsequent submissions

Find out what updates you need to submit to us during and after a clinical trial.

What are subsequent submissions

Local sponsors are required to submit substantial amendments, updates or reports to us after obtaining a CTA, CTN or CTC. There are no fees involved for such subsequent submissions. 

Substantial amendments

Substantial amendments refer to amendments:

  • Which change a local sponsor or principal investigator of the trial
  • Which is likely to affect, to a significant degree:
    • The safety, or physical or mental integrity, of any subject of the trial
    • The scientific value of the trial
    • The conduct or management of the trial
    • The quality or safety of any investigational product used in the trial

Local sponsors should assess whether an amendment qualifies as a substantial amendment.

All substantial amendments must be submitted to us (for approval or acceptance of notification) prior to implementation. However, an exception may be made if the amendment is to protect subjects against any immediate hazard to their health or safety (i.e. urgent safety measures).

The sponsor of the clinical trial should also ensure that the details and rationale for the amendments are clearly described in the submission.

In addition, the sponsor is required to keep records of all substantial and non-substantial amendments to the trial, and provide such records to us if requested.

Supporting documents

Type of substantial amendments To be submitted
Amendment to protocol
  • Clinical trial protocol amendment
  • Summary of protocol amendment
  • IRB approval letter (mandatory for CTN)
Amendment to informed consent form (ICF)
  • Revised ICF
  • Track change version for ICF
  • IRB approval letter (mandatory for CTN)
Change of local sponsor Letter from current local sponsor indicating transfer of local sponsorship to the new local sponsor
Change of Principal Investigator (PI)
  • Curriculum vitae of new PI
  • Revised ICF (if applicable)
  • Track change version for ICF (if applicable)
  • IRB approval letter (mandatory for CTN)
Addition of trial site
  • Curriculum vitae of PI
  • ICF for new trial site
  • IRB approval letter (mandatory for CTN)
Change of manufacturer For change or addition of a manufacturer not licensed or certified by HSA:
  • Good Manufacturing Practice (GMP) certificate
  • Where the GMP certificate is not available, a declaration by the manufacturer of its compliance with GMP
  • Certificate of Analysis of the product manufactured by the new manufacturer (if applicable)
Change of Chemistry, Manufacturing, Controls (CMC) information (if CMC was submitted in the clinical trial application) Supporting CMC information, where relevant

Refer to the Clinical Trials Guidance on Determining Whether an Amendment to a Clinical Trial is a Substantial Amendment572 KB for more details.

Serious breaches

A serious breach is a non-compliance to the principles of Good Clinical Practice, study protocol or the regulations, that is likely to affect, to a significant degree, either of the following:

  • The safety, or physical or mental integrity, of any subject of a clinical trial.
  • The scientific value of the clinical trial.

The local sponsor should submit a notification to us via PRISM (view sample online form264 KB) as soon as possible and no later than 7 calendar days after being aware of the serious breach.

Refer to our Guidance for Notification of Serious Breach544 KB for examples and more details on considerations in the reporting of serious breaches. 

Urgent safety measures

Urgent safety measures refer to actions taken by the local sponsor or the investigator, in order to protect any trial participants against any immediate hazard to their health or safety.

The local sponsor should submit a notification to us via PRISM (view sample online form264 KB) as soon as possible and no later than 7 calendar days after the urgent safety measure. Details should be given on the circumstances leading to the urgent safety measure.

Adverse events reporting

Local sponsors are required to report adverse events associated with therapeutic products, medicinal products or medical devices used in clinical trials.

Refer to our guide on adverse events reporting in clinical trials

Updates to the investigator's brochure or new safety information

The local sponsor must notify us of all updates to the investigator’s brochure or new safety information. 

Trial status reports

Trial status reports should be submitted by local sponsors every six months from the approval or acceptance date of CTA, CTN or CTC, up until the completion or termination of the trial. The report is due within 14 calendar days of each due date.

We may request for status updates at any time in addition to the above.

Definitions of trial status and recruitment status is found in our Guidance for New Applications and Subsequent Submissions521 KB

Submission should be done via Clinical Trial Status Report module in PRISM (view sample online form17 KB).

Suspension, termination or completion of a clinical trial

Notification of suspension or termination should be done within 15 calendar days from trial suspension or termination, while notification of trial completion should be done within 30 calendar days from trial completion.

Trial completion is generally defined as the achievement of Last Patient Last Visit (LPLV). For clinical trials with remote follow-up after LPLV, trial completion will be the end of follow-up.

Notification should be done through the Clinical Trial Status Report module in PRISM (view sample online form17 KB).

Final clinical trial reports

The local sponsor should submit the final report of the clinical trial within one year of the study's completion, unless otherwise agreed by us.

You may refer to ICH Guideline E3: Structure and Content of Clinical Study Reports for more information on the structure of the final report.

For investigator-initiated clinical trials, a publication of the clinical trial may be submitted to us in place of a final report. 

Other submissions

Updates or changes to the following should also be submitted:

  • CRM notification (e.g. changes to CRM quantity, research sponsor, clinical research)
  • Information to be published in the Clinical Trials Register
  • Regulatory status of the trial in other countries (e.g. clinical hold or non-approval by regulatory authority)

Refer to our Guidance on Regulatory Requirements for New Applications and Subsequent Submissions521 KB for full details.

How to make subsequent submissions

Submissions and updates are to be made via PRISM by the local sponsor, unless advised otherwise. Ensure you have the following credentials before you access the e-service:

If you encounter technical issues, e-mail the HSA helpdesk or call 6776 0168 (from 7.00 am to midnight daily).

Refer to the following for more details:

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